New pharmacy efforts enhance inpatient education, care and safety.
By Stephanie Marsau
Come along with us to Mary Greeley's oncology unit in this short video
, where new pharmacy efforts are keeping patients safe.
Enter a pharmacy and one of the first people you see? The pharmacist, ready to fill your order and answer your questions.
Wouldn’t it be great if the same thing happened at the hospital? At Mary Greeley it does. Recently, the medical center started putting large, computerized medicine cabinets on each inpatient hospital floor. Pharmacists are also now stationed on the Oncology floor, readily available to educate cancer patients about their often complicated drug regimens.
“Their presence on the Oncology unit represents the most important quality improvement of the last five years at Mary Greeley Medical Center,” says Dr. Joseph Merchant, McFarland Clinic oncologist.
In the old hospital system, doctors ordered medication for a patient. Nurses sent it via a tube system to the pharmacy. The order was added to the pharmacy work flow—and hours could pass before the patient received the medication.
Automated Dispending Cabinets (ADC) at Mary Greeley has changed that. The on-floor, computerized units fill drug orders—placed electronically by medical staff and verified by the pharmacist— in less than 10 minutes. The ADC device records what drugs were removed and by whom.
In March 2012, Doug Wetrich, director of the Mary Greeley Medical Center Pharmacy, made another change. “Pharmacy has been a very distribution oriented profession,” says Wetrich. “We dispense drugs, but we have so much more to contribute to quality patient care. We started thinking about how we could dispense not just drugs, but knowledge.”
Wetrich decided to take the pharmacists from behind the glass window and put them on the inpatient units. “In a large hospital, this is not uncommon. Nearly all of them have at least one pharmacist for an inpatient unit,” states Wetrich. “It is uncommon to see a hospital of our size be able to do it, simply due to our smaller staff. We knew it would be a challenge, but it was still something we wanted to try for our patients.”
Pharmacist Jill Bode consults with cancer patient
Macy Owen before she is discharged from
Mary Greeley. The hospital’s on-floor pharmacist
program is improving patient education and safety.
After piloting the program on Medical Telemetry, the system was moved to Oncology. “The medications administered on Oncology can be much more complicated than the medications given throughout the rest of the hospital,” Wetrich says. “An extraordinary amount of communication is needed, so it made sense to have pharmacists on that floor.”
Today, pharmacists Jill Bode and Lori Frederick are primarily found on the fifth floor on Oncology, Mary Greeley’s new west patient tower.
“I welcomed the opportunity to go to the floor,” says Frederick. “It sounded exciting and interesting, and like it would use the knowledge I gained in pharmacy school to a greater extent than working behind closed doors in the pharmacy.”
According to both Frederick and Bode, a large component of what they do now is patient education. “Medications are often a misunderstood part of a patient’s care. Being there gives the patient access to another health care professional who specializes in that,” says Frederick.
When a patient is discharged from the hospital, the pharmacists go through a discharge medication teaching session. They double check that the medications are correct and review dosage and other information.
“We explain what their medications are for, potential side effects and other tips to help patients comply and get the most from their medications,” Bode states. “It also gives the patient an opportunity to ask questions about any new medications.”
For Amanda Engnell, an oncology RN, the on-floor pharmacists are vital patient care resources.
“We are able to provide better patient care,” Engnell says. “They’re the experts on medications, and now if I have a question concerning a complicated chemotherapy regimen, I can talk directly to the experts. They’ve made the Oncology floor a safer place.”
Frederick and Bode also play an important role in the planning and administering of chemotherapy. They check dosing and prepare worksheets that help ensure pre-medications, chemotherapy and labs are correct. They also talk to patients and discuss chemo timing, side effects, and future doses.
According to Sarah Heikens, director of Oncology Services, the education resonates with patients. “We place follow up phone calls to our patients after they go home,” she says. “On those calls, patients often comment on the excellent teaching they have received from the pharmacists and speak about how well they understand the medicines they’re taking. This communication between the pharmacists and the patients really is improving patient safety.”
Due to the Oncology on-floor pharmacy success, the program is expanding. Pharmacists are now available in Medical Telemetry, which originally served as the location for the pilot program. There are also plans to station pharmacists on the Intensive Cardiac Care Unit.
“We’re a community hospital doing what’s right for the community, and we’re doing it with the expertise and resources we have,” Wetrich says. “We’re using the current staff we have in place to improve patient safety and enhance the care of our patients. That’s really what all of this is about—the patients we serve.”
Pharmacy Program Receives Patient Safety Award
Mary Greeley Medical Center’s inpatient Oncology pharmacy program has received a 2015 Iowa Healthcare Collaborative Patient Safety Award. The program, which involves stationing pharmacists on the oncology floor to help educate cancer patients about their medications, was cited in the category of “achievement in improving
culture of safety/safety across the board.”