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Customer Anecdote — Improving Medication Management in the OR

Customer Profile

Size: 450
Status: For Profit
Type: Regional Referral Center
Kit Check Use: Crash carts, OB trays, OR Anesthesia

Background

This hospital had an ongoing problem: an inefficient Anesthesia medication management process with little visibility into inventory and expiration. In fact, two back-to-back Joint Commission visits found expired medications in OR trays. The hospital realized they needed to improve the situation without adding additional Pharmacy time investment.

Before Kit Check was implemented in the OR, Anesthesia techs restocked the OR trays using stock from their medication room, which was separate from Pharmacy. To make sure the medication room was stocked, Anesthesia would send a four- to five-page floor stock request to Pharmacy once a week. Between pulling those medications and filling emergency orders a few times a week, Pharmacy was spending more than four hours each week on medications for Anesthesia alone.

This resulted in a few issues:

  • Lost visibility of medication after it left Pharmacy
  • Lots of expired medications, as one Anesthesia tech was assigned to tracking of expiring meds in 50+ trays
  • Drug “hoarding” in OR stock rooms to try to stay ahead of stockouts

The Compliance Pharmacist met with the hospital’s lead CRNA, who oversaw the main OR and Anesthesia areas. The hospital had previously implemented Kit Check in crash carts and OB trays, so they decided to expand into OR Anesthesia.

Results

Instead of having Anesthesia refill trays on an as-needed basis from a separate stock room, Pharmacy now delivers a rack of restocked trays to the hospital’s ORs every morning. Anesthesia puts their used trays into the rack and swaps it out with restocked ones. The rack goes back to Pharmacy in the afternoon, where the used trays are scanned and restocked. Rinse and repeat! The Anesthesia Techs were fully on board with this new workflow, and the transition was pretty much seamless.

The time to restock is about equivalent to the previous process, but the new workflow is more efficient than the old scattershot way of restocking. And since all medications and expiration dates are verified by the tray scans, error rates have been reduced to zero. All medications are controlled through Pharmacy, so there are no more “lost” medications, there is no need for floor stock in the OR, and there are also fewer stockouts.

An unexpected benefit is that par levels optimized after three months. Kit Check’s usage reports showed Pharmacy what medications were being used, how often medications were replaced, etc. Anesthesia as able to evaluate their tray loads and make changes accordingly. In turn, this reduced crowding in trays, sped up tray processing by eliminating underused stock, and saved the hospital hundreds of dollars per tray on drugs lost to expiration.

Conclusion

Implementing Kit Check for the OR showed real value for this hospital. Pharmacy now has more reportable data, better visibility into expiring meds, and optimized trays and inventory.

The hospital found that optimizing tray processing doesn’t have to take more time. Pharmacy can focus its time on restocking all the trays at once, instead of pulling floor stock and dealing with emergencies. And it’s faster for Anesthesia as well—they can just swap and go, without having to worry about checking expiration dates.

Communication between Anesthesia and Pharmacy is key to making a seamless transition and realizing fully optimized processes and inventory.

Finally, the hospital is realizing a savings of hundreds of dollars per tray due to no longer having expired or expiring medications.