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EMAR Bar Coding Implementation plan process

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EMAR Bar Coding Implementation plan process

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    1. March 8 & 9, 2005 HCA Corporate Campus Nashville, Tennessee eMAR & Bar Coding Implementation plan & process

    3. HCA’s Guiding Principles Visible support from leadership throughout HCA Well-executed communication plan required Practice recommendations will exceed the industry standard Solutions must be simple, easy to implement, cost effective, user-friendly, and scaleable to varying HCA facilities Caregiver (Nurses, RT, etc) will be involved in the co-design of solutions Outcomes must be measurable

    4. Project Overview

    5. HCA Patient Safety Initiative: Improving Medication Practices

    6. Project Time Line 6-7 Month Project

    7. Implementing eMAR/Barcoding

    8. Project Workload: Fluctuations over 6 months

    9. Implementation Timeline

    10. Our Learning's eMAR & Bar Coding requires strong clinical leadership…is not just a technologically driven enterprise Biggest change for nurses, pharmacists and respiratory therapists involve operational re-engineering

    11. Our Learning's Ways to lessen FTE impact Independent work Make bar coding decisions early Involve staff in equipment decisions Begin addressing potential issues Meet regularly and meet often Communicate, Communicate, Communicate

    12. Steering Committee is essential for interdisciplinary dialogue and decision-making required throughout the project Membership: Administration IT&S Education Pharmacy Quality/ Risk Nursing Respiratory Project leadership Getting Started

    13. Project Leadership Project Management Skills Strong Communication Skills Interdisciplinary Team Focus Patient Safety Passion Dedicated Project Time

    14. Budget Considerations Corporate Budget Infrastructure upgrades Mobile carts for computers (laptops and scanners) Thermal printers for pharmacy Meditech software upgrades Facility Budget Operational costs for bar coding medications Fixtures or changes to pharmacy Staff time for planning, testing, developing, training Printers for armbands Travel for site visits

    15. Who is Impacted . . . Pharmacy Nursing/ Respiratory Therapy IT&S Others HIM Physicians Ancillary Departments

    16. Workflow Diagrams: Step 1 Develop a workflow study of the actual steps in the medication preparation and delivery process at your facility Facility studies should be performed through a multidisciplinary team Start at the patient and work backwards

    17. Overview of the Project plan for facilities Pre-Assessment Conf Call Post PA Call Activities (Issues List) Barcoding of medications WLAN installation Initial Status call with facility Executive kick off at facility

    18. Continued Every other week status conference calls Super user training visit Pre-go live status calls Go/No go call Go-live

    19. Roll Out of eMAR Roll out in waves Bring up first 1 or 2 units Maintain for 1-2 weeks Troubleshoot and resolve issues as they arise Roll out remaining units quickly Turn on Admin Billing

    20. Post Implementation Follow up visit 6-8 months after you are live house wide Survey Tool Written feedback to CEO, CNO and Project Lead Ongoing review of Scanning Reports

    21. Post Implementation Communication Quarterly Conference Call/Webcast Monthly Newsletter eMAR Website Monthly eMAR Conference Call

    22. On-going Workload Impact Pharmacy Increase in packaging Decrease in crediting Decrease in phone calls Nursing Increase in med pass time Decrease in computer time Respiratory Therapy Increase in med pass time IT&S Increase time for device support

    24. electronic MAR Integrity Dictionary edits and maintenance Timeliness and accuracy of order entry Pharmacy hours of operation

    26. Corporate Tools Atlas keyword: eMAR Virtual Manual Practice Recommendations Communication toolbox Measurement toolbox Equipment Starter kit

    27. Measurement Packet Pre-measurement packet – begin now Medication error data MAR Billing audit MAR Documentation audit Armband audit Staff Perception surveys

    28. Measurement Packet Post-measurement – due 3 months after implementation Medication error data MAR Billing audit MAR Documentation audit Staff Perception surveys

    29. Improvement Schedules Regional meetings MD Training Admin Training Beyond Blame video ISMP Self-Assessment HCA Patient Safety video Executive walk arounds Improve use of technology to prevent and detect error Use MAR from CPCS on all inpatient units Analysis of scan med report / measurement report

    30. Communication contd.. eMAR monthly conference call eMAR Website eMAR monthly Newsletter eMAR and Barcoding Mailbox and Discussion Group Implementation Coordinator

    31. Equipment

    32. Packaging Options The challenge… New Vendors entering the market Stand alone system? Shared packaging operations

    33. Utilize Packaging Solution Decision Guide Initial questions we asked: What is your distribution model? What is your model for care delivery? primary, team, functional nursing Do you have system automation? For Dispensing For Storage/ Distribution What are the estimated daily packaging needs?

    34. Utilize Packaging Solution Decision Guide Additional questions How will capital/ FTE needs impact your facility operation? Are you a non-24 hour pharmacy? What are your packaging needs? Example: What percentage of packaging involves liquids?

    35. Utilize Packaging Solution Decision Guide Additional questions What size space is available for packaging? Do you have specific state requirements for packaging/ labeling? What is available pre-packaged from the manufacturer and/or distributor? Is there a potential for a shared solution?

    36. Equipment Options HPG packaging vendors: McKesson ScanPak MPI Automed Omnicell

    37. Rubbermaid Cart Configurations

    38. Lionville cart & Metrologic scanner

    39. Cygnus Wall unit

    40. 21st Century Healthcare Professional

    41. Questions?

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