march 2010 inpatient pharmacy management reports

March 2010

Inpatient Pharmacy Inpatient Pharmacy Management ReportsManagement Reports

Objectives

• Utilize Inpatient Pharmacy management reports effectively

• Distinguish between various reports

• Describe the utility of each report

• Recall reports that should be run at scheduled intervals

Objectives (cont)

• Describe implementation of major projects from a management perspective– Planning– Implementation Approach– Pitfalls & Lessons Learned– Maintenance & Fine tuning

Major Inpatient Pharmacy Projects

• Examples– Inpatient Order Entry (by Pharmacy)– Computer based MARs– ADM (Pyxis or Omnicell) for drug distribution– ADM-RPMS Interface– Inpatient Electronic Health Record– Bar Code Medication Administration

Project Planning – ADM (Pyxis/Omnicell) as example

• Initial considerations / research– Is one company better?

• Capabilities of system• Size/types of machines, types of drawers• Customer service• Experience of your staff (e.g. at other hospitals)• Cost comparison• Rent vs. purchase

– Ask company reps to give sales pitch

• Evaluate site to estimate needs– Number of wards/clinics/ED– Usage pattern of meds on each ward– Space available for machines?– Modification of med rooms necessary? – Infrastructure requirements– Identify Pharmacist(s) and tech(s) who will

spearhead and maintain


• Prepare a written proposal– Emphasize benefits to patients & site

• Medication security, accountability, reduced med errors and paperwork, Joint Commission standards

– Provide overall cost estimate– Provide project options with cost estimates– Provide estimated time-line

• Gain support of nursing dept.– Consider nursing perspective & concerns– Political clout of nursing department

• Share proposal with administration


Project implementation – ADM (Pyxis/Omnicell) as example

• Finalize contract with company– Establish delivery dates

• Send staff to company HQ for training– Pharmacist– +/- Tech, +/- Nurse

• Communicate issues to resolve– Engineering– Information Technology

• Ensure adequate time for staff to prepare:– Write policy / procedures– Prepare ADM Formulary– Establish override meds – Enter Users– Establish par levels for each med/ward– Configure drawers/pockets– Set-up batch reports– Load meds into machines


• Provide training (ADM Company can help)– Consider loading machines with candy– Have technicians practice refilling machines– Document competency

• Ensure display of meds at station screens is understandable

• Ensure everyone is comfortable and ready for “Go-live” date– E-mail widely to notify staff


• Provide support on Go-live date– Be available to answer questions– Ask for feedback– Make modifications as needed

• Keep admin/supervisors in the loop – Send follow-up e-mail “progress report”– Recognize those individuals and departments

that were instrumental


• Review reports daily– Who will do this?– Where will the reports be filed?

• Review policy periodically– Work with nursing to update override list

• Teach additional staff members to perform higher level tasks

• Evaluate med error rates

Project Evaluation/Maintenance – ADM (Pyxis/Omnicell) as example

Summary – Project Implementation

• Research• Plan ahead as much as possible• Enlist support from other stakeholders• Communicate frequently• Provide staff with adequate time• Provide training• Be available on Go-Live date(s)• Celebrate accomplishment & recognize others• Monitor and fine-tune

Inpt Pharm Management Reports

• ADT Reports

• IV Reports

• Unit Dose

Reports

ADT Menu Reports – Statistical Reports

• ADPL (Average Daily Patient Load)– Select time frame – Sort by ward or

service– Provides total

patient days & average census over time period selected

– Inpatient staffing is based on ADPL

ADT Menu Reports – Statistical Reports

• Inpatient Statistics by Ward– Report of ADT activity, sort by ward or service– Useful to evaluate LOS (length of stay)

ADT Menu Reports - Other• Current Inpatient Census

– Displays number of patients currently admitted– Does not display patient information– Useful to determine staffing

ADT Menu Reports - Other• Current Inpatient Listings

– Report showing individual patient data• Multiple pre-configured options – can select to print by ward,

service, insurance data, severity of illness, etc.

– Useful to take to rounds, discharge planning meetings, etc.– This example is by ward (includes all services)

ADT Menu Reports - Other• Current Inpatient Listings (continued)• If choose by service, list is condensed

– Less room for notes

ADT Menu Reports - Other• View Admissions History

– View all admissions and discharges at your facility for a selected patient

– Only shows dates of admission & discharge, not diagnoses or other data

IV Menu – Auto-discontinue Set Up• Med orders are automatically discontinued for

patients who are admitted or discharged– This cannot be changed

• This option allows configuration of auto d/c upon transfer from one ward or service to another– e.g. transfers out of ICU to other wards

• Recommendation: DO NOT activate these – Even if your policy requires orders to be re-written– Use renewal of orders under IOE instead– Will set up Auto-Discontinue in the EHR parameters

IV Menu – Management Reports: AMIS (IV)

• List of all IV’s dispensed & average cost– User selects time frame

• List sorted by ward– Within ward, by IV type (A, P, S, C, H)

• Sub totals for each ward, grand totals

• Recommendation: run report on regular basis, e.g. monthly– Periodically run one year data & divide by 12

• Example of AMIS (IV) report

• 30 day time period selected (June ’09)

• Totals = workload data for selected time period

• # of doses (bags) dispensed, recycled, cancelled, & destroyed

• Cost for each drug & totals• Can separate out by ward or skip ward data• Can print all drugs, by IV type, or only 1 drug• Lots of paper if you run the full report

– 132 columns – use condensed print

• Recommendation: use to look at only 1 drug

IV Menu – Management Reports: Drug Cost Report

• Example – single drug (Daptomycin) chosen, past 30 days data

IV Menu – Management Reports: Drug Cost Report

• List of all patients on one or more drugs– Choose IV, UD, or both– Choose orderable item, dispense drug, or VA

drug class– Can choose more than one drug

• Select “# of matches”– If looking for only one item, enter 1– If looking for patients on both drugs, enter 2

IV Menu – Management Reports: Patients on Specific Drugs (PSD)


• Example 1: All patients with dispense drug Morphine 4mg syringe


• Example 2: patients on both clopidogrel & omeprazole

Unit Dose Menu Reports – AMIS (Cost per Ward)

• Shows total # of doses dispensed, total cost, & ave cost per unit dose– Time frame selected

• Broken down by ward with totals

• Recommendation:– Run monthly– Periodically run 1 year

data & divide by 12

Unit Dose Menu Reports – Drug (Cost / Amount)

• Shows # of doses of each drug dispensed, and cost– Time frame selected

• Can break down by ward or just show totals• Can choose one or more drugs, orderable items, or

VA Drug Classes• Utility: to evaluate usage pattern of drugs for

inventory purposes, or cost information

Unit Dose Menu Reports – Provider (Cost per)

• Sorted by provider (one or more), then drug– Total units dispensed for each drug, cost– Grand total & cost, average cost

• Time frame selected• Utility – “heavy” prescriber identification

Questions?

march 2010 inpatient pharmacy management reports

Documents