Closed Loop Medication Process aka The Journey W

Closed Loop Medication Process (aka The Journey) W. Perry Flowers, RPh, MS System Executive, Patient Care Support & System Pharmacy Donna Mac. Donough, RN, MSN Administrative Director, ISD Clinical Solutions

First Closed Loop Scans MH SL – first med scan Oct 5, 2009 MH NW Rehab – first med scan April 20, 2009 at 5 am MH NE – first med scan June 28, 2009 at 11 am 1

Building the Platform Closed Loop Meds e. MAR

Project Quadrants • Equipment Assessment • Inventory Assessment • Configure Care. Admin • Formulary Clean up • Order Catalog Linking • Develop Training Material • Deploy Scanners • Resolve Scan Issue • Purchase Bar-Coded Unit Doses • Evaluate & Purchase Packaging and Labeling Equipment • Purchase Labeling Devices • Bar Code All Products • Implement Quality Control • Develop Standards Informatio n Technolog y Backend Managemen t Pharmacy Operations Meds Admin • Scan Compliance Reports • Scanning Issues Reports • Develop Custom Reports • Clinician Scoreboard • Compliance Enforcement • Establish Workflow • Determine Training Needs • Conduct Staff Training • Med. Safe Practice • Issue Reporting

e. Ordering go LIVE dates Sugar Land Katy Southeast TMC OB TIRR Katy Rehab TMC Adult NW 2006 2010 2011 MC Children’s TW (Pending) SW (Pending) NE (Pending) 2012 2013

MEDSAFE Central 1) Ph. ACTs (now Care. Fusion) Pharmo. Pack is an oral solid packager. 2) White vertical carousel for bulk stock and for final repacked items

MEDSAFE Central Part of our risk mitigation equipment – low(er) tech: liquid (left) and oral solid (right) repackaging

Closed Loop Future State -Enteral Feedings -Breast Milk -Blood Med. Safe Closed Loop Med

Lessons Learned • • Central Supplies Items Test multiple CPOE Ordering Scenarios Mixing Medication on the Floor Device Locations (where does the COW/WOW think it is? ) Minimum Billing Unit (Pass Through) items Duplicate NDCs Long character string bar codes will not scan On Boarding External Agency Staff

Closed Loop Must Haves • • • A Philosophy & Strategy An Operational Plan Organizational Commitment Get some money Communicate and then communicate some more • Know that any closed loop changes will uncover weak links (clinical & operational) 11

System Specifics • Memorial Hermann Healthcare System has 11 campuses in the greater Houston area with several associated free-standing inpatient entities. Fact Sheet Inpatient Facilities Adult Heart Children’s Texas Medical Center Hospitals Licensed Beds TIRR Southwest 15 3, 581 Annual Emergency Visits 360, 256 Annual Deliveries 26, 731 Annual Life Flight Missions 2, 960 Medical Staff 4, 857 Employees 20, 840 Memorial City Southeast Northwest The Woodlands Northeast Katy Sugar Land

QUESTIONS