The FailSafe Medication Management Study did not result from a grant application or any of the other, more typical methods that usually launch a research study. Instead, it started out simply as a hospital director looking for a way to scrutinize his institution’s medication processing system and identifying ways to improve that system. Missouri Rehabilitation Center in Mount Vernon assembled a multidisciplinary medication management team, which quickly determined that some areas would require a technology-based solution. The team purchased a system order entry software.
At about the same time, the maker of the software was purchased by Baxter Healthcare Corporation, and the ASHP Foundation expressed an interest in studying how the automated system would impact patient safety. Baxter offered to fund a study of its product, and the ASHP Foundation agreed to administer the study. The 5-year study recently completed – and the results are very telling.
“I truly believe that the study shows there is value to having integrated technology,” states Barbara White, R.Ph., M.S., the principal investigator on the study. “I also believe the study shows that technology is not the end-all – it’s just a tool.”
The concept was to combine two things to create the ideal medication-use system: automation that helps practitioners confirm important steps in the process, and to determine the impact of the present medication system to that of an entirely re-engineered one that considers the ideal design principles. White looked at the safety measures in place in 2002, when the study began. She measured cart-fill errors, led the redesign process implementing the new Baxter system, and then remeasured the safety parameters after 6 months of use. The goal was to develop a “failsafe” design for the hospital.
“It was a 5-year-long process,” says White. “We improved in some areas. For example, we went from a cart-fill to an all-floor stock with automated cabinetry. In other areas that had previously used manual methods, such as a paper medication administration record, we actually did not improve because the manual method was better than the digital check.”
The results of the study are in the December 15, 2006, issue of the American Journal of Health-System Pharmacy. “My hope is that pharmacy leaders and IT vendors and hospital administrators will take our numbers and try to better them,” states White. “Close the loop, make the technology even better, make the orders straight to the pharmacy, do the studies, and do it even better, because we need those numbers! We need those business plans!”
White says the most challenging aspect of the FailSafe Medication Management Study for her was working with statisticians. “I had to learn how to work with them, but I had 100% support from the university leadership. They allowed the resources, the time and the budget to make it possible. The key to having a successful study like this is senior leadership support, or you cannot do it.”