1 / 46

GEORGETOWN HOSPITAL SYSTEM GEORGETOWN MEMORIAL HOSPITAL WACCAMAW COMMUNITY HOSPITAL

GEORGETOWN HOSPITAL SYSTEM GEORGETOWN MEMORIAL HOSPITAL WACCAMAW COMMUNITY HOSPITAL TECH TREKKING. TEAM APPROACH. PHYSICIAN. PATIENT. PHARMACIST. NURSE. CASE MANAGER. Pharmacist Job Duties. Order Entry &/or Order Reviewing/Dosing Order Clarification Order & Patient Follow up

kay
Download Presentation

GEORGETOWN HOSPITAL SYSTEM GEORGETOWN MEMORIAL HOSPITAL WACCAMAW COMMUNITY HOSPITAL

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. GEORGETOWN HOSPITAL SYSTEM GEORGETOWN MEMORIAL HOSPITAL WACCAMAW COMMUNITY HOSPITAL TECH TREKKING

  2. TEAM APPROACH PHYSICIAN PATIENT PHARMACIST NURSE CASE MANAGER

  3. Pharmacist Job Duties • Order Entry &/or Order Reviewing/Dosing • Order Clarification • Order & Patient Follow up • Medication Dispensing • IV Admixtures calculations & checks • Clinical Interventions • Medication Procurement • Automation- Pyxis Control • Unit Inspections • Quality Assurance/ PI • Communication- phone/ rounds/ face to face • Med Reconciliation • Supervision

  4. Increase Knowledge Base • New procedures • New equipment • New research • New drugs • Continuing education

  5. Increased Work Load • Increased Patient Numbers • Automation • New Medications • Expanded Clinical Duties

  6. Regulations • CMS • JCAHO • Licensure • DHEC • DEA • SIP Guidelines • Hospital Policies • 100,000 Lives • LeapFrog • Healthgrades • ASHP 2015 • USP 797 Standards

  7. Multiple Tasks Continuing Ed Projects Community Involvement Pills

  8. Medication Safety Facts • Medication errors account for more than 7000 deaths annually • Approximately two out of every 100 patients admitted to the hospital will experience a preventable adverse drug event • Over 12% of patients experience an ADE within 2 weeks of discharge Massachusetts Coalition for the Prevention of Medical Errors

  9. US TF on HC Cost Control • Med Errors 30% of Health Care Cost • Med Errors cost 10-15 % of hospital’s annual operating cost • Med Errors $23 billion national cost • (more than 50% are preventable)

  10. National Pharmacists Shortage Increasing Knowledge Base Expanded Duties Safety-preventableADE/Drug Conc/Interventions Quality-Core Measures/SCIP/HAI/VAP Changing Roles-Dispensing vs Clinical Roles

  11. Goal • To utilize Pharmacists to provide evidence based Best Practices using the most cost effective methods to support medication safety by providing a universally consistent process regarding medication therapy across the continuum of care. • .

  12. TEAM APPROACH PHYSICIAN PATIENT PHARMACIST Pharmacy Tech NURSE CASE MANAGER

  13. Expansion of Technician Role • Techs must be registered with SCBORX • National Certification • SC- State Certification June 2006- Grandfathered in or Must be a graduate of approved accredited program

  14. Today: Tech Job Duties • Order Entry &/or Order checking • Medication preparation • Tech check Tech • Prepare IV Admixtures • Calculations • Procurement-ordering, receiving, stocking • Inventory Control-Max/Min • Automation- Pyxis Control • Unit Inspections • Quality Assurance/ PI • Communication- phone/ rounds/ face to face • Med Reconciliation

  15. JOB DUTIES SHIFT • Medication Reconciliation • Tech Check Tech • Unit Inspections • Chemo Admixtures

  16. The Dilemma • What to do ???

  17. Development of Career Ladder Pharmacy Technicians Organizational Value Self Worth Recruitment/Retention Cutting Edge

  18. Development of Career Ladder Organizational Value: Increasing education, knowledge, responsibilities of the tech gives the Pharmacists increase support with the daily routine technical functions, allowing them more time to spend on Clinical Issues, which will create a more efficient department, while saving the organization dollars.

  19. Development of Career Ladder Self Worth: This gives the Tech an opportunity for career growth and advancement by increasing their job responsibilities, accountability and their learning which, in turn, increases their self worth and the morale in the department.

  20. Development of Career Ladder Recruitment/Retention: Replacing a trained, seasoned employee is very costly to the institution($ 48,378)The career ladder not only provided a method to increase income, it helps retain the employee by giving them extra incentives to work toward as they increase their longevity with the organization. ( Year prior to starting WCH lost 3 techs-CVS/Cosco/ExCr)

  21. Development of Career Ladder Cutting Edge: To continue to hire the high caliber employee we desire and keep them incentivized, we must be creative and look for ways to build self esteem, promote professionalism and add opportunity for growth to hire and retain them. Providing this creative advancement, not only gives the “self starter” goals to work toward, it also creates a “need to grow” in the department, so others are not left behind. (Environment of friendly competitiveness with support)

  22. Expanded Responsibilities • USP 797 Compliance- IV Admixture • Monthly Unit Inspections • Medication Reconciliation • Tech check Tech • Quality Assurance Studies • PI Review • Pharmacy Projects • Community Involvement

  23. Pharmacy Tech LevelsPharmacy Trekking • Pharmacy Tech Levels Non-Certified Pharmacy Tech…….220……..$ (1 year) Certified Pharmacy Tech I….…….245……..$$ Certified Pharmacy Tech II………275………$$$ • Pharmacy Trekking Differential Trek A…………$ 0.75 ($1560) Trek B…………$ 1.50 ($3120) Trek C…………$ 2.50 ($5200)

  24. Pharmacy Tech Levels Non-Certified Pharmacy Tech…….220……..$ No National or SC State Certification Certified Pharmacy Tech I….…….245……..$$ National Certification Certified Pharmacy Tech II………275………$$$ National & SC State Certified OR National Certified with at least 3 years hospital pharmacy experience Qualification to begin Trekking process may not occur until employee has attain Certified Pharmacy Tech II Status

  25. Pharmacy Trekking A • Must be performing at a “meets” level or higher on all performance appraisal standards • Must have demonstrated cross training competency in all areas of Pharmacy as documented on the Pharmacy skills checklist. • Demonstrated and documented competency in preparation of all IV admixtures and Chemo solutions • Documented ability and evidence of conducting monthly unit inspections • Documented completion of Pyxis minimum and maximum inventory standards on a quarterly basis. • No evidence of written or suspension level corrective action over the previous 12 months. • Documented minimum of 20 preceptorship hours of training new pharmacy staff.

  26. Pharmacy Trekking B Compliant with all Competency Level I criteria AND: • South Carolina State Certified Pharmacy Technician with SC BORx OR 3 years experience as a hospital pharmacy technician with overall “exceeds” rating on most recent performance review. (based on 2006/2007 set up this means a 3.0 or higher) • 797 Compliant (Completed documented 797 skills checklist & passed media-filled testing) • Minimum of 40 documented hours of preceptor ship with Pharmacy Tech students during annual review period OR Participation in local career day event • Documented participation with andmentorship of applied Ed of Pharmacy Students of 8 hours during annual review period OR complete 1 approved (in addition to those required for annual licensure)

  27. Pharmacy Trekking B (continued) • Participates in one documented department quality assurance initiative during annual review period. • Participates in Departmental one documented process improvement (PI) activity during annual review period • Participates in Pharmacy Week project OR Participates in Poison Prevention Week project • Participates in one or more GHS Community Health Events

  28. Pharmacy Trekking C Compliant with all Competency Level I and II criteria AND: • Must have been a Pharmacy Technician with GHS continuously for a minimum of five years OR must have graduated from an accredited pharmacy technician program and must have been a Pharmacy Technician with GHS continuously for a minimum of three years. • Demonstrates and documents completion of medication reconciliation process for 2 months during annual review period • Identifies specific opportunities for internal departmental policy changes that results in improvement in safety or operational efficiency. Writes and/or revises drafts of policies for review. • Tech Check Tech as assigned documented by skills test and log sheets • Researched and identifies a minimum of one industry or otherwise external “Best Practice”/benchmark process improvement to be presented as a possible best practice for GHS to adopt. • In addition to the minimum required preceptor ship hours with Pharmacy Tech students, individual will participate in the design of the training plan.

  29. Pharmacy Trekking C (continued) • Identifies and leads a minimum of one department quality assurance initiative. • Identifies and leads a minimum of one Departmental process improvement (PI) activity • Serves in the leadership role to develop Pharmacy Week project plans OR Serves in the leadership role to develop Poison Prevention Week project plans • Participates in one or more GHS Community Health Related Event • Completes 2 hours additional CEUs (in addition to those requires of annual licensure renewal) during annual review period

  30. WCH Pharmacy Trekking Costs • PM……………C...........$5200 • GW……………C……….$5200 • VG…………….C……….$5200 • GB…………….B……….$3120 • BI……………..B……….$3120 • LD………….…B……….$3120 • AY…………….B……….$3120 • SS………..…..B……….$3120 • AJ…………….A……….$1560 • KM……….…..A……….$1560 Total Costs……..…………………$34,320

  31. GMH Pharmacy Trekking Costs • MHR………….B.........$3120 • TF.……………B……….$3120 • MLR.………….B……….$3120 • RS…………….B……….$3120 Total Costs……..…………………$12,480

  32. Medication Reconciliation (Trek Level CCriteria) • $59.09/hr Average RPh $14.21/hr Average Tech • 5.5 mins/patient • WCH 2 EAST –July thru Dec 2007 1064 admissions 1064 X 5.5 mins=5852mins/60=97.5 hrs 97.5 X $59.09= $5761.28 97.5 X $14.21= $1385.48 $5761.28- $1385.48= $4375.80/ 6mon X 2=$8751.60/yr Annual Efficiency Savings = $8751.60 @ WCH 2 East

  33. Medication Reconciliation (Trek Level CCriteria) • $59.09/hr Average RPh $14.21/hr Average Tech • 5.5 mins/patient WCH : July Thru December 2007 (3604 Admissions) 5.5 min X 3604=19,822/ 60 = 330.37 hours 330.37 X $59.09= $19,521.56 330.37 X $14.21= $ 4,694.56 $19,521.56-$4694.56=$14,827/ 6mon X 2=$29,654/yr Annual Efficiency Savings = $29,654 @ WCH

  34. Tech check Tech (Trek Level CCriteria) . Pyxis Refills & Narc Pulls • $59.09/hr Average RPh $14.21/hr Average Tech • WCH: Done Monday thru Friday • 1.5 hrs/day X 5days/week x 26 weeks = 195 hrs • 195 X $59.09= $ 11,522.55 195 X $14.21= $ 2, 770.95 $11,522.55 - $ 2,770.95= $8751.60/ 6mon 8751.60X2=$17,503.20/yr Annual Efficiency Savings = $ 17,503 @ WCH

  35. Tech check Tech (Trek Level C Criteria) . Medication Repackaging Verification • $59.09/hr Average RPh $14.21/hr Average Tech • Done Daily • GMH: July-Dec 2007 = 1009 Repackaging Procedures • 0.1 hours/procedure (6 min) • 0.1 x 1009 = 100.9 hrs/6 months • 100.9 X $59.09= $ 5,962.18 100.9 X $14.21= $ 1,433.79 $5,962.18 - $ 1,433.79= $ 4528.39/ 6 months 4528.39 X 2= $ 9,056.78/yr Annual Efficiency Savings = $ 9,056.78 @ GMH

  36. Unit Inspections (Trek Level A,B, & C Criteria) • $59.09/hr Average RPh $14.21/hr Average Tech • WCH Done monthly: 9 units @ 1 hour/unit = 54 hours/6month • 9 X $59.09 = $ 531.81/mon x 6 months = $3190.86 9 X $14.21 = $ 127.89/mon x 6 months = $ 767.34 $3190.86 - $767.34 = $2423.52/6mon X2= $4847.04/yr Annual EfficiencySavings = $ 4847.04 @ WCH • GMH Done monthly: 10 units @ 1 hour/unit = 60 hours/6month • 10 X $59.09 = $ 590.90/mon x 6 months = $3545.40 10 X $14.21 = $ 142.10/mon x 6 months = $ 852.60 $3545.40 - $852.6 = $2692.80/6mon X2= $5385.60/yr Annual Efficiency Savings = $ 5385.60 @ GMH

  37. Chemo IV Admixture (Trek LevelA, B, & C Criteria) • $59.09/hr Average RPh $14.21/hr Average Tech • GMH : July Thru December 2007 • # Admixtures per 6 Months = 76 • # Hours per Admixture = 1 • # Hours per 6 Months = 76 Hrs • 76 X $59.09= $4490.84 /6 months 76 X $14.21= $1079.96 /6 months $4490.84-$1079.96= $3410.88 /6mon $3410.88 X2=$6821.76/yr Annual Efficiency Savings = $ 6821.76 @ GMH

  38. Financial Benefit WCH Med Reconciliation………..….. $ 29,654.00 WCH Tech Check Tech……………... $ 17,503.00 WCH Unit Inspections……………….. $ 4,847.04 WCH Efficiency Savings…….$ 52,004.04 GMH Tech Check Tech………….……. $ 9,056.78 GMH Chemo Admixtures………….…. $ 6,821.76 GMH Unit Inspections…………………. $ 5,385.60 GMH Efficiency Savings……..$ 21,264.14

  39. Safety Allergy Procedure ADR Procedure Med Scanning Procedure Order Checking Tylenol Dosing Checks

  40. Quality • Metformin- SrCr Checks • Tech check Tech • Inventory –Max/Min Levels • Anesthesia Gases- Flow Rates • Charge Capture-OR/Endo/Anes • Billing Log Checks-Doc/Over/Rejections • Blood Derivative Log Documentation

  41. Worth • Organization Recruitment, Retention, Cost Effectiveness, Community • Department Morale, Competitiveness, Environment • Self Motivation, Attitude, Importance

  42. Cost/Benefit Analysis • Financial WCH Costs……………………….. $ 34,320.00 WCH Savings……………………. $ 52,004.04 WCH Net Gain……..$ 17,684.04 GMH Costs……………………….. $ 12,480.00 GMH Savings……………………. $ 21,264.14 GMH Net Gain……..$ 8,784.14 • Safety:ADR/Allergy/Scanning/Tylenol • Quality:TechCheck/Inventory/Charge Capture • Worth: Organization/Department/Self

  43. Time Benefit WCH: Med Rec…………….….195 Hours Tech check Tech….…390 Hours Unit Inspections……..108 Hours 693 Hours GMH: Chemo Prep……….…..152 Hours Repackaging Checks..202 Hours Unit Inspections….…..120 Hours 474 Hours 693 + 474= 1167 Hours (0.6 FTE)

  44. Benchmarks • Financial Costs………..$17,684.04 WCH Gain • Financial Costs………..$ 8,784.14 GMH Gain • Turnover……………..…O Trekking Techshave Left • Shift In Duties…………Tech check Tech, Unit Inspections, Med Reconciliation, Chemo Admixtures • Best Practices………Scanning/ADR/Allergy Inventory Control/Med Rec

  45. THE Future • Family Caring For Family • 6 Key GHS Initiatives • Shift of more duties • Increase in Quality & Safety • Promotion of Best Practices • Leader in Pharmacy Practice

More Related