Oct. 25, 2019 – Today I visited a team with a crucial mission: promoting the safe and effective use of medication to ensure the best possible outcomes for our patients. This is Pharmacy Services, which includes both inpatient and outpatient pharmacies and is staffed by pharmacists, pharmacy technicians and other team members.
My tour began in the large inpatient pharmacy space between the cafeteria and the Rose Pavilion. Following a pathway marked out on the floor, I first learned about how the team works to find savings for Rady Children’s when ordering medications. To do so, they coordinate with a pharmaceutical group purchasing organization and transition from branded to generic drugs when possible. With the Hospital spending about $40 million annually on pharmaceuticals, even a small savings can make a big difference. In fact, our pharmacy has been honored for purchasing 98 percent of products through a contract agreement, reflecting their commitment to contract compliance and cost savings for the organization.
Next, I learned about the variety of ongoing efforts that go into preventing medication errors. The team has a robust medication error reduction plan and has implemented a missing medications process improvement project. A taskforce has found ways to reduce the number of missing medications through targeted interventions over the last four years.
We then followed the path down the hallway to the crew that manages Willow, the pharmacy module on Epic. Willow oversees the pharmacy’s inventory by tracking the core database of medications and the processes around filling medication carts and patient prescriptions. This team, which meets on a weekly basis, includes pharmacists and techs in collaboration with IT, which supports the application and its functionality. I also learned about future plans to use a tiny camera that will take pictures during medication preparation to improve patient safety and utilize clinical pharmacists in a more efficient manner. As Pharmacist Manager Ron D’Ulisse put it, they’re “trying to move the needle from a safety perspective.”
Next up, I met the two-person investigational drug service team, which helps researchers accomplish goals while maintaining compliance with all applicable standards and regulations. There are about 100 active drug trials underway at Rady Children’s and many others pending. A number of these trials are focused on children in need of specialized treatments, such as those with Kawasaki disease.
I then got an education in how the Omnicells work. These automated medication cabinet systems allow authorized staff to access medications at the point of care. The system automatically tracks the quantity of drugs in the cabinet and keeps tabs on the expiration dates of drugs, which increases efficiency and patient safety. We have Omnicells in the pharmacy and in select clinical areas, including operating rooms. Every three months at a minimum, pharmacists conduct a manual inventory of schedule 2 drugs, which are medications with a high potential for abuse or dependence. There is a further safeguard built into the Omnicell software that requires a pharmacist to review the intended use of certain drugs before they are allowed to be accessed.
From there, I met with some pharmacy techs, who assist in the preparation and delivery of medications throughout the Hospital. Responsibilities include managing patient-specific medications, as well as stocking the Omnicells and anesthesia trays. I learned there is a lot of production involved in preparing these trays, which are loaded with dozens of specific medications. Once the tray is stocked, it is placed in a machine that scans all of the drugs and then alerts the technician if drugs are missing or there are too many of an item. Pretty cool!
The well-being of our patients is our top priority, and this team’s role is absolutely critical in keeping them healthy and safe. Thanks for your commitment and the great visit!