Build an Infusion Center Tracking Board

July 2022 - Vol.19 No. 7 - Page #14
Category: Medication Tracking

In 2016, the Alaska Native Tribal Health Consortium’s (ANTHC) infusion center broadened access to care by expanding from a 10- to an 18-chair infusion center in order to accommodate a growing need to support the Alaska Native people served throughout the state. This 80% growth equated to an increased workload, which required workflow changes to help maximize productivity and communication. Simultaneously, ANTHC sought to sustain quality and access while maintaining cost efficiency.

Key to these goals was adopting processes that enhance efficiency and communication. ANTHC streamlined communication through the implementation of a patient tracking board to follow the patient throughout their infusion center visit. By streamlining workflows and communication, the implementation of the patient tracking board resulted in increases in patient safety, cost savings, and efficiency.

Research-Based Approach

The expertise of peers can provide a foundation for creating a new policy, procedure, or workflow. ANTHC contacted infusion centers around the country to learn their workflow for tracking patients throughout their visit. Similarly, existing technology was reviewed to ensure that the full scope of features was being utilized.

ANTHC sought to use its current electronic health record (EHR) to meet efficiency goals, while leveraging the knowledge of facilities with strong patient and medication tracking policies. As such, the existing electronic health record was evaluated to identify underutilized capabilities. Research from both other facilities and the existing EHR was culminated into a single goal of developing a real time electronic tracking board to follow the patient through their infusion center visit.

A Collaborative Focus

This proposal was presented to the hospital’s Medical Informatics Steering Team and approved to build. ANTHC recognized that a project of this scope should enhance efficiency for all stakeholders impacted by the change. As such, a multidisciplinary team was formed to design the board and develop an implementation plan. The team had representation from:

  • Information technology
  • EHR
  • Infusion pharmacy
  • Nursing

Custom Screens for Efficiency

The tracking board is viewable from any workstation containing the electronic health record system. This allows the pharmacy technicians to view patient workflow and prioritize the compounding needs. To accommodate all stakeholders, the tracking board is designed with three discipline specific views—one tailored for pharmacy’s needs, one for nursing, and the general display [see the TABLE]. The notification column in every display posts when each medication is delivered to the medication room. This helps maintain an efficient workflow as the medication room is separate from the nurse station, preventing nurses from having a visual on medication delivery. The free text fields for nursing and pharmacy comments allow for the communication of customized patient specific information, thus, avoiding unnecessary phone calls and allowing more time to focus on patient care. The length of stay column aids the pharmacy staff in determining the order of medication preparation.

This opportunity for streamlined communication not only improved workflows, but patient safety as well. Decreasing distractions and interruptions are important aspects of patient safety, especially in an environment where high-risk medications are prepared and administered. Each distraction and interruption increases the chance of an error. The Institute for Safe Medication Practices (ISMP) Recommendations include creating a less chaotic environment for the medication use process through staff education, as well as system improvements, specifically electronic communication between nurses and pharmacists for regular issues not requiring immediate phone conversations.1 The tracking board helps ensure that accurate information about patients and medication is transferred between these departments quickly and efficiently with minimal distraction.

Implementation Results

Implementation of the tracking board increased efficiency for both the nursing and pharmacy departments. More than 600 phone calls were eliminated monthly, saving more than 40 hours of nursing and pharmacy time monthly, which equates to $24K in cost savings annually. Additionally, there are over 70 nursing hours saved monthly with real time notification of when medications are ready for administration, which translates into annual cost avoidance of $36K. Patient safety improved with fewer distractions from phone calls and real-time tracking of patient status. Many areas of communication were streamlined including:

  • Notification of infusion chair being clean or dirty
  • Location of patient
  • Identification of assigned nurse
  • Easily identifiable safety factors (eg, fall risk, allergies)
  • Patient’s weight
  • Patient’s physician
  • Two-way, open field communication for nurses and pharmacists
  • Patient’s length of stay

Conclusion

With the implementation of the patient tracking board, pertinent patient encounter information is now readily visible. This enhances pharmacy and nursing time management, decreases pharmacy and nursing workflow interruptions, and streamlines interdepartmental communication and satisfaction. These benefits result in an increase in both patient safety and cost savings at ANTHC.


Acknowledgments

The authors would like to thank the following individuals: Marlena MacDonald, Laura Trawicki, and Alicia McDonald


References

  1. Institute for Safe Medication Practices. Side Tracks on the Safety Express. Interruptions Lead to Errors and Unfinished… Wait, What Was I Doing? November 29, 2012. Accessed May 24, 2022. https://www.ismp.org/resources/side-tracks-safety-express-interruptions-lead-errors-and-unfinished-wait-what-was-i-doing

Anne Marie Bott, PharmD, BCOP, BCPS is the lead infusion center and oncology pharmacist at the Alaska Native Tribal Health Consortium (ANTHC) in Anchorage, Alaska. She received her PharmD from Virginia Commonwealth University in 2005 and completed an IHS pharmacy practice residency in 2006.

Ashley Schaber, PharmD, MBA, BCPS, is the director of pharmacy at the ANTHC. She received her PharmD from the University of Georgia in 2006 and completed a pharmacy practice residency in 2007.

Login

Like what you've read? Please log in or create a free account to enjoy more of what www.pppmag.com has to offer.

Current Issue