15/05/2012 1 IT to improve the safety of the medication process at the hospital Prof. Pascal BONNABRY Berner Fachhochschule Geneva, May 25, 2012 Agenda 13h45 Theoretical introduction 14h30 Di i 14h30 Discussion 14h45 Break 15h00 Visit in 2 groups - Pharmacy - Central warehouse Central warehouse 16h30 Discussion 17h00 End
23
Embed
SafetyProcess BernerFachhochschule 12 Production Quality control ... Automated Robotized dispensing ... Microsoft PowerPoint - SafetyProcess_ BernerFachhochschule_12.pptx Author:
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
15/05/2012
1
IT to improve the safetyof the medication process
at the hospital
Prof. Pascal BONNABRY
Berner Fachhochschule
Geneva, May 25, 2012
Agenda
13h45 Theoretical introduction14h30 Di i14h30 Discussion14h45 Break15h00 Visit in 2 groups
- Pharmacy- Central warehouseCentral warehouse
16h30 Discussion17h00 End
15/05/2012
2
Geneva university hospitals(HUG)
Geneva university hospitals(HUG)
Consortium of public hospitals in the Geneva county
One of the 5 swiss university hospitals
1900 beds
≈ 50’000 hospitalisations/year
≈ 800’000 outpatientsconsultations/year
www.hug-ge.ch
15/05/2012
3
Pharmacy: Missions
• Supply drugs to the whole hospital(purchase stock management distribution) (purchase, stock management, distribution)
• Implement a full traceability of drugs until the administration to the patient
• Ensure a production and a personnalisedpreparation of drugs, when they are not available on the market
Observation study in 36 institutionsBarker KN, Arch Intern Med 2002;162:1897
Limited performance of controls
• Introduction of errors during unit dose dispensingdispensing
• Detection ability during human-performedcontrol:
• Pharmacists: 87.7%• Nurses: 82.1%
Facchinetti NJ, Med Care 1999;37:39-43
Efficiency ≈ 85%(known value in the industry)
Do not be too confident with the double-checks!
15/05/2012
11
Implementation of IT in the medication process
Diogène 1 - 1978
Potential interests of IT
• To improve– The safety
by reducing the rate of errors and improving the reliability of controls
– The traceabilityby facilitating the registration of logs
– The efficiencyby increasing the working performance
– The communicationby connecting the different steps of the processes
15/05/2012
12
Many questions before to start
• Positive impacts ?• New risks ?• New risks ?• Return on investment ?• System selection ?• Commercial or homemade ?• Interoperability ?• User’s training strategy ?• User s training strategy ?• Acceptability ?
• Adaptation to processes• Adaptation to processes• Project leadership• Financing
Actors identificationThe patient
The caregiver The drug
15/05/2012
20
Drug identification
Reconditionedby the pharmacy
Identified
?Identified
by the industry
Drug identification
Unit dose• Hierarchy
Unit dose
Secondary package
Hospital package
Box
Pallet
= international standard
15/05/2012
21
GS1 codification of pharmaceuticals at HUG
• Product ID (cytostatics)y
01 07613167000009 7003 1103161400 21 cyt-11198499GTIN - cytos EXP (date and time) Serial
GS1 codification of pharmaceuticals at HUG
• Product ID (batch production)p
01 17613167001249 17 120831 10 PDS-11289663GTIN BatchEXP date
15/05/2012
22
Adaptation to processes• Reasons for workaround
– Process– Process• Training requirements• Process flow (administration of drug
before scanning, shortage of time)
– Technology• Hardware (performance of scanners)• Software (delays in response)• Barcode (difficulties in reading)
– Resistance• Communication• Changing role• Negative perception of IT
Van Onzenoort HA, Am J Health-Syst Pharm 2008;65:644Nanji KC, J Am Med Inform Assoc 2009;16:645
How to progress?
• Determine an institutional strategy and an implementation schedule taking into accountimplementation schedule, taking into account– the local organisation– the local culture– the expected return on investment
• Involve the different partners• Re-think the process organisation
(re-engineering)• Manage each projet independently, without
loosing the global vision
15/05/2012
23
Conclusion
• The medication process at the hospital iscomplex and involves many differentcomplex and involves many differentprofessionals
• A clever organisation contributes to improvethe safety, the efficiency, the communication and the traceability
• IT take more and more importance in the i h h iprocess improvement approaches: their
implementation is necessary but is a challenge• Each hospital must determine a strategy, based