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Lake Hospital System First in Ohio to Implement Automated Medication Dispensing Technology

Making Patient Care Safer

Getting the right medication to the right patient at the right time seems a pretty straightforward proposition. However, the medication administration process—from central pharmacy to patient bedside—is fraught with possibilities for patient safety system failures.

“The missing link,” said Dr. Becky Ohlsen, clinical pharmacist at LakeEast Hospital, “has been a system that ties it all together and extends the safety system into patients’ rooms. The more integrated technology we use, the more accurate we become. All this results in increased patient safety, which is always our top priority.”

This month, Lake Hospital System became the first hospital in Ohio to introduce a comprehensive solution for reducing medication-related errors. The changes, which cost nearly $750,000 annually, integrate a computerized medication order system with AcuDose-Rx medication dispensing cabinets, an automated storage and retrieval system, and a specialized process for managing controlled medications and narcotics.

Instead of waiting for medications to be hand delivered from the pharmacy, departments throughout the hospital now have stocked medications in their AcuDose –Rx cabinet. Once a pharmacist has verified medication orders for accuracy and safety, medications are available for immediate use.

“The entire process is a great system of checks and balances,” said DJ Orlando, RN, a nurse in the Intensive Care Unit at LakeEast Hospital. “When we remove medications from the cabinets using a private code, we compare them to printed lists. We take the printed copy to the bedside and check the patient’s armband to make sure that the patient’s information matches the medical administration record we have for that patient.”

An automated inventory control system, called MedCarousel, ensures that medications are always in stock and heightens the accuracy of replenishing medications in the AcuDose-Rx cabinets.

“Instead of having to run reports and place an order with our wholesaler, the MedCarousel determines what medications we need and automatically transmits the information to our wholesaler,” explained Leslie Manzo, vice president of Clinical Informatics. “The MedCarousel actually takes over the inventory control piece for us.”

Before dispensing medications to the AcuDose-Rx, a technician receives a bar code label from the MedCarousel. The locator indicates the proper bin on the carousel from which to obtain the medication. Prior to taking any medication from the bin, the technician must first scan the bin bar code and then the label bar code to confirm the right medication being selected. The staff then uses the bar code to restock the AcuDose-Rx cabinets in the patient care area, further safeguarding the accuracy of each patient’s medications.

Controlled medications and narcotics require even more diligent tracking, primarily due to stricter regulatory requirements. To ensure proper monitoring and restocking of narcotics and controlled medications, Lake Hospital System has implemented the NarcStation. NarcStation enables the pharmacy to electronically manage, access, control, and track all controlled medications and narcotics within the hospital system.

With all of the tracking the pharmacy conducts, the staff has been able to distinguish between—and avoid—look-alike and sound-alike errors, which can occur frequently. The entire automated process streamlines paperwork and handling of medications and provides greater accuracy and accountability.

“Nationwide, medication errors are a large source of patient injuries in the hospital setting. Lake Hospital System is investing in this technology that reduces the chance of errors when dispensing, restocking and administering medications,” said Manzo. “Ultimately, this system takes patient safety to new levels by helping to ensure that the medications and dosages that nurses administer are absolutely accurate.”