Case Study: Unit Dose Promotes Safe and Efficient Drug Administration

By American Health Packaging

The 269-bed Florida Hospital Waterman is part of the Adventist Health System which spans 45 hospital campuses across nine states. The 450,000 square-foot facility provides general and surgical services to patients in Tavares, Florida. The Emergency Department annually sees 65,000 plus patients and admits nearly 15,000 people. In any given year, physicians perform more than 5,500 in- and out-patient surgeries respectively.
Patient safety is a core value at Florida Hospital Waterman. The Leapfrog Group recognized Florida Hospital Waterman for safety, a national honor. “A culture that prioritizes safety has earned us nine consecutive strategy A’s and we were named a Top Hospital in 2016,” says Leslie Feuerbacher, Inventory Management Technician & Pharmacy Buyer for Florida Hospital Waterman.

As a buyer for Florida Hospital Waterman, Feuerbacher also applies LEAN methodologies to further the efficiency and budget optimization of the faith-based hospital’s pharmacy purchasing operations.

The challenge: Boosting safety and reducing waste
“By revising our processes to reduce human error, we lower the possibility of mistakes,” explains Feuerbacher. “By using externally-sourced unit dose (UD) medications, we leverage a provider that optimizes automation in the production processes.”

The challenge for Feuerbacher was that many manufacturers had moved away from UD packaging, which led to a rise in repackaging work for Florida Hospital Waterman. “Manual unit-dosing had increased the burden on our resources both in terms of increased labor, training programs and infrastructure. It also increased the potential for errors inherent in the repackaging process along with shortening the expiration date of our repackaged medications to nine months.”

Due to regulations on in-house UD repackaging, along with Florida Hospital Waterman’s practice of queuing medications two months in advance of expiration, the short dates led to an increase in unusable medications. Consequently, Feuerbacher adopted a strategy to leverage externally-sourced UD to mitigate this trend. The problem, however, is that manufacturers are trending away from UD offerings.

“Five years ago an estimated 80 percent of medications on my formulary were available in UD format—that percentage has fallen to around 40 percent today,” explains Feuerbacher.

The solution: American Health Packaging® Unit Dose and Unit Dose Plus™
Feuerbacher’s best-practice criteria for unit dose procurement includes quality products that promote patient safety and that easily scan into Florida Hospital Waterman’s Automated Dispensing Cabinets and Electronic Medical Record system.

Other preferences include “a broad—and growing—portfolio that allows me to source more UD medications externally,” says Feuerbacher. Since AHP is readily available via Florida Hospital Waterman’s Premier contract, Feuerbacher remains compliant with formulary requirements.

Feuerbacher also notes how AHP’s barcode catalog makes her job easier. “If I don’t have the product on hand, it’s faster and easier to scan the barcode to bring it up in our wholesaler system. AHP is one of a few providers that offers this feature. To me, the catalog shows that AHP fully understands the needs of our pharmacy. The catalog is also a great tool to use with new hires and Pharmacy Technician students.”

The outcome: Combining Safety With Less Waste
The AHP UD and UD Plus product lines have delivered a number of benefits to Florida Hospital Waterman’s procurement and medication delivery operations.

A safer med delivery process
“They consistently scan into our system to ensure the timeliness of medication delivery at the point of care,” says Feuerbacher.

“The use of Tall Man lettering enables speedy and accurate readings by nurses and pharmacy staff on the floor.” Those are important benefits because, “medications that fail to scan cause all sorts of issues,” according to Feuerbacher. “It is a priority to have trouble-free scanning—i.e. reducing treatment delays due to barcode errors.”

AHP product features reduce expiration waste

By leveraging the up to two-year shelf life of AHP’s certified products, Feuerbacher has nearly tripled the expiration date of various meds. “That enhancement alone contributed to a sizable reduction in product expiring.”

Pharmacy Technicians like AHP’s UD packaging perforations. “Our technicians tell me that AHP perforations consistently pull apart,” explains Feuerbacher. “With other manufactures’ products, some technicians use scissors to cut them, or when manually torn, the poorly-made perforations rip into the product or bar code— which could cause waste and/or delay in treatment.”

AHP’s Unit Dose Plus™ offering further reduces waste by allowing Feuerbacher to stock necessary, but low-volume-utilized meds, in UD format. “We can meet the clinical needs of our healthcare providers while lowering the waste formerly associated with the expiration of excess inventory.”

A more efficient process

The AHP UD offerings also increased the efficiency of pharmacy operations. For example, by delivering narcotics in 100-count containers, “We’ve streamlined our counting process,” says Feuerbacher. “Because we’re continuously counting narcotics, it’s much easier to complete this process using higher-volume packages versus the low-volume unit-count containers that other suppliers provide.”

A cost-effective solution

“AHP consistently delivers on their promises of both safety and availability,” says Feuerbacher. “Not only are their prices competitive, but also their wide selection of UD and UD Plus offerings allow me to source more UD medications externally. This is a great benefit to my pharmacy staff.”

That’s liberated labor hours formerly devoted to in-house repackaging to be reallocated elsewhere. “Our pharmacists and technicians have more time to devote to patient-centric activities,” says Feuerbacher. “The ease of procurement and lack of scanning issues free up time needed on other, higher-value-add functions as well.”

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