Bad

Musings on poor resource management in healthcare

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I’ve recently had the displeasure of running up against some significantly poor resource management that has had a negative impact on my ability do my job, and it got me thinking about what kind of overall impact poor resource management has on healthcare. I’ve held a full time position as a pharmacist in four hospitals and worked either part time or per diem in two others. That’s a total of six separate facilities in five different cities, so I’m going to assume that I have a fair sampling. No two facilities were the same, but they all suffered from the inability to manage resources, i.e. people, hardware, software, reference material, etc.

I’m sure running a hospital doesn’t come cheap, but I believe you have to create a balance that gives you not only the ability to move forward, but also creates an environment that allows one to perform at a high level.  The problem I see in healthcare is a general lack of foresight when it comes to moving forward.  For example, you can’t purchase a new piece of automation hardware for the pharmacy and expect it to run itself forever at no cost for maintenance, optimization and upgrades. But that’s how we, i.e. healthcare, view things. While I’m general speaking about things related to pharmacy because that’s what I know, the basic principles can be applied to almost anything.

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Quick Hit – CPOE, a pharmacist’s time and laughter

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We’ve finally stepped off the curb and are moving full speed ahead with our CPOE implementation. As a result I spent quite a bit of time last week with our Siemens assigned CPOE consultant. He’s a pharmacist which makes things nice because we understand each other and speak the same language.

The goal of one of the meetings I attended last week was to discuss the resources necessary to implement a CPOE system. Needless to say the project is going to be resource heavy. When it came time to tease out the IT pharmacist part of the project I was a little surprised at what I heard. The time requirements weren’t surprising – several hundred hours – but where the pharmacist fits into the entire scheme was.

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Scanning difficulties with certain barcodes

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I’ve been following the Twitter stream from the ASHP Midyear in Tampa (#ashpsm10). Sunday morning I saw a Tweet from Karl Gumpper come through the ticker stating “ASHP Statement on Barcode on Inventory, Compound & Dispense approved by House of Delegates.” That’s a good thing.

The ASHP Statement on Bar-code Verification During Inventory, Preparation, and Dispensing of Medications can be found here. I re-read the paper Monday morning. There is a lot of good information throughout the document, but I one paragraph in particular caught my attention. “In addition, for BCMA to function, a vast majority of doses must be accurately bar coded, meaning there must be a highly reliable relationship between the information in the bar code and the contents of the dose. Additionally, the bar code must be readable by commercially-available scanners. Although doses delivered directly from manufacturer-labeled packages generally meet these conditions, there are numerous drug products that may not.” This makes sense as a bar-code is useless if it can’t be easily read by a scanner.  And believe me when I say that we find our fair share of bar-codes that don’t want to cooperate. The same can be said for bar-code scanners. I’ve heard people say that almost any of the new bar-code scanners today will do the job. I humbly disagree as I’ve had the misfortune of using some awful bar-code scanners on our way to settling on those currently used in our facility. Some of it is personal preference, but some of it is quality of the device. I’ve written about my opinion for consistency with scanning hardware before.

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Microsoft: the good and the bad

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Microsoft has been in the news quite a bit lately, some of it good and some of it bad. The software giant has done everything from creating an incredible computing environment to building one of the most successful online gaming environments in history. And like most mega-companies they’ve collected their fair share of lovers and haters. With that said, it’s beginning to look like the haters are starting to out number the lovers.

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My first “cloud” letdown

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The cloud punched me in the nose recently and it’s still a litter tender. I’m a huge proponent of cloud based solutions from simple things like online document collaboration and storage to web-based enterprise SaaS solutions, and I have been slowly migrating my digital life away from the desktop toward the cloud. The cloud and I have been very happy together for well over a year now, but we had out first argument last week and I lost. It’s not serious enough to consider divorce, but it was a wake up call to re-evaluate the relationship.

I use both Live Mesh from Microsoft and Dropbox to manage and synchronize documents on multiple computers. The combination has worked very well for me. I use both applications because I like to try new things; Live Mesh came first followed by Dropbox at the recommendation of my brother.

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