Cook County News Herald

High-tech medicine cabinets at hospital to improve patient care




What if a nurse accidentally grabbed the wrong medication and dispensed it to a patient? What if a medication recently prescribed interfered with another medication but that fact was overlooked when the prescription was written? What if someone with access to medications was tempted to take some and sell them on the street?

North Shore Hospital and Care Center’s purchase of three locked, computerized pharmacy dispensing cabinets (one in the emergency room and two at the hospital nurses’ station) will greatly reduce the chances of any of those things happening. They will also aid in accurate billing.

On October 20, 2011, Hospital Pharmacist Deidre LaRock- Muggley, Ph.D., an employee of Arrowhead Pharmacy on contract with the hospital, showed the hospital board how the cabinets work and what they can do.

Each user accesses cabinets with a password unknown to his or her coworkers and calls up patient information that has been downloaded into the system by the pharmacist. The computer alerts personnel if a medication that has been prescribed will interfere with other meds or if the patient is allergic to that medication. The only drawer that will open is the one with the right medication in it.

LaRock-Muggley keeps the cabinets stocked, and when medications go in, bar codes on the medication and the drawer they go into are scanned to make sure the medications are where they are supposed to be. The computer keeps track of inventory and expiration dates. LaRock-Muggley mixes some drugs up ahead of time if possible for things like shots so that nursing staff doesn’t have to figure out the formulation. Medications that are taken out but not dispensed for some reason are put into a secure box for restocking, which only LaRock-Muggley has authority to do.

Eventually, pharmacists outside the county will be able to review orders and program the pharmacy computer remotely. They will fill in when the local pharmacist is off-duty. St. Luke’s Hospital, North Shore Hospital’s administrative partner, offers remote pharmacy dispensing services for eight or nine rural health care providers. It doesn’t necessarily make any money at it, however, said St. Luke’s president John Strange.

“It’s a huge patient safety issue,” said LaRock-Muggley. “It has really helped that aspect.”

“Medication errors are probably one of the riskiest things in health care,” said Hospital Administrator Kimber Wraalstad. Whenever checks and balances such as this system can be implemented, she said, patient safety is improved.

“I think it’s a very good system,” said LaRock-Muggley, “and there’s a lot of controls with the system.”

The company providing the cabinets and annual maintenance is Omnicell, and it came down in price from $172,087 for two cabinets to $104,354 for three.

Ophthalmology/optometry services

Optometrist Kevin Mueller and Ophthalmologist Kevin Treacy will start seeing patients in Room 9 of the hospital in late November or early December. Cataract surgery patients will no longer have to travel to Duluth to see Dr. Treacy for follow-up exams. The doctors will initially be on hand one Friday per month.

John Strange arranged for Dr. Treacy to set up this satellite office, Wraalstad said. “We really do need to recognize St. Luke’s for making this happen,” she said.

Occupational therapy

Anna Sorenson will be providing regular part-time occupational therapy services at the hospital.

Digital mammography

Digital mammography equipment has been ordered. $210,000 was budgeted for the equipment, but it will cost $195,000.

New pharmacy in town

Board member Sharon Bloomquist asked if the hospital would be required to go out for bids on medications now that Grand Marais Pharmacy has opened in addition to Arrowhead Pharmacy. Administrator Wraalstad said the hospital would not.

Assisted living

Administrator Wraalstad said she heard that Spectrum Health Companies would not be pursuing an assisted living facility in Grand Marais at this time. It recently investigated the possibility.

Board member Tom Spence said the West End townships are interested in pursuing smaller assisted living facilities. He said he had been told that some staffing requirements could be met through remote monitoring technology (such as for checking people’s heartbeat, etc.).

Finances

Year-to-date losses are $84,245, Controller Yvonne Gennrich said, but the projected loss for this point in the year was $512,946. The hospital has brought in more revenue this year than expected. While home health care is down, swing bed days are up almost 78 percent over last year at this time, she said.

Patient satisfaction survey

Patients leaving the hospital will be offered an opportunity to participate in a patient satisfaction survey. It is part of a project by the U.S. Department of Health and Human Services to measure the quality of care in hospitals.



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