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News : New Providence Last Updated: Feb 13, 2017 - 1:45:37 AM

New Medicine Management System at Princess Margaret Hospital
By Felicity Ingraham
Nov 5, 2015 - 1:10:02 AM

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CDM execs engaging in a training exercise of the Carefusion system with doctors, nurses and hospital pharmacists. (Photo: Carlin Carter Sr.)

Nassau, Bahamas - The Princess Margaret Hospital (PMH) drastically improved its medication management system this year with the introduction of state-of-the-art technology that is reducing wastage and saving money, while setting the stage for improved clinical outcomes for patients.  

The Public Hospitals Authority (PHA) commissioned the CDM Group (Commonwealth Drugs & Medical Supplies Co. Ltd.) to implement a system that would efficiently service the Critical Care block as well as the Accident and Emergency section.  It is a part of a series of steps being taken by the PHA to upgrade and improve the management of public healthcare in The Bahamas.  

CDM Group introduced the CareFusion Medication Management System into the hospital in February, 2015, and completed installation in May.  Marked improvements in the delivery and administering of medications have already been noted since the CareFusion system was implemented.

The critical care wards including Theatre, Intensive Care Unit, Neo-natal Intensive Care Unit, and A&E are outfitted with Pyxis MedStation systems, which can safely and effectively dispense millions of medications every day.  The system is also being used in the A&E section of the Rand Memorial Hospital in Grand Bahama.  This is the kind of technology that hospitals all over the world are investing in, as it has been proven that the path medication takes from the pharmacy to the patient can be error-prone and inefficient.  These challenges often increase risks and cost, and can delay proper treatment and therapy.

The PHA invested some $2 million into the CareFusion system, which researchers say has the ability to pay for itself within the first year to year-and-a-half of proper use.  The CareFusion system had to be interfaced into the current hospital software for maximum benefit.  

Philip Gray, General manager/ Pharmacy Consultant of Hospital and Home Health Services for the CDM Group oversaw the installation, calling it an "exciting venture" that the PHA has embarked upon.

"This was a major transition for the PHA in their whole medication delivery system and process, that allows greater access for the patients, greater inventory controls, and frees up the pharmacist to do more clinical work, which proves very prudent," he said.

"All the things you need for inventory management and making astute clinical decisions in terms of what medications are best served and used from the hospital can be had from the machines themselves."

The Pyxis MedStations comprise of holding cabinets with locked drawers that are properly stocked with medication and supplies.  It is connected to a computer and monitor, which allows the Pharmacy to see what is being used, replenishing daily or twice daily depending on the need.  A nurse or trained personnel with certain levels of security can override for access on the locked drawers in emergency situations.   The Pharmacy and Nursing unit work together to determine what medications are needed for a 24-hour period.  The Pharmacy then sets out par levels to avoid over-dispensing and wastage.  Once that is determined, the items are placed into the cabinets and are monitored from the Pharmacy's information software system.  When a nurse or trained medical personnel asks the system for a specific medication, only the drawer with that specific medication can be accessed.  The Pyxis medication station includes pharmaceuticals, tablets, IV fluids, injections, creams, anesthesia-related products and controlled substances.  The supply station includes bandages, sutures, screws, medical devices, instruments, and materials management apparatus.

CDM execs engaging in a training exercise of the Carefusion system with doctors, nurses and hospital pharmacists. (Photo: Carlin Carter Sr.)

CDM reports that hospital staff have adjusted well to the technology and is using it effectively.

"Usually when there is a paradigm shift, it is initially approached with cautious enthusiasm," said Mr. Gray.  "As CDM led the training process for the systems, guiding physicians, nurses and pharmacists through the various aspects of their responsibilities, fears dropped when they realized that the system is actually user-friendly and something they can utilize by rote."

"The collation of data calls for a different level of analysis, but it's what we as pharmacists are trained to do to make the necessary recommendations going forth," he added.

Hospitals which have implemented the system report that it has allowed for patients to receive their medications more quickly and allow for them to be taken at the appropriate times to increase effectiveness.  Pharmacists report they are able to actually work the floor more efficiently and focus more on patient care.  Nurses report that the system saves time, allowing them to also focus more on patient care.  Hospital administrators report that the cost decreased to two times less than the antiquated unit dose process.  This is the kind of success PHA foresees and CDM is confident of.  CDM has provided the necessary training to PMH staff and at the six month mark, they are now reviewing the results with hopes of the same kind of success.  

The highly intelligent system can determine patient demographics from information provided from the hospital's main server.  For example, when a patient is admitted at A&E, the CareFusion system will be able to access the patient information to assist medical personnel in administering the correct drug for that individual based on age, medical history, and other vital information.  The information is interfaced in real time and can provide reports and billing at the same time that the patient is being released from hospital.  This information becomes vital for insurance companies and will also be critical for National Health Insurance.  Accurate information and the proper administration of medication provides cost savings for the healthcare provider and the patient.  Most importantly, the system drastically reduces common errors in the industry and provides the patient with the most effective administration of medication.  

The CareFusion system was first implemented in the A&E sections at PMH and the Rand Memorial Hospitals, and analysis of the initial data gathered from cost/ benefit analisys revealed that there was an "exponential increase in the capture of charges to patients", according to Mr. Gray.

"This gave us a true picture of how much product is being used, and how specific doctors utilize the medications to treat specific patients - so the necessary details you want to have for the procurement agency is available from the business office, so that the hospital could receive proper remuneration," said Mr. Gray.

The Pyxis Medstation system provides many benefits for PMH including: helps start patient therapies faster by reducing time to first dose; gives nurses fast and easy access to the medications they administer; improves the predictability of where to find medications; reduces missing doses and improves workflow efficiency; minimizes the risk of harm by alerting clinicians about potential medication errors before they reach the bedside; and provides the ability to pre-select medications and document waste remotely from any hospital computer, resulting in more time for direct patient care.

CDM has been providing Professional Pharmaceutical services to the government since its inception 29 years ago.  Once known as Commonwealth Drugs, the company underwent a rebranding exercise as it ventured beyond just pharmaceuticals.  The company now provides a myriad of products including vital; healthcare accessories and supplies, as well as health and beauty products.  CDM has the skill set and complimentary staff to manage the Information technology center, training and project management to liaise between the product manufacturer and the client for this kind of multi-million dollar initiative. 

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