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PRESCRIPTION-DISPENSING SYSTEM FOR WOUND DRESSINGS

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European Statement

Selection, Procurement and Distribution

Author(s)

A. Navarro-Ruiz, F.J. Rodriguez Lucena, C. Matoses-Chirivella, A.C. Murcia-López

Why was it done?

Ulcers imply a lower quality of life for patients and caregivers, and are considered a negative indicator of healthcare quality with increased costs. Global spending on wound dressings from our hospital in 2010 was 600,000 euro, for an estimated population of 300,000 habitants.In the Pharmacy Department there exists wide experience with the Unit Dose Drugs Distribution System (UDDDS) with decentralized stocks that are greatly reduced. It is for this, so it aims to make a management at our UDDDS of special wound dressings for wound care in hospitalized patients, under the same criteria for selection, adquisition, and clinical and financial management of medicines.

What was done?

To establish a rational and efficient use of medical devices for the prevention and advanced wound care, through a prescription dispensing system of wound dressings in hospitalised patients within the unit dose distribution system of the pharmacy department. Furthermore, to evaluate the effectiveness and continuity of process improvements, and extend it.

How was it done?

The Pharmacy Department, along with hospital nursing staff specialized in treatment of ulcers, developed a prescription-dispensing circuit for wound dressings (April 2012-January 2013). At internal medicine and surgery inpatients, the nursing staff of their hospital units (HU) prescribes dressings in medical orders and refers to our UDDDS where it validates, monitors and verifies the consumer. Dressings included in the project are: Class IIb for wounds to be healed by secondary intention, and Class III incorporating substances that can be considered drugs.

What has been achieved?

The prescription-dispensing dressings with UDDDS access contributes to a more efficient use and management thereof in the treatment of inpatients’ ulcers. Furthermore, the creation of a multidisciplinary group for the selection of health products included in the hospital and the development of protocols and guidelines, promotes continuous training of health personnel and improves the quality of care by standardizing the criteria.

What next?

The developed program is currently established and there is a continuous increase in other hospital clinical areas that benefit from this UDDDS for wound care.

A ROBUST LEAN METHOD FOR IMPROVING THE MEDICATION MANAGEMENT PROCESS

European Statement

Patient Safety and Quality Assurance

Why was it done?

Hospitals are facing strong economic constraints and increasing requirements in terms of quality and safety of care. To address these difficulties, a solution could be to reorganise processes and relocate resources through the use of industrial engineering Business Process Improvement approaches such as Lean.

What was done?

An original Lean method for business process improvement was designed and tested in an acute general medicine department in order to improve the mediation management process.

How was it done?

A Lean method for the hospital setting was elaborated based on a triangulation between literature data, semi-structured interviews and a case study. This method, relies on 5 operational activities (Understand the process, Measure, Analyse, Improve, Implement) and 6 support activities (Establish top management support, understand the environment, Organize a project team, Manage change, Monitor and continuously improve). A multidisciplinary project team (nurses, head nurses, pharmacists, physicians, pharmacy technicians, nurse’s aide) was then formed to experiment this method in the acute general medicine ward.

What has been achieved?

This project allowed improving the efficiency and quality of the medication management process. Medication errors at admission and risk for medication errors during administration were reduced (46% vs 12%), non -value added activities during administration were eliminated (25 minutes/nurse/day saved), ward stock management was streamlined (double bin system) and medication delivery was secured. More than 80% of the stakeholders surveyed (45) considered that the changes made to the process improved their working conditions (no impact for the others) and all the participants to the project team were satisfied or very satisfied with the project. The team now meets once a month to continuously improve the process.

What next?

The top management of the hospital has decided to promote this method and is currently creating and training a specific improvement team to support other improvement projects in the hospital.

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BOOST is where visionaries, innovators, and healthcare leaders come together to tackle one of the biggest challenges in hospital pharmacy — the shortage of medicine and medical devices.

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Our aim is to investigate the causes of medicine and medical device shortages in the hospital setting,  while also gathering effective solutions and best practices implemented at local, regional, and national levels.

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Join us in Prague for the 2nd edition of BOOST!

Secure your spot in the Movement for Shortage-Free World

BOOST is where visionaries, innovators, and healthcare leaders come together to tackle one of the biggest challenges in hospital pharmacy—medicine shortages.