Elizabeth Rodman, PharmD

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Information Overload: Auditing the Clinical Utility of Smart Pump Reporting Tools Elizabeth Rodman, PharmD PGY1 Health-System Pharmacy Administration Resident Froedtert & the Medical College of Wisconsin Froedtert Hospital

Purpose Assessment of smart pump reporting tools available at Froedtert Hospital Development of a CQI process for optimal utilization of smart pump reporting tools

Interoperability Out of Scope Procedural areas Emergency department Out-of-scope medications Blood products Penicillin G Selected chemotherapeutic agents

Definitions Interoperability: two-way interface between smart pumps and electronic health record (EHR) “Near miss” related to interoperability: differences in medication, dose, rate, concentration, or patient weight Scan patient Scan med Scan pump Send order to pump Start pump Carefusion. Alaris™ System with Guardrails™ Suite MX User Manual. Cardinal Health; Dec. 2016.

Figure 1. Comparison of Select Features from Smart Pump Analytics Reporting Tools Available at Froedtert Hospital EHR: electronic health record

Study Primary Outcomes Identify top 10 medications implicated in smart pump near miss events Reduce number of near miss events related to smart pump programming

Post-Intervention Data Identify & Implement Intervention Figure 2. Continuous Quality Improvement Process for Smart Pump Reporting Tools Initial Analysis of Reporting Tools Select Report Collect Post-Intervention Data Analyze Trends Identify & Implement Intervention

Figure 3. Top 10 Medications Implicated in Smart Pump Discrepancies for Q2 & Q3 2017 (n=4,440 discrepancies in 291,503 infusions)

Example Near Misses

Determining Intervention Risk matrix Modified Delphi approach

Risk Matrix

Intervention Adjusted propofol order sets to promote ordering of bolus from the bag Paired propofol order panel with nursing order for sedation vacation to increase ordering from panel

Future Directions Collect and evaluate post-intervention results Repeat CQI process using smart pump-specific reports Biannual reporting to Medication Safety and Pharmacy Quality Committees

Conclusions Evaluation of interoperability reports demonstrates technology is working well Interoperability reports are useful for workflow and patient-specific information Out-of-scope medications and areas not on interoperability were not captured

Acknowledgements Megan Holsopple, PharmD, BCPS Shannon Werner, PharmD Tina Wagner, PharmD Kristin Hanson, BSPharm, MS Philip Brummond, PharmD, MS

Questions? Information Overload: Auditing the Clinical Utility of Smart Pump Reporting Tools Elizabeth Rodman, PharmD Elizabeth.Rodman@Froedtert.com PGY1 Health-System Pharmacy Administration Resident Froedtert & the Medical College of Wisconsin Froedtert Hospital

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