Prevention of medication errors is a top priority for every healthcare organization. Errors can endanger lives, reduce the efficacy of care, impede caregiver efficiency and adversely impact an organization’s reputation and bottom line.
As technology increases in sophistication and advances into more aspects of healthcare, it brings substantial capability to reduce the potential for errors. At the same time, new technologies frequently involve some degree of interoperability, or connectivity, with existing systems. Once an implementation plan is executed and products supporting integration are released, they must be verified in the organization’s test environment. It is also essential for the organization to have a process in place to educate staff about workflow or other application changes. With the right team and the right plan, the benefits of integrated technology can be realized, leading to reductions in healthcare costs and medication errors, as well as improved efficiency.
Emerging I.V. clinical integration technology enables fully integrated management of I.V. medication delivery by linking smart infusion pumps with health information platforms, such as electronic health records (EHRs). This integration provides great potential to reduce the occurrence of medication errors, but it also requires healthcare organizations to develop and coordinate a comprehensive implementation plan.
With I.V. clinical integration in place, clinicians have access to advanced technology to improve safety in the administration of I.V. medications, which is one of the most common areas where medication errors can occur. Recent studies report that medication errors can result in up to 400,000 preventable injuries annually, and thousands of deaths. According to the Institute of Medicine, an estimated 1.5 million errors occur annually in the United States and drug-related injuries and deaths cost the healthcare system more than $77 billion annually.
While the benefits of I.V. clinical integration are clear, implementation of any new technology can be intimidating. At Hospira, we have supported multiple healthcare organizations in successfully implementing integration functionality, and we’ve seen that with proper planning and cross-disciplinary involvement, these state-of-the-art systems can be deployed with minimal disruption and often with eye-opening results.
Lancaster General Hospital, a 538-bed community teaching hospital in Lancaster, Penn., worked with Hospira and other technology partners to implement interoperability between its barcode medication administration (BCMA) and smart infusion pump systems. Lancaster established a multidisciplinary team to develop and manage its I.V. clinical integration implementation plan, including representatives from pharmacy, nursing, physician groups, biomedical engineering, information services and hospital administration. The team utilized a four-stage approach to implementation: Plan. Do. Check. Act.
PLAN. Nurses and pharmacists from Lancaster, Hospira and the BCMA vendor discussed BCMA workflow and screen design as well as infusion pump behavior. At the same time, the team identified other needs that would have to be addressed prior to I.V. clinical integration implementation, such as modifications to the pump safety software drug library and how the BCMA identified pumps using bar codes on the devices.
DO. Pilot programs were established in phases, starting with training of a small group of nurses and pharmacists in a test environment. Test patients and orders were created for each medication in the safety software drug library. Once testing was done and the resulting changes were completed, the integration was deployed in a single nursing unit. The unit selected was the hospital’s cardiac telemetry unit, an area known for its predictable number and variety of medication infusions.
CHECK. The pilot program provided insights that enabled the team to develop comprehensive training for hospital staff. Software introductions and one-on-one training with the technology providers were conducted to ensure that the entire nursing staff was prepared to use the system with maximum efficiency. During this time, the team also conducted workflow efficiency testing by directly comparing nurses’ performance with the new system versus the previous manual processes.
ACT. This training and validation work set the stage for broad deployment of I.V. clinical integration throughout the hospital. Even during this period, some additional adjustments were required, such as tweaking network access point settings and modifying a power setting on the pumps to ensure more reliable connectivity. But the Lancaster team was able to quickly identify and rectify issues as the system was being deployed.
Preliminary data from the first 90 days of an I.V. clinical integration demonstrated the results of the successful implementation: no I.V.-related medication errors were reported, a 17 percent increase in safety software drug library compliance and a 24.8 percent reduction in the average nursing time required for pump programming.
Hospira, provider of the Hospira Symbiq and Plum A+ infusion pump with Hospira MedNet safety software, has supported multiple healthcare organizations through similar I.V. clinical integration adoption processes. Similar impressive results also have been reported from other implementations.
For example, WellSpan Health York Hospital in southern Pennsylvania concluded that I.V. clinical integration helped to prevent an estimated 30 potential adverse drug events in a two-month period. After implementing I.V. clinical integration, another hospital estimated that it avoided $6-10 million dollars in costs annually by preventing adverse drug events.
With the right plan, right technology and a well-executed implementation, virtually any healthcare organization can implement I.V. clinical integration to help clinicians enhance patient care, increase efficiency and improve the cost-effectiveness of hospital operations.
Jeff Rinda, R.Ph., M.S., is manager, technology alliances, Hospira. For more on Hospira: click here.