— Jayson Przybyla, Pharm.D., Informatics pharmacist
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Fix barcode errors before they are reported
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Dynamic alternative alerts
Dynamic alternative alerts are on-the-fly alerts generated by the system that suggest a list of alternative medications when a non-formulary or non-stocked medication is ordered from the Prior to Admission med-list. These alerts provide benefit by suggesting a formulary or hospital stocked product, which may decrease pharmacy clarification calls.
Before turning on this functionality, make sure to test it out and analyze the results. Some Non-formulary examples to test may include Calcium products, opioids, cardiac meds as well as other critical meds. Then analyze the list of suggested alternatives generated by this alert. This may help with how you decide to configure the alert settings. If you plan to set these alerts to suggest on pharmaceutical subclass, consider excluding classes like oncological, HIV, vaccines, antidotes and others. When system level alerts finds matching meds in these classes, they commonly do not provide appropriate alternatives.
Medication Age based context by age and location
Age based contexts can be set up to use patient location (department) in addition to age. Sometimes this may be necessary for patients that are older than the defined age but, located in neonatal or pediatric department. When choosing which departments that would qualify for age based contexts be sure to discuss the reasons why a department should apply the age context as well as why not.
Making Therapeutic substitution alerts easier to review
When creating Therapeutic substitution alerts, consider using the smartgroup based alternative alerts that allow for display name modification. Consider changing the original display name with the therapeutic interchange (ordered product >>product substituted). Displaying the therapeutic interchange in the display name may facilitate appropriate selections when the alert fires for the ordering user.
Post implementation follow-up with end users
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Ask open ended questions. Ask for feedback on what works, and what doesn’t. How can this be better? A majority of issues are discovered by end users. Therefore it is important to follow up with end users and continue foster the relationship.
Fixing Barcodes at go-live
When a nurse cannot scan the medication barcode or gets and error message, consider implementing a process where the nurse can place the empty package with the non-scanable barcode into envelope with the order ID# and other useful pt data at the automated dispensing station. The pharm tech can collect these barcode packages during ADS fills and bring down to pharmacy to return to Willow team to troubleshoot and fix.
Remind physicians of expiring meds with system lists column
Setting expirations on medications is intended automatically stop the medication along with to have physicians assess if treatment needs to be reordered. However sometimes expiring medication are not assessed and there by expire. If this occurs frequently, consider a reassessment of the expiration duration and discuss the pros & cons of extending the duration for different classes of meds.
In addition, consider utilizing an expiring meds column that displays an icon when a medication order is set to expire within predefined time prior to expiration. Additional configuration may be necessary; make sure to test the build. If expiring med column is used, consider adding it to the physician’s system list as a standard column. This may help alert physicians of expiring meds, as they are in the process of reviewing their list of patients. Also, training and education may be necessary in order to improve compliance and limit orders from expiring without being reviewed.