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Pharmacy helped with smart pump and CPOE installation projects
Carving out pharmacy staff time is key
Hospital pharmacists could be an important resource as health systems upgrade their technology and install new electronic systems, such as computerized provider order entry (CPOE) systems.
In one case study of how pharmacy involvement assisted with CPOE and smart pump projects, a pharmacist with information systems (IS) experience helped to assemble a team.
The team had no experience in implementing smart pump and CPOE systems, and this can create anxiety, says Brendan J. Reichert, MS, RPh, assistant director of med use informatics at the Johns Hopkins Hospital in Baltimore, MD.
Vendors provided estimates of how many resources would be needed, but team members wanted their own projections based on worst- and best-case scenarios, Reichert says.
"You want to prepare for the worst and plan for the best," he says. "So I got my team together, and we kicked off the building of the pharmacy computer system before we started the official project."
The first step was to move hours that were allocated for pharmacy services to the project of implementing smart pumps and a CPOE system.
"We tried doing some resource leveling," Reichert explains. "We said, 'We're kind of in a lull period now, and we have routine maintenance with our clinical systems, but there are no big projects screaming at us, so let's put some little projects by the wayside and pull one employee to build the pharmacy computer system.'"
With the dedicated pharmacy employee, they began to build the pharmacy formulary in the computer system, he adds.
"We decided what IV labels we would use, reports we'd load into it, and the institution's formulary items, and we set up some of that infrastructure," Reichert says. "There were certain things we could not build, but we got innovative with our resources."
The key is to level out the peaks and low periods.
"Say you have a deadline with 4,000 medications you have to build into a formulary in two weeks," Reichert explains. "There will be a lot of anxiety among your team."
But if the team starts early and builds it over four weeks, then it's a less frustrating task and deadline.
"We already had the computer system up at four of the hospitals, and we were bringing it live at a brand new hospital," he says. "So we needed to think outside of the box on how to do resource leveling."
The team decided to start some steps early, veering off of the project plan provided by the system's vendor.
"Think about what can be started a little early, what's required for each step, and how you can bring in additional resources to do the work," he says.
Other questions to ask are as follows:
"You try to mirror your work commitment with the resources you have on hand and do resource leveling," Reichert adds.
"Imagine going to work tomorrow with nothing to do and then the following day you have 10 hours of work to do," he says. "It helps your stress level to balance it out."
Another time factor to keep in mind is that a project that involves eight hours of work will likely require a 10-plus hour day to complete.
"You might have six of seven hours of a day scheduled out, but the other two or three hours are going to be spent handling your routine items, like answering emails, answering the phone, returning phone calls, and there will be something coming up in that day that you haven't scheduled for," Reichert says. "So you have to figure that it will be at most 30 hours a week that you'll be able to devote to a special project."