Serious adverse drug events are unfortunately common in hospitals and can occur across all stages of the medication delivery process. Here, Francine de Stoppelaar shares her top tips for implementing effective closed loop medicines management systems as part of a hospital’s digital transformation journey to enhance patient care, reduce expenditures and build a sustainable future for healthcare.
In today’s healthcare landscape, hospital pharmacists face a multitude of challenges that impact patient care, including operational inefficiencies, workforce shortages and compromised medication safety.
The responsibilities of hospital pharmacists now extend significantly beyond traditional dispensing and distribution roles, encompassing medication therapy management, regulatory compliance and improving patient outcomes. In addition, economic consequences, such as unplanned readmissions, longer hospital stays and litigation costs, can negatively affect hospitals’ economies.
Among these many demands, the need for precise and timely medication administration has become more pressing than ever, especially in environments where patient volumes are high, resources are limited and the margin for error is small.
Medication errors are still too prevalent in hospital settings, significantly compromising patient safety.1 Hospital administrators are driven to eliminate these medication errors in order to improve patient safety and ensure economic stability.
Yet, what is the best and most cost-effective way to achieve this?
Digitalisation and automation
Several studies2–4 show that hospitals across the globe are working towards utilising digital applications and automation to improve safety and patient outcomes.
Closed loop medicines management (CLMM) is a powerful way of addressing this problem.
It is an integrated system designed to ensure the safety and efficiency of medication processes within hospitals. CLMM ensures that, across all stages of the process – from prescription to bedside administration, including medication preparation, dispensing and distribution – the ‘six rights’ of medication administration are met:
1. Right patient
2. Right medication
3. Right dose
4. Right time
5. Right route
6. Right documentation.
CLMM, including barcode medication administration (BCMA) at the bedside, has been shown to increase patient safety through a reduction in medication errors by around 50%.3
Seamlessly connecting its various digital applications and automation technologies, CLMM supports the medicines’ prescribing, management, administration and monitoring processes from end to end. By complying with the ‘six rights’, CLMM aims to deliver safe, efficient, cost-effective and sustainable medicines management in hospitals.
CLMM has now become a gold standard and a strategic priority for many hospital pharmacists seeking to modernise and optimise their operations as well as to ensure patient safety.
Implementing effective CLMM
As with any complex digital transformation project, successfully implementing a CLMM system requires thoughtful planning, a high degree of collaboration and a strong foundation of support.
For healthcare organisations planning to embark on a CLMM transformation journey, these 10 top tips are crucial for planning, preparing, managing and assessing progress.
1. Secure C-suite backing
First and foremost, securing backing from the C-suite leadership is essential, both for financial investment and strategic alignment. Leaders must endorse the project to ensure long-term commitment.
2. Establish good governance
Equally important is establishing good governance from the outset. This helps to manage risks, set clear goals and maintain accountability throughout the implementation.
3. Assess current workflows
Begin by carefully assessing current workflows, identifying where inefficiencies lie and selecting automation solutions that meet your specific needs – there is no one-size-fits-all answer.
4. Resist the temptation to digitise existing workflows without adaptation
Simply copying existing inefficient and laborious workflows from an analogue to a digital system is not going to do the trick. It shows a lack of imagination and thoughtless planning, and this can lead to more inefficiencies rather than improvements.
5. Build strong relationships
Building strong relationships with partners and stakeholders, including vendors and key hospital teams, is crucial for a smooth transition. Work hand-in-hand from the planning stage to implementation and beyond.
6. Engage the multidisciplinary team
Involve the entire multidisciplinary team and foster trust and enthusiasm through regular communication, team building and ‘cheerleading’.
7. Provide training and support
Training, re-training and ongoing support are critical to ensure staff are confident and competent in using the new system.
8. Pause and take stock
It is also important to review and reflectat various stages, ensuring the right expertise is in place for each phase.
9. Do not panic or give in!
Remember that it is entirely normal to be met with significant setbacks, resistance from staff and a need to adjust timelines.
10. Persevere and be brave
Above all, dedication, trust and courage will help overcome challenges and ensure successful transformation.
Conclusion
A project hardly ever goes to plan, hence the ability to be flexible and agile is essential. However, being mindful of these top tips will strengthen an organisation’s ability to adapt, gain the support of all stakeholders and keep the workforce engaged in the transformation journey. It will also significantly increase the chance of bringing the transformation to a successful end.
Take the first step towards safer and more efficient medication management by planning a CLMM system today. Together, organisations can improve patient care, save costs and create a sustainable future for healthcare across the globe.
Author
Francine M. de Stoppelaar PharmD MSc CertBA MPharm
Honorary associate professor, University of Leicester, UK
Co-founder of The Asclepius Project and former chief pharmacist at Cleveland Clinic London
References
1. Elliot R et al. Prevalence and economic burden of medication errors in the NHS in England. Policy Research Unit in Economic Evaluation of Health & Care Interventions (EEPRU) 2018.
2. Thompson KM et al. Implementation of Bar-Code Medication Administration to Reduce Patient Harm. Mayo Clin Proc Innov Qual Outcomes 2018 Nov 26;2(4):342–51.
3. Poon EG et al. Effect of barcode technology on the safety of medication administration. N Engl J Med 2010;362:1698–707.
4. Jesserun JG et al. Effect of automated dispensing with barcode scanning on medication administration errors: an uncontrolled before-and-after study. Int J Qual Health Care 2021 Nov 13;33(4).
