RFID Improves Management of Emergency Medicine Kits. Adrienne Shepardson PharmD

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2 RFID Improves Management of Emergency Medicine Kits Adrienne Shepardson PharmD 2

3 BALTIMORE 3

4 BALTIMORE

5 University of Maryland Medical Center

6 University of Maryland Medical Center 757 bed academic teaching center Over 300 ICU beds 28 Operating rooms

7 University of Maryland Medical Center R Adams Cowley Shock Trauma Center First trauma facility in the world 100 beds dedicated to trauma patients 12 bed resuscitation area

8 Code Cart

9 Code Cart Contains all the medications and supplies needed during an emergency Separate code carts for adult and pediatric patients Located in all patient care areas 135 Adult Code Carts 30 Pediatric Code Carts

10 Emergencies An average of three patients daily Includes cardiac arrest, severe allergic reaction or other emergency Average does not account for Trauma Resuscitation Unit May have up to four patients at once requiring emergency interventions

11 Emergency Drug Trays

12 Emergency Drug Trays The average tray contains medications There are nine different types emergency trays/kits Each different tray type has unique medications Approximately trays/kits processed by the pharmacy daily

13 Emergency Drug Trays Each medication had to be handled and visualized Right drug Drug integrity Expiration date Process repeated for validation

14 What s the Problem? Process was tedious and error prone Error rate of 1 in every 20 trays. Time consuming Each tray took ten minutes per pass Pharmacist must perform final check No tracking mechanism What happens if something is recalled

15 What s the Problem? 20 trays X 10 minutes = 200 minutes per day 200 minutes per day X (1 tech + 1 pharm) = 400 minutes per day 400 minutes per day = Huge time resource!

16 Automation of Checking Barcode technology Scan the drug, scan the tray Limitations Still have to handle every medication Checking expiration remains a manual process No way to track recalled medication

17 Automation of Checking RFID Technology Scan the entire contents of tray at once Limitations Removes the manual check for drug integrity

18 Seven Technology Goals Improve Quality and Safety Efficiency Compliance Security Worker Sa;sfac;on Advance Clinical Prac;ce Sustainability Ini;a;ve

19 UHF C1G2 Passive Tags - One scanning/reading station to read all of the kits - One Zebra printer for printing the tags - SaaS / Web based software - no servers onsite. Implemented in April 2012

20 How Does it Work? Each drug is labeled with an RFID Tag National Drug Code (NDC) number Lot number Expiration date Each tray has an RFID Tag Indicates type of tray

21 Tagging the Drugs

22 Tagging the Drugs

23 Tagging the Drugs When the drug barcode is scanned the user is prompted to enter: Lot Number Expiration date The system will prompt a double check if combo not previously seen

24 Process for Used Trays The technician will visually inspect the tray and remove any used drugs The returned tray is placed in the scanning station The system will analyze and report Items that are missing Items that are expired or expiring soon

25 The Scanning Station

26 Kit Scanning Result

27 Kit Replenishment The technician will replace all the missing or expired medications The tray will be rescanned for validation A charge sheet will print The technician will cover with tamper evident overwrap

28 Charge Sheet

29 The Pharmacist s Role Entirely behind the scenes Only system administrators allowed to assign drugs to segments Meets many Board of Pharmacy requirements

30 Pharmacist s Role

31 Implementation The scanning station requires a dedicated space Will fit under a counter Tagging the trays and medications the most time consuming Obtain the printer ahead of time to start tagging drugs

32 Lessons Learned Tag medications when they are being restocked Takes advantage of same lot number/ expiration date The tags like to stick to each other Beware the phantom tag

33 The Results Time for tray completion decreased to 5 minutes Error rate decreased to 1 in 4000 Pharmacist deployed to clinical work

34 Unexpected Bonuses Record numbers of drugs recalled Old process was to look for recalled drug in every tray

35 Unexpected Bonuses Each tray has a unique number Now have an exact number of trays in the hospital Can work with our buyer to order products with longer expiration dates

36 Reporting Features Easily locate recalled item System knows lot number Get real time information about what drugs are being used Help minimize inventory on hand

37 Reporting

38 Expansion In December 2012 expanded to Operating Room trays/kits Identified a repackaging company to pretag medications Implement system that provides location of trays in the hospital

39 Expansion Use system to help rotate stock in the trays Use RFID technology to manage expired medications in unit based cabinets Other functions?

40 Summary (My Favorite Things) Decreased tray processing time Reduced error rate Better tracking of recalled medications Increased technician job satisfaction Redeployment of pharmacist to more clinical tasks

41 Questions

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