Medication Management Assessment
By Deborah Fort

Medication management is a complex, high-risk clinical process that includes: taking patient history, ordering, verifying, dispensing, as well as administration, surveillance, and reconciliation. It has been the keystone for patient safety over the past several years as it can yield a frighteningly high percentage of adverse events.

Through the combination of process redesign and technology implementation, an organization can achieve and sustain significant improvement. The major challenges are how to target interventions (alerts) toward existing high risk processes, how to integrate multiple applications that are part of clinical systems so that information flows smoothly, and how to design interventions in a way that provides clinician value and promotes safe use, but does not cause “alert fatigue” for the clinician.

Organizations that approach the medication management process as separate processes from other patient safety initiatives run the risk of disparate applications, wasted investments, and interventions that annoy the clinicians they were designed to help.

Medication Management Diagnostic Assessment
Analyze your current medication management process to help identify areas of risk within the current medication management process and review the current use of clinical information systems involved in the process.

The assessment should involve a combination of interviews, document review, and clinical unit and pharmacy observations. Following the assessment, review strengths and address weaknesses and create initiatives to close the identified gaps. A comprehensive, organization-wide roadmap should be drawn out to improve the safety and reliability of the medication management process.

Medication Management Strategy Based on the results of the medication management diagnostic assessment, develop guiding principles for how your organization wants to improve the medication management process. The strategy can identify and include: organizational structures, roles and accountabilities, new processes and technologies, and an estimate of the benefits that can be achieved. At the end, the medication management strategy assists in integrating departmental initiatives into an organizational strategy to improve medication management.

Through the combination of process redesign and technology implementation, an organization can achieve and sustain significant improvement. The major challenges are:

• Targeting interventions toward an organization’s high risk processes
• Integrating the multiple applications that are part of medication management so that information flows smoothly
• Designing the interventions in a way that provides clinician value, promotes safe use and are balanced against expected human behavior

The positive impacts from a patient perspective are:

• Increasing time with caregivers
• Decreasing length of stay
• Being cared for in a safer environment

Critical Success Factors

There are a number of critical success factors that should be addressed during the implementation of the vision. These can include:

• Financial support for comprehensive medication management (charge on administration)
• Continuous improvement training
• Users and creators of the system work together to develop system functionality and recognize that it is a continuous improvement process
• Mandate physician order entry (with critical exceptions)
• Communicate the positive aspects including increased safety and simplicity
• Common integrated functionality across all phases and patient care areas
• Consistent data across all areas and disciplines
• Commitment from senior hospital leadership
• Availability of supporting technologies such as wireless networks, hand held devices with appropriate software and bar code technologies

For help with your medication management assessment contact us at (610)444.1233 or email us vcs@getvitalized.com. You can also find more information about VCS’ and the PMO practice at our website www.getvitalized.com.