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Background
According to the 1999 Institute of Medicine report, To Err Is Human,
7,000 deaths occur annually in U.S. hospitals as a result of preventable
medication errors. Most errors are caught at the prescribing stage; only
two percent are caught at the administration stage.
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Launch
of Program
- Mercy Meds was conceived in 2001 as a Systemwide approach to improving
medication safety across the Sisters of Mercy Health System (Mercy).
- The Mercy Meds program is a comprehensive transformation of the medication
administration process that incorporates technology, supply chain management,
strategic partnerships and improved work processes to enhance safety
and efficiency in the delivery of medications to patients.
- In the fall of 2003, Mercy launched Mercy Meds in its first location,
St. John’s Mercy Medical Center in St. Louis.
- By the end of 2004, Mercy Meds will be introduced Systemwide at 10
hospitals located in Mercy’s seven service areas. When complete, it
will serve more than 3,000 patient beds. (back to top)
How
Mercy Meds Works
The Mercy Meds program simplifies the medication process
by eliminating unnecessary steps and implementing technology where possible
to help intercept potential medication issues. Mercy Meds involves the
following processes:
- Mercy purchases medications in bulk from a single supplier, then individually
repackages and barcodes medications in its centralized distribution
center in Springfield, Mo. The bar-coding of medications in single-dose
packages is a critical step in the Mercy Meds process.
- Hospitals electronically order medications from the distribution center,
which are delivered via Mercy’s own vehicle fleet.
- Hospital pharmacists enter physicians’ medication orders for patients
into a computer. Because patients may be treated by several different
doctors during their hospitalization and, on average, are prescribed
seven to eight medications during their hospitalization, pharmacists
review the various prescription orders to verify each patient’s medication
regimen and identify potential issues.
- The individually packaged, bar-coded medications are stored in computer-controlled
cabinets on each nursing unit for easy and timely access.
- Nurses enter medication requests into the computer-controlled cabinet,
which automatically verifies and dispenses the appropriate medication
for the particular patient.
- Patients receive a bar-coded ID wrist badge that, when scanned, accesses
information on a computer that stores the patient’s individual medication
regimen.
- From a computer that can be wheeled to the patient’s bedside, nurses
use a handheld scanner to scan their own ID badge, the patient’s ID
wrist badge and the barcode on the medication to verify accuracy.
- As a final safety check, the computerized system prompts nurses to
check for potential medication issues, such as the patient’s blood pressure
and diet, before giving the medication.
- By using the barcode technology, the medication administration is
automatically and accurately documented in the patient’s electronic
medication record. (back to top)
Partnerships
Mercy has developed innovative partnerships with
the premier organizations in the pharmaceutical supply chain to create
a safe, efficient and cost-effective system.
- Mercy purchases all medication from AmerisourceBergen, the country’s
largest pharmaceutical wholesaler. .
- Mercy’s Consolidated Services Center (CSC), a centralized distribution
warehouse, uses an automated system to barcode and repackage all medications
into single-dose units.
- Omnicell dispensing cabinets securely store bar-coded medications
and allow nurses to obtain prescribed doses on the nursing unit easily
and quickly.
- Bridge Medical supplies the patient safety software system that allows
nurses to access patient information and verify medication at the patient’s
bedside by barcode scanning.
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National
Standards
- In February 2004, the U.S. Food and Drug Administration (FDA) issued
a final rule that will require drug manufacturers to bar code prescription
drugs by 2006.
- The National Quality Forum (NQF), a non-profit organization created
to develop and implement a national strategy for healthcare quality
measurement and reporting, and the Leapfrog Group for Patient Safety,
a national organization representing 160 companies that advocate for
healthcare quality and safety, have endorsed medication-related “safe
practices” that should be universally used in clinical settings to reduce
harm to patients:
- active participation by pharmacists in the medication use process
- dispensing medications in unit-dose form
- standardizing methods for labeling, packaging and storing medications
- The Mercy Meds program greatly surpasses both the FDA rule and the
NQF/Leapfrog safe practices in both timing and scope by combining unit-dose,
bar-coded medications with bedside barcode scanning technology, and
increasing nursing and pharmacist participation in medication safety.
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Benefits
of Mercy Meds
- A primary goal of the initiative is to allow nurses to spend more
time with patients, which will result in better hospital experiences
and better health outcomes.
- Pharmacists become an integral member of the patient care team, lending
their unique expertise and insight to improve medication safety. (back
to top)
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