Pharmacy Solution Activation An Interdisciplinary Team Approach Utilizing SharePoint Terese Kornet, MSN RN, NE-BC Robert Sunday, MSN, RN-BC
Medication Management Model Clinical Decision Support New CDS Requirement Identified Management of CDS (Order Sets/Alerts/Rules) Reviewed & Approved by CPOE Adv Committee Approved by Medical Care Evaluation Committee Annual CDS Review & Maintenance CDS in CPOE Implement & Maintain CDS in CPOE Ordering Pharmacy Management Diagnostic/ Therapeutic Decisions Made Medication Ordered Order Reviewed & Submitted Evaluate & Verify Order Prepare Medication or Select from ADM Prepare Medication Dispense/ Distribute IV & Meds Medication History / Updates Medication Inventory Management Obtain Medication Related History Document Medication History & Updates Formulary Purchasing Decisions Inventory Management Monitor & Surveillance Medication Administration Management Measurement & Analysis of Performance Incident/adverse event surveillance reporting Monitor / Evaluate Response Intervene as indicated for adverse reaction/error Assess & Document Patient s response to med according to defined parameters Document Document Admin of drug & Associated information Administer Medication Administer Drug to patient Select the Correct drug For the Correct Patient Educate Patient Re: Meds Education Educate Staff Re: Meds
Sunrise Acute Care SCM 5.0 SP3 CPOE TDS (1996) SCM with e-mar (worklist) (2004) Structured notes/documents (2006) Sunrise Pharmacy June 2009 KBC June 2011
Sunrise Pharmacy Implementation Dates Penn Medicine @ Rittenhouse May 2009 Hospital of the University of Pennsylvania June 2009 Penn Presbyterian Medical Center October 2009 Pennsylvania Hospital March 2010
Sunrise Pharmacy Project Main Stakeholders Pharmacy Information Services Nursing Physicians/NPs Quality /Safety Finance
Roles in the Project SCM analysts SRx pharmacy builders SCM system administrator Pharmacy Directors Nursing Leadership MDs, NPs Clinical Nurses and Clinical Pharmacist
Strategies to Improve Success Develop min-projects/rapid results iniatives a miniature version of the hoped for result. Brought the smallest hospital up first (from 700 beds to 100 beds), no neonatal or chemotherapy Implemented TPN changes before go live at HUP
First Implementation Ritt pilot Less than 150 beds no chemotherapy or neonatal drugs Good test on the adult build Lessons learned at Ritt..more information on the SharePoint, increase utilization of the project managers
Past Implementations Conversion from TDS to SCM January 2004 Prescribers, pharmacy, nursing, IS team all working in separate locations Time lags in how issues were communicated When questions arose phone call to reach the appropriate person
Preparation for Go-live Order clean up flyer communication Medication reconciliation order
Attention Prescribers! Please help to speed the Sunrise Pharmacy transition planned for Friday at 8pm by reviewing ALL medication orders and discontinuing any unnecessary medications (prns no longer indicated, old IV orders etc) Once completed place the following order SRx Medication Review Complete into SCM Please complete by Friday @ 5pm Thank you for your support The SRx transition team
Go-live Planning Anticipating 12 hour down-time Users were blocked out of order-entry for medications, other could be entered ie radiology, lab. System available for view only Alert created that if users tried to enter medication order you are not part of the transition team therefore you will not be able enter medication orders
Sunrise Pharmacy Go-Live June 5-6 th, 2009
Sunrise Pharmacy Go-Live June 5-6 th, 2009
Sunrise Pharmacy (SRx) go-live Four roles in each team Prescribers discontinuing/reordering medications Pharmacist verifying all new orders Nursing check process with medication summary sheet/new med orders IS Project Manager - kept team moving reported issues to command center, updated the sharepoint
Patients not Transitioned due to Issues Issues could be filtered by Order Entry (MD) Pharmacy Verification (Rx) Nursing Worklist (RN) Respiratory Worklist (RESP)
Issues - Filtered
Sunrise Go-Live June 5-6 th, 2009
Questions?