By Steven Howell, PharmD
INTEGRIS Baptist Medical Center—part of the INTEGRIS health system—is a 522-bed hospital offering a full range of diagnostic, therapeutic, and rehabilitative services. As part of a larger conversion to Omnicell automation solutions for our central pharmacy and supply management, we implemented the OmniLinkRx order management system in 2007.
Shifting to Paperless Documentation
As our health system expanded, archiving paper records posed an increasing challenge due to space and manpower limitations. In addition, our record keeping systems were not standardized across the 13-hospital network, and this was a concern as well. In order to address these challenges, we decided to implement an electronic order management system, and we reviewed multiple vendors before deciding on OmniLinkRx. We chose this solution for a number of reasons, including that it would eventually allow us to transition all of our hospitals from a manual archiving process to a fully integrated order management platform. Also, OmniLinkRx was compatible with our existing multifunction devices—located on the nursing units—allowing us to use them as scanners.
Under the previous paper-based system, physicians would write orders on triplicate order sheets with pharmacists then retrieving those sheets from bins located on the patient care units. At least eight different pharmacists were assigned to collecting orders from different floors, and we lacked a systematic process for reconciling the sheets in chronological order. On top of this, double or triple checking high-risk orders, such as TPN or chemotherapy, required a physical handoff of the paper order from one pharmacist to another. With most of our pharmacists based on the floors, this usually required delivering the order to another floor. Problematic orders that required administrative help or approval also had to be hand delivered to the appropriate person.
After implementing OmniLinkRx, we experienced some push back, as our staff was used to dealing with paper, rather than electronic orders. However, once staff learned the correct processes, they quickly recognized the advantages of working with an electronic order system. With this system, unauthorized abbreviations, illegible handwriting, and lost or misplaced physician orders were no longer issues. Furthermore, manual administrative tasks associated with physician order processing have been eliminated, dramatically decreasing paperwork and time spent on the telephone. Currently, OmniLinkRx tracks all orders in six of our hospitals, and we are planning to implement it at our remaining facilities in the future.
Improving Order Communication
OmniLinkRx simplified the communication of orders from nursing stations to pharmacists and integrated the medication management process within the central pharmacy. The software includes safety features that allow pharmacists to flag sensitive orders and alert other staff. TPN, chemotherapy, and other high-risk orders can be cycled electronically for additional safety checks, or for administrative help or approval.
Handoff communication also has greatly improved as pharmacists can now work out of individual queue folders within the master program—facilitating a seamless exchange of information during shift changes. Pharmacists can insert comments on orders requiring clarification, and the oncoming shift can follow up on items and actions. Full tracking of who accessed and edited any documents is stored within the system. OmniLinkRx has proven valuable for auditing, as all patient orders are now electronically filed and we no longer have to pull charts or physically search for medical records. A detailed history of all transactions gives pharmacy the opportunity to easily capture data for reporting and data analysis and helps us comply with TJC regulatory standards.
OmniLinkRx also allows for remote pharmacist order entry. Our pharmacy department provides support to a sister hospital—INTEGRIS Bass Baptist Health Center—when their pharmacy is closed at night. We are able to review all physician orders for both hospitals using one OmniLinkRx system.
By automating the communication of medication orders between nursing and pharmacy, we improved the efficiency and productivity for both departments. Since the 2007 implementation, we recently surpassed one million pages of processed orders—all tracked and filed systematically, and easily accessible. OmniLinkRx allows for faster order time, reduced time spent processing and verifying medication orders, and the elimination of paper management, all combining to improve our level of care and system-wide patient safety.
Steven Howell, PharmD, is manager for inpatient pharmacy services at INTEGRIS Baptist Medical Center. Steven received a BS in chemistry from Southern Nazarene University, and PharmD from the University of Oklahoma.
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