Automating the IV workflow process helps ensure safety for patients and accuracy for pharmacy. The syringe pull-back method coupled with manual documentation can introduce significant patient safety risks, especially in emergency situations. While any new software implementation can present growing pains, with vendor support and training, IV workflow adoption will deliver a strong ROI in terms of patient safety and pharmacy efficiency improvements.
Part of Dignity Health’s seven acute-care hospital system, St. Joseph’s Hospital and Medical Center (SJHMC) is a 604-bed, non-profit, academic teaching hospital caring for the underserved population in downtown Phoenix, Arizona. A nationally recognized center for quality tertiary care, medical education, and research, SJHMC is home to the Barrow Neurological Institute and Norton Thoracic Institute. The emergency department treats over 83,000 patients a year and the hospital has a level 3 neonatal intensive care unit (NICU). SJHMC also operates 126 adult ICU beds split among the neuro ICU, medical/surgical ICU, trauma ICU, and cardiothoracic ICU; these services draw some of the area’s most complex patients. Dignity Health utilizes carousels for drug storage within the inpatient pharmacy, automated dispensing cabinets on the nursing units, and bar code medication administration at the bedside.
In 2016, SJHMC implemented its first IV workflow software suite, PharmacyKeeper from Grifols. During this time, Dignity Health was rolling out the software in phases across the health system, and our facility was one of the first in line. At the outset we focused solely on batched compounded sterile products, as we felt this would give the technicians and the pharmacists some experience using the system prior to expanding the system to all of the patient-specific doses produced in the pharmacy.
Prior to PharmacyKeeper, SJHMC utilized the syringe pull-back method: Once the pharmacy technician had drawn up the appropriate volume of medication, they would inject it into the bag containing diluent and then pull the syringe back to the volume that they had injected. The technician placed the syringe with the medication vials and the final labeled product in a plastic bin, and presented it to the pharmacist for verification.
There was little to no documentation pertaining to compounded products prior to implementing PharmacyKeeper. While the batched products were manually documented on paper, the practice was prone to errors and did not accommodate patient-specific doses. With the introduction of an automated IV workflow system, all patient-specific doses are accurately documented even when they are ordered on an emergency basis.
Features and Benefits
Beyond IV workflow management, PharmacyKeeper also features the following capabilities:
A key benefit offered by PharmacyKeeper is the reduction in waste. Beginning with the ability to track a medication from initial creation upon scanning the label in the IV room all the way to the nursing unit medication room, waste has been dramatically decreased, as misplaced medications can easily be located. PharmacyKeeper has also allowed us to decrease waste during compounding, as the process of scanning each component before mixing has led to a reduction in errors.
The breadth of detail offered by PharmacyKeeper could not be achieved by manual tracking on paper, and the ability to visually inspect the process at every step of the way adds to the credibility of the technicians’ work. Pharmacists are now able to quickly establish trust with technicians with whom they may not have previously worked.
PharmacyKeeper’s training module offers an additional advantage, because this component of the system allows pharmacists to create competencies and track the results within the software. As opposed to scoring competencies on paper, this saves time for other tasks within the pharmacist’s already busy schedule.
Implementation and Future Improvements
Fortunately, PharmacyKeeper is quite customizable in terms of workflow, and we were able to adjust it to our facility’s needs; but as with any major change, the staff had to adapt to the new system. It took approximately 3 months for pharmacists and technicians to feel completely comfortable with the new process.
The hands-on customer support from Grifols played an important role in our implementation. During installation, our facility was assigned a designated tech support agent to help address any difficulties that arose. Since implementation, we have weekly WebEx calls with our support team, giving us the opportunity to review, troubleshoot, and resolve any issues.
The software offers a clean interface that is user-friendly for all staff members. PharmacyKeeper has continued to evolve since we first went live, with regular updates including new features and enhancements.
Implementing IV workflow management software allows SJHMC to ensure the safe preparation of every IV medication in our cleanroom. In addition, the increased efficiency and patient safety realized through electronic documentation is far superior to our previous manual approach. PharmacyKeeper’s additional features—medication tracking and training modules—contribute to a decrease in waste, an increase in trust in our technicians, and frees staff from time consuming manual processes.
Paul Frey, PharmD, is the inpatient pharmacy supervisor at St. Joseph’s Hospital and Medical Center (SJHMC) in Phoenix, Arizona, where he provides oversight and leadership for pharmaceutical operations. Paul earned his Doctor of Pharmacy degree from The University of Arizona. His interests include pharmacy operations, automation and informatics, and regulatory compliance.
Enter our Sweepstakes now for your chance to win the following prizes:
Just answer the following quick question for your chance to win:
Entries are limited to one entry per person in any active sweepstakes.
Thank you for your entry.