Evaluation of STAT medication ordering process in a community hospital

Abstract

Background:In most health care facilities, problems related to delays in STAT medication order processing time are of common concern.Objective:The purpose of this study was to evaluate processing time for STAT orders at Kimball Medical Center.Methods:All STAT orders were reviewed to determine processing time; order processing time was also stratified by physician order entry (physician entered (PE) orders vs. non-physician entered (NPE) orders). Collected data included medication ordered, indication, time ordered, time verified by pharmacist, time sent from pharmacy, and time charted as given to the patient.Results:A total of 502 STAT orders were reviewed and 389 orders were included for analysis. Overall, median time was 29 minutes, IQR 16–63; p<0.0001.). The time needed to process NPE orders was significantly less than that needed for PE orders (median 27 vs. 34 minutes; p=0.026). In terms of NPE orders, the median total time required to process STAT orders for medications available in the Automated Dispensing Devices (ADM) was within 30 minutes, while that required to process orders for medications not available in the ADM was significantly greater than 30 minutes. For PE orders, the median total time required to process orders for medications available in the ADM (i.e., not requiring pharmacy involvement) was significantly greater than 30 minutes. [Median time = 34 minutes (p<0.001)].Conclusion:We conclude that STAT order processing time may be improved by increasing the availability of medications in ADM, and pharmacy involvement in the verification process.

A Quality Improvement Intervention Reduces the Time to Administration of Stat Medications

“…We also found that turnaround times were significantly faster if the medication was available in the clinical unit, which is consistent with previously published findings. 21 …”

Designing and evaluating an automated intravenous dosage medication calculation tool for reducing the time of stat medication administration in a pediatric emergency department

“…In addition, a study at Aramco Johns Hopkins in Saudi Arabia revealed a decrease in the time needed to deliver stat medications (from 59.7 min to 40.7 min) after the implementation of multiple systems, which included structured communication, an electronic inbox for stat medication orders sent by nurses to the pharmacy, and the use of a pink envelope for delivering stat medication orders [2]. Another study at the Kimball Medical Center in New Jersey revealed that the median time needed to process non-physician-entered orders was significantly less than that needed for physician-entered orders (27 min vs. 34 min) [11]. However, another study from the United States revealed that "ward bay wall charts" for documenting and communicating stat medications actually increased the median time to administration (from 94 min to 146 min, a 55% increase), which was associated with delayed medication delivery and poorer communication [3].…”

O que mudou nos serviços farmacêuticos hospitalares em uma região de saúde do Distrito Federal (Brasil) após três anos do diagnóstico inicial?

“…O serviço de distribuição correspondeu a um dos com maior impacto em termos no cumprimento dos serviços, sendo essencial para disponibilização oportuna do medicamento e segurança no processo de seu uso 20,[29][30][31] . Os resultados corroboram com a literatura que aponta melhora na execução de serviços farmacêuticos hospitalares como resultado de mudanças no sistema de distribuição de medicamentos 21,32 .…”