Evaluation of Medication Turnaround Time Following Implementation of Scanning Digital Prescriber Order Technology

Abstract

This internship project is a retrospective summative evaluation to assess medication turnaround time (the time between medication order composition to the time the medication is delivered to the nursing unit) before and after implementation of digital scanning prescriber order technology for all medications and antibiotics only in three Capital Health sites. The data in this evaluation study obtained from Pharmacy Information System (Centricity® Pharmacy) and screened for initial inclusion criteria and then audited for physician composition time, nurse scan or fax time and patient medication administration time. These times were collected from Horizon Patient Folder (HPF) digital record and Centricity® Pharmacy System. Two turnaround times were analyzed: total turnaround time (time from order composition to patient administration time) Phase 1 turnaround time (time from order composition to pharmacy verification). Medications were categorized to three groups: all medications, antibiotics and non-antibiotics. Lack of composition time was the main reason for exclusion. Included orders were analyzed first for median values (inter-quartile range) and again using Mann-Whitney U test for significant difference between turnaround time before and after implementation of the prescriber order scanning technology. The study results showed a significant reduction in total turnaround time by 9% (P=0.04) and Phase 1 turnaround time by 21% (P=0.03) for all medications. Implementation of innovative technology, such as digital scanning prescriber technology, achieved an improvement in medication turnaround time. This improvement may be associated with increase in patient safety, quality of care and reduced costs. Based on the evaluation study findings, the main health informatics proposed recommendations are: • Establishing a policy for defining and standardizing medication turnaround times and time for first dose antibiotics. • Emphasizing the importance of proper documentation of composition time by the physicians and fax/scan time by the nurses through education and policy enforcement. • Designating a space for documenting the composition time by the prescribers in forms related to medication prescribing such as medication reconciliation forms and pre-printed medication orders. • Future implementation of technologies such as Computerized Prescriber Order Entry (CPOE) to reduce medication turnaround time and improve patient safety.