1. 1 Medication Management: New Technology to Reduce Cost and Increase Efficiency By Dan Grady, MEd, RRT, FAARC copyright 2011

2. 2 Disclosures Relationships with: CPC, Inc. TherOx, Inc. Outcome Solutions LLC AARC copyright 2011

3. 3 Presentation Outline Background Joint Commission Standards Research Study Results New Solution for Meeting Standards, Saving Steps, and Cost Savings copyright 2011

4. 4 Background: Joint Commission Inspections for Medication Safety In past, TJC cited Respiratory Therapists for carrying Medications in pockets or fanny packs. Rationale was that meds were: (1)heated and chemically broke down (2) not secure copyright 2011

5. 5 Background The prohibition against carrying meds in pockets resulted in more time performing procedure, decreased efficiency, and multiple steps back and forth to med storage machines. We conducted an original study to determine if RT’s carrying meds in pockets resulted in significant temperature changes compared to med temps in storage (Pyxis) machines. copyright 2011

6. 6 Joint Commission 2011 Standards for Medication Management 2. “ The hospital stores medications according to the manufacturers’ recommendations, or in absence of such, according to a pharmacist’s instructions.” MM.03.01.01 Performance Element: 2 Joint Commission 2011 e-dition copyright 2011

7. 7 Manufacturer Recommended Storage Temperatures for RC Medications Trade NameGeneric NameManufacturer Recommended Storage Temp Degrees F Manufacturer Recommended Storage Temp Degrees C AlbuterolAlbuterol Sulfate36-772-25 AtroventIpatropium Bromide59-8615-30 DuonebIpratropium and Albuterol36-772-25 PulmicortBudesonide68-7720-25 XopenexLevalbuterol68-7720-25 copyright 2011

8. 8 Joint Commission 2011 Standards for Medication Management 4. “The hospital has a written policy addressing the control of medication between receipt by an individual health care provider and administration of the medication, including safe storage, handling, security, disposition, and return to storage.” MM.03.01.01 Performance Element: 4 Joint Commission 2011 e-dition copyright 2011

9. 9 Joint Commission 2011 Standards for Medication Management 5. “The hospital implements its policy addressing the control of medication between receipt by an individual health care provider and its administration. MM.03.01.01 Performance Element: 5 Joint Commission 2011 e-dition copyright 2011

10. 10 Joint Commission 2011 Standards for Medication Management 4. “The hospital reviews the literature and other external sources for new technologies and best practices.” MM.08.01.01 Performance Element: 4 Joint Commission 2011 e-dition copyright 2011

11. 11 Joint Commission 2011 Standards for Medication Management Definition of Secure: “In locked containers, in a locked room, or under constant surveillance. “ Glossary for Medication Management Joint Commission 2011 e-dition copyright 2011

12. 12 Joint Commission 2011 Standards for Medication Management 1. “The hospital collects data on the performance of its medication management system.” MM.08.01.01 Performance Element: 1 Joint Commission 2011 e-dition copyright 2011

13. 13 Joint Commission 2011 Standards for Medication Management 5. “Based on analysis of its data, as well as review of the literature for new technologies and best practices, the hospital identifies opportunities for improvement in its medication management system.” MM.08.01.01 Performance Element: 5 Joint Commission 2011 e-dition copyright 2011

14. 14 Comparison of Methods for Medication Storage and Transport by RT’s Recently conducted a research study for medication storage and handling by RT’s. The temperature of 31 saline samples stored in Pyxis machine was compared to 31 samples of saline transported by RT’s. Compared temperature in both groups via t-test. copyright 2011

15. 15 Scattergram of Temperature Measurements for Pyxis Storage (n =31) compared with RT Transport of saline samples (n=31). * Note data for both groups > 77 degrees F ! copyright 2011

16. 16 Comparison of Methods for Medication Storage and Transport: Table Shows Sample Sizes Outside Acceptable Temperature Storage Range (> 77 degrees F). Both Methods Need Improvement!. MethodTemps > 77 Degrees % Temps > 77 Degrees Therapist1652% Pyxis1548% copyright 2011

17. 17 Research Study Implications Joint Commission will no longer enforce standard that RT’s not carry meds in pockets. However, per new 2011 standards, RT Departments must (1) have a policy for medication management, and; (2) produce data showing meds are within manufacturer storage guidelines. How will you comply? copyright 2011

18. 18 New Technology for Medication Management We have developed a novel device for transporting medications which is: Safe Secure Temperature monitored Multi-Medication transport Inexpensive, Lightweight, and saves RT steps and time. copyright 2011

19. 19 IsoThermal Solutions Medipac Device from: www//OutcomeSolutions.net patent pending copyright 2011

20. 20 IsoThermal Solutions Medipac Device Components from: www//OutcomeSolutions.net patent pending copyright 2011

21. 21 IsoThermal Solutions Medipac Device Assembled from: www//OutcomeSolutions.net patent pending copyright 2011

22. 22 Comparison of Methods for Medication Storage and Transport: Table Shows Sample Sizes Outside Acceptable Temperature Storage Range (> 77 degrees F). Medipac was superior to Pyxis and RT Transport. 00Isothermal Medipac MethodSamples with Temps > 77 Degrees (n =31 in each group) % of Samples in each group with Temps > 77 Degrees Therapist1652% Pyxis1548% copyright 2011

23. 23 Comparatitve Study of IsoThermal Medipac, Pyxis, and RT Transport. Results: The IsoThermal MediPac device: 1. Maintained 100% of saline samples transported by RT’s for 1 hour within manufacturer recommended guidelines (68- 77 Degrees F). May last up to 6 hours with refrigerated gel pad. 2. Achieved statistically significant differences in temperature compared to (1) Pyxis and (2)RT pocket transport (n = 31. alpha =.05 for all groups, P = 0.0006 and P = 0.0001, respectively). copyright 2011

24. 24 Annualized Cost Savings of Retrieving Multiple Medications from Storage Reduces steps and travel time back and forth to storage machine. Reduces time by 3 minutes/procedure. At 800 bed medical center, estimated cost reduction of 155,000/yr by improved efficiency. Estimated cost savings for 20 NC Hospitals equals 1.6 million dollars/yr. copyright 2011

25. 25 IsoThermal Solutions Medipac More information at http//www.outcomesolutions.net copyright 2011