Perhaps now more than ever, hospitals need a quick, efficient way of tracking and restocking pharmaceuticals. Radio frequency identification (RFID) tray systems can help to streamline this process, providing data on the medication that moves through a facility. This automated solution not only improves efficacy, but also elevates patient safety by eliminating some opportunities for human error. With the aid of a vendor, RFID systems can be seamlessly integrated into a health care system to help improve the pharmaceutical tracking process, increase safety for patients, and help to save costs and time.
Benefits of an RFID System
Reading Hospital is a 724-bed facility that first implemented the Kit Check RFID restocking solution in February 2019 to track and manage crash cart trays and kits prepared in the pharmacy.
After a “near-miss” event occurred involving one of our crash cart trays, we conducted an evaluation of the entire process of crash cart restocking and inventory management. It was immediately apparent that the process was not only time consuming, but it also involved multiple steps and staff to complete, introducing several opportunities for errors to occur. Our goal was to implement a technology that would reduce the time and resources involved in restocking trays while also helping to ensure a high level of accuracy. After evaluating bar code and RFID solutions, we chose Kit Check for the time savings and safety it delivers.
We required a solution that allowed us to stay organized and streamlined while keeping a close eye on our pharmaceuticals, and the RFID tray system has done just that. Reports from the system allow our pharmacy to plan inventory adjustments proactively and ensure cost savings and efficiency. Additionally, it has saved our staff precious time, as it has reduced a 20 to 30 minute restocking process down to just 2 to 3 minutes.
Since implementing an RFID solution in Reading Hospital, we have realized a significant improvement in visibility into our pharmaceuticals, allowing us to accurately track every drug that passes through our facilities. Error-prone manual tracking processes have been eliminated in favor of automated solutions that help us to maintain comprehensive records of stock while freeing staff to focus on top-level patient care. Every step of the tracking and restocking process has been made easier and far more efficient.
The Medication Tracking Process
Upon receipt, medications are tagged with RFID labels so we can see exactly where they are in the hospital, when they are used, and when they are close to expiration, which also allows us to determine when drugs need to be replenished. Since each medication is tracked at the dose-level using RFID, it allows us to fill medication trays accurately and monitor how those medications move throughout the hospital. This also supports par level optimization and the reallocation of short dated medications.
We typically utilize one of two approaches to ensure new stock has an RFID tag applied. When we purchase medications through Kit Check’s partner manufacturers, those medications arrive pre-tagged. For medications from other sources, we apply the RFID tags as soon as the stock arrives. That way, we can ensure every single drug that comes through the hospital is accounted for and trackable.
RFID Systems and COVID-19
Once we started receiving COVID-19 vaccines, we quickly realized we had to implement an automated solution to accurately manage inventory counts. Previously, we relied on manual inventory counts written in marker on the door of the ultra-low freezer where the vaccines were stored. Unfortunately, this led to incorrect inventory counts at the end of each day. This was unacceptable and required immediate action to ensure all vaccines passing through Reading Hospital are accurately accounted for and reach a patient in the community. Given the success we have had with our RFID tray system, we decided to create an RFID enabled inventory management solution specifically for the COVID-19 vaccines by adapting Kit Check’s existing shelved inventory functionality to our vaccine clinic workflow. The system keeps track of the quantity that is stored in the freezer (or on the shelves) and will decrement from the inventory when the kit is re-stocked and scanned. The process is very precise.
Now, when we receive a shipment of the Pfizer vaccine, we create, print, and scan the RFID labels into the ultra-low freezer shelved inventory location. Each RFID tag is encoded with the shipment’s lot number and expiration. When vaccines are removed from the ultra-low freezer, they must sit out for a few minutes to warm up, and then a technician can apply the pre-printed, lot-specific RFID label to each vial and scan them in the scanning station to start the five-day beyond use date (BUD) countdown. The BUD indicates how long vaccines are viable for once they have been removed from the freezer.
Best Practices for RFID Systems
Hospitals interested in RFID systems should evaluate their core organizational needs and goals when deciding which solutions to implement in order to ensure long-term success. One of the biggest challenges an organization may face when implementing any new technology is a lack of cohesion across departments. All new technology, especially that which deals with pharmaceuticals, must be carefully vetted and monitored by department heads, and hospitals should take into consideration the time needed to implement new systems and training for those systems.
Clinicians also need to work with vendors with a proven track record of timely implementations and training for their staff. Ensuring staff is confident on how to optimize RFID, or any new technology, is essential for effective adoption. Additionally, clinicians will want to look for vendors that are collaborative and agile, as no hospital workflow is exactly the same. In the case of the COVID vaccine rollout at Reading Hospital, Kit Check was able to collaborate to create a solution in just a few business days, and that level of partnership is extremely valuable.
RFID is uniquely poised to make a huge impact on patient safety concerns, as well as create a more efficient drug supply chain. I envision a future with interoperable RFID-enabled hardware and software systems throughout the hospital, such as a carousel that takes perpetual inventory of its content, or bedside RFID scanning that integrates with the patient’s EMR. Complete visibility of medications at the unit of use from the manufacturing plant, to the hospital, to the patient’s EMR is a forthcoming possibility with RFID that would remedy many of the medication supply chain challenges clinicians must navigate every day: shortages, adverse drug events, inefficient inventory management, and more. There are consortiums around best-practice usage of RFID in the health care space that provide certifications for their members to ensure interoperable and high performing RFID tags and automation solutions to help work toward these goals.
RFID systems are a dynamic technology, which make them a wise investment for both today and the future. With help from a vendor, these systems can grow with a hospital’s needs and ensure that the facility is efficient and safe.
Alan Portnoy, PharmD, MS, MMI, is the operations manager at Tower Health-Reading Hospital in West Reading, Pennsylvania. Alan earned his bachelor’s degree from Temple University School of Pharmacy and his doctor of pharmacy from the University of Florida. He also holds master’s degrees in Healthcare Administration and Medical Informatics from Saint Joseph’s University and Northwestern University, respectively. Alan spent the first part of his career working in several different hospitals in the Philadelphia area, holding both clinical and management positions, including assistant director and director of pharmacy roles. Prior to Reading Hospital, he worked for 12 years in the electronic health record industry serving as a product manager for pharmacy, BCMA, and CPOE applications. He was responsible for overseeing the design, development, and deployment of software for the US and European markets.
Medication Tray Management During COVID
There are three COVID infection risk considerations for medication trays that are sent out to the units. The tray could be contaminated if it is returned from the room of a COVID positive patient. There is also the possibility that the tray could be returned from the room of a patient whose COVID test results have not yet been received. Furthermore, we cannot always identify the room from which the kit was returned.
To address these risks, we decided that every tray is to be treated as if it has come into contact with the virus and is potentially contaminated. Therefore, all trays are disinfected the same way regardless of the patient room type from which they are returned. Staff now run every returned tray, kit, and component under ultraviolet C light for 15 minutes, and then wipe every component with 70% isopropyl alcohol.
Additionally, in April 2020, we became one of the first hospitals in the US to adopt a sanitization confirmation feature with our RFID system by implementing Kit Check’s Sanitization Check. This feature lets staff know whether a tray has recently been sanitized, giving providers and patients alike more peace of mind when it comes to the drugs and equipment they may come in contact with amid the pandemic.