Why it is a good thing to never hear about your Long Term Care Pharmacy

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Ideally, your nursing staff should never complain to you about your Long Term Care pharmacy provider. As a nursing administrator or faculty director, the provider should be an invisible service that gets the right medication to the right nurses at the right time.

The people who work in Long Term Care facilities have enough to worry about. The main goal is to make sure patients and residents have the best care possible. Medicine administration alone is complicated enough without all the paperwork and hassle of dealing with pharmacy problems. Medication errors and Orders Not Received can not only frustrate staff, it can put patient’s or residents’ lives at risk.

However, modern medical technology is making it easier than ever to keep track of medications. There is technology on the market that will bundle a patient’s daily medications into a single package. Inside that package will be labeled smaller packages for each round of medication. With many residents needing multiple types of medication with different dosing schedules, this makes it much easier for nurses to ensure that all the medication is taken at the proper time.

Your staff shouldn’t be coming to you and complaining about the pharmacy. If you’re not hearing anything about your vendor from your staff, this is a good thing. Nurses should be able to get their medication with the minimum amount of hassle. Ask yourself if your medication procedures are as efficient and fool proof as they can be. Is there room for improvement?

Here are some things to look for that can make your pharmacy interactions run smoother if you’re considering a switch:

  • Do they use barcodes on their labels? What is their process from when they receive the order to
  • getting the medicine to a nurse?
  • How quickly can they pull up a record if there’s a medication question for a patient or resident?
  • Is there an automated pill cabinet or multi-package dispensing system that the pharmacy can install at the hospital or Long Term Care setting ?
  • What are your most common staff complaints about your pharmacy? Does the new provider address those complaints?
  • Can the potential new provider train staff quickly in using the new system?
  • Have they dealt with regulators in the past? Will they go to bat for their facilities?

Another thing that long-term carefacilities such as nursing homes, hospices, and DD facilities have to contend with is medical regulation. The worry of an inspection uncovering a flaw in their patient care processes is a big one, and medication errors are a big red flag to the surveyors. Using automated medication dispensing systems, such as AcuDose, as well as hiring a long-term carepharmacy that uses barcode labeling and scanning can go a long way in reducing headaches.

Why changing your Long Term Care Pharmacy provider doesn’t have to be that difficult

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Some long term care facility managers consider a pharmacy vendor change to be stressful. That’s why many facilities are content with putting up with a sub-par vendor.

There are certain things vendors must offer their clients to ensure a smooth transition. Here’s a list of some our most important ones:

  • A transition team that will begin talking with your staff very early in the process and will learn
  • your needs before pushing their solutions.
  • A detailed implementation plan before anything happens so there are no surprises.
  • Training regimens on the vendor’s medication technologies
  • Full explanation of the vendor’s procedures, and who to contact in the organization if there is a previous problem.
  • The vendor should work with your previous vendor to get a copy of all of your order sheets before they step in, so that all medications will be ready to go on the first day.
  • Thorough auditing of the changeover procedures as they happen, to ensure that there are no problems with medication, documentation, or billing.
  • Pharmacy phone support whenever you need it.

There’s no reason to put up with a sub-par vendor. Your staff and your patients deserve a pharmacy that caters to their needs. This has to be done from the very first day, and we know how to do it. If you are thinking about switching, ask potential vendors what their changeover procedures are. Do they give you peace of mind?

What are the top Long Term Care pharmacy errors, and how to correct them?

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In 2005, a Gurwitz study estimated that there are 800,000 medication errors yearly in Long Term Care facilities. That number has probably risen as the Boomer generation continues to age. What are the main pharmacy errors and how can we correct them? There are three main trouble areas:

• Medication errors
• Orders not received (ONR)
• Lack of integration

The key solutions for solving these problems revolve around diligent training of pharmacy staff and the use of current pharmacy technology to track every stage. From the moment that an order comes in, a pharmacy should be able to see where that order is in the process from printing the label to putting the completed order into the tow. They should also be able to easily find out who touched the order along the way.

According to the Institute for Safe Medication Practices, there will be over 1.4 million people in Long Term Care (LTC) facilities in 2013. About one-third of these patients will be on an average of nine medications daily. Therefore it is imperative for Long Term Care facilities to address these problems early.

Medication errors

The two main errors in medication are wrong dosage and wrong medicine. Wrong dosages may be more common than you think, especially between whole tab and half-tab dosages. It is up to the pharmacist to ensure that when a label is printed and filled that the correct dosage is there.

No medical professional wants to give the wrong medicine to a patient, but mistakes do happen. With proper training and technology, medication errors can be reduced significantly. If your pharmacy is still running on paper and memory, consider upgrading your system today. You could save a life.

Current technologies now use barcode scanners that give more information about the exact timing and dosage information. This technology can also warn techs when they’re about to give the wrong dosage or medicine to a patient. This scanning procedure also keeps all the records straight, including which tech filled which prescriptions and when they were sent to the Long Term Care facility. If you are currently not using a scanning system for your labels and medications, then your risk for medication errors is high.

Orders Not Received (ONR)

Label tracking systems also reduces another major error in pharmacies called ONR or Orders not received. When a Long Term Care facility does not receive the medication they ordered it can threaten a patient’s life. The key thing is to have a way to track the entire order from start to finish. A pharmacist should be able to scan a label and know everything about that order.ONR’s can also originate from the Long Term Care facility. Having the ability to go back and show what exactly was in an order can reduce confusion and help both Long Term Care facilities and pharmacists in their training of staff. It can also identify people who need disciplinary actions.

Lack of integration

Efficiency is the name of the game for hospitals and for pharmacies. Pharmacies and Long Term Care providers should be working hand-in-hand to develop systems that allow everyone to see the current status of medication supplies. If it takes a pharmacist a half an hour to pull up an order or a nurse to report that an antibiotic is low, efficiency and patient care quality will be reduced.There are several pharmacy technology providers that have stepped in to help increase the integration between the pharmacy and the nurses and doctors. Products like AcuDose-Rx allow nurses to retrieve drugs from special cabinets that are wired to the overall pharmacy system. A nurse can pull a patient’s medication and have it all bundled right from the cabinet. The system will prevent incorrect medication from being dispensed. When supplies are getting low, a message is automatically sent to the pharmacy to fill the cabinet.

Sources:

Gurwitz JH et al. American Journal of Medicine. 118(3):251–258. 2005
//www.ismp.org/newsletters/acutecare/showarticle.asp?id=54
//www.mckesson.com/pharmacies/inpatient/pharmacy-automation/acudose-rx-pharmacy-benefits/

Why Your Pharmacy Vendor Should Be Hiring Independent Consultants To Audit Work

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There is a potential conflict of interest that the Centers for Medicare and Medicaid Services (CMS) have wanted to squash for some time. Many consultant pharmacists at long term care facilities are supplied by the pharmacy vendor. These consultant pharmacists are responsible for many things:

  • Reviewing and managing medication regimens
  • Ensuring regimens are as safe and effective as possible
  • Educating patients and doctors about medications
  • Preventing medication-related complications

However, CMS has observed some behaviors that have made them want to require consulting pharmacists to be independent from pharmacy vendors. The major behavior is changing drug regimens to take advantage of discounts that the pharmacy gets from drug manufacturers. This practice can compromise the health of patients, and also increase Medicare costs.

In particular, they are worried about increases in the amount of anti-psychotic medication being prescribed to patients in nursing homes. Testimony presented at the end of 2011 by Inspector General Daniel Levinson, JD, said that 14% of nursing-home residents had prescriptions for these drugs, and that half of the prescriptions should not have been paid for. This is a very scary statistic! It may seem unbelievable that some vendors push their consultant pharmacists to find cost savings, but if the CMS is investigating then there is definitely a problem.

Some pharmacies think that it would be too much of a hassle to implement independent consultants. There are a lot of legal hurdles. A separate company has to be set up to hire the consultants, and great care must be taken to ensure that they stay independent. It’s a big headache for the pharmacy, but it delivers peace of mind to facilities. No facility wants to think that the consulting pharmacist has an agenda beyond doing their job.

Vendors should take the step to hire independent pharmacy consultants. By having independent consultants, this conflict of interest can be easily removed. The results would help drive down Medicare costs and provide an improved quality of life for patients in long term care facilities. In turn, this would give the facilities we serve peace of mind about their pharmacy, and lead to improved customer service.

Supporting material: //www.ncbi.nlm.nih.gov/pmc/articles/PMC3278190/

Why A Personal Connection With Your Pharmacist Is Important For Customer Service

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To someone on the outside of the healthcare industry, all pharmacies look the same. But if you’re on the inside, you know how different pharmacies can be. Retail pharmacies are not the same as hospital or long term care facility pharmacies. The needs are different and the structures are different, and so is the relationship between pharmacy and customer.

However, there is one thing that that long term care pharmacy vendors should learn from the retail pharmacies: personalized customer service. Many vendors just don’t have that personalized touch that older independent pharmacies used to have.

McPharmacies

Many Long Term Care pharmacy vendors try to offer a one-size-fits-all solution to facilities. If your facility meshes with their model, that’s great. However, how often does that happen in practice? Think about the last time you switched vendors. How long did it take you to work out all the communications issues and the medication protocols? Did your staff have to learn how to call in an order all over again?

These “McPharmacies” can harm more than they can help. If you’d like to change this model, here are two suggestions for improving your customer service.

Dedicated staff

The first thing is that the people taking the orders from the facility should be the same people who fill the orders. This keeps communication errors down. The order takers should be deeply familiar with every aspect of the order fulfillment process, and be empowered to fix any problems that they encounter.

Also, each facility should get a dedicated group of staff. That way, your facility will quickly learn who they need to talk to in case of an emergency. If you currently have to hop through a phone tree or a long line of people to get your question answered, you may be dealing with a McPharmacy.

Regular audits

The only way to truly know what a customer needs is to ask them directly. Send representatives out every 2-3 weeks to your facilities as auditors to find out what is happening. Talk with the nurses and staff to find out how everything is working, check the pharmacy dispensing systems, and to talk about any upcoming changes at the pharmacy. By having regular communication with everyone, problems can be nipped in the bud, and suggestions can be taken from the people who have their hands on the cabinets.

By bringing in a retail pharmacy mindset to long term care facilities, vendors can differentiate themselves in a way that larger McPharmacies can’t.

Why Multi-Dose Packaging Is Better Compared To Unit-Dose Packaging

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When a nurse receives a package of medications for a patient or resident, the way that it is packaged can have a profound effect on their efficiency. Medical technology has advanced to the point where daily medications can be packaged for each patient in a single bundle, rather than in separate individual dosages. Multi-dose packaging is one of the many reasons why systems like Parata, a medication dispensing technology that offers this type of packaging, are growing in popularity.

Multi-dose packaging has several advantages:

Less work for the nurse

A medication dispensing system like Parata can distribute just the right amount of medication for a client each day. There’s no need to comb through all the medications, disassemble blister packs, count them up, and place them in the right bundles. The machine handles it for them. Just this feature alone can save each nurse 30-45 minutes each day.

Increased accuracy

When nurses have to take care of many different patients or residents, it can be difficult to maintain medication accuracy day after day. Instead, the nurse can pull up the patient record, confirm the correct amounts, and have the Parata System bundle everything up.Not only that, it is possible to have each package of medicine labeled with a time stamp to let the nurse know when to dispense it. It’s a simple matter of opening the patient’s bundle and taking out the correct package at the correct time.

Less waste

Less waste is generated when a multi-dose system is used. All of the medications are specifically packaged for dispensing when they are put into the machine. In a large facility, the dumpsters receive hundreds of thousands of little blister packs and foil peels. Not so with a multi-dose distribution system.

These are just three reasons that medication cabinets with multi-dose packaging, like Parata, are superior to older unit-dose methods. It’s simply a more efficient, accurate, and less wasteful method for medication dispensing.

How Customized Pharmacy Billing Solutions Increase Client Customer Satisfaction

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Conceptual 3d randering of a silver brass scale with money and a butterfly

With pharmacies, after accurate and timely medication delivery, the biggest worry on a facility’s mind is billing.
Medical billing is a hugely complicated process, and every facility has specific procedures. There is no one-size-fits-all solution to medical billing. Vendors must customize their billing process to match the needs of the facility.

At a minimum, there should be an itemized bill of which patients received which prescriptions, with subtotals for each one, and a final total at the bottom. There should also be a method to work with systems where a patient has a certain amount of money for medications each month. These are common in Long Term Care facilities and nursing homes, and are fairly straightforward. However,there are many medications that require special approvals, whether from insurance companies or from hospital staff, and that’s where complications come in.

Ideally, the pharmacy will have the information in their systems to immediately flag situations where an authorization is needed. The sooner they know whether a medication is covered and which authorizations are needed, the better. Obtaining authorizations to send out a medication is one of the biggest bottlenecks in the pharmacy process, especially for people who aren’t covered by medical insurance.

The preferred method can even change depending on the thresholds. One of the problems that can come in with a vendor transition is figuring out the vendor’s new billing and authorization systems. This can be quite challenging, but it doesn’t have to be.

It is not the pharmacy vendor’s place to offer their own authorization methods unless there is a clear need. Facilities have good reasons for why their systems are set up the way they are. Pharmacies must adapt, especially when a facility decided to transfer to another vendor. If you can show that they can keep their current billing system mostly intact, that’s a point in your favor.

Why staff never complain about your Long Term Care pharmacy provider

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Ideally, your nursing staff should never complain to you about your Long Term Care pharmacy provider.

As a nursing administrator or director, the provider should be an invisible service that gets the right medicine to the right nurses at the right time.The people who work at Long Term Care facilities have enough to worry about. The main goal is to make sure patients have the best care possible. Medicine alone is complicated enough without all the paperwork and hassle of dealing with pharmacy problems.

Medication errors and Orders Not Received can not only frustrate staff, it can put patient’s lives at risk.

However, modern medical technology is making it easier than ever to keep track of medications. There is technology on the market that will bundle a patient’s daily medications into a single package. Inside that package will be labeled smaller packages for each round of medicine. With many patients needing multiple types of medicine all with different dosing schedules, this makes it much easier for nurses to ensure that all the medicine is taken at the proper time.

Your staff shouldn’t be coming to you and complaining about the Long Term Care pharmacy.

If you’re not hearing anything about your vendor from your staff, this is a good thing. Nurses should be able to get their medication with the minimum amount of hassle. Ask yourself if your medication procedures are as efficient and fool proof as they can be. Is there room for improvement?

Here are some best practices to look for that can make your Long Term Care pharmacy interactions run smoother if you’re considering a switch:

  • Do they use barcodes on their labels? What is their process from when they receive the order to getting the medicine to a nurse?
  • How quickly can they pull up a record if there’s a medication question for a patient?
  • Is there an automated pill cabinet or multi-package dispensing system that the pharmacy can install at the hospital?
  • What are your most common staff complaints about your Long Term Care pharmacy? Does the new provider address those complaints?
  • Can the potential new provider train staff quickly in using the new system?
  • Have they dealt with regulators in the past? Will they go to bat for their facilities?

Another thing that Long Term Care facilities such as nursing homes, hospices, and DD facilities have to contend with is medical regulation. The worry of an inspection uncovering a flaw in their patient care processes is a big one, and medication errors are a big red flag to the inspectors. Using automated medication dispensing systems, such as AcuDose, as well as hiring a Long Term Care pharmacy that uses barcode labeling and scanning can go a long way in reducing headaches.

LifeLine program is available to eligible low-income consumers in every state, territory, commonwealth

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To participate in the program, consumers must either have an income that is at or below 135% of the federal Poverty Guidelines or participate in one of the following assistance programs: The LifeLine24 program is available to eligible low-income consumers in every state, territory, commonwealth, and on Tribal lands. Consumers with proper proof of eligibility may be qualified to enroll.  To participate in the program, consumers must have an income that is at or below 135% of the federal Poverty Guidelines or participate in a qualifying state, federal or Tribal assistance program. To participate in the program, consumers must either have an income that is at or below 135% of the federal Poverty Guidelines or participate in one of the following assistance programs:

LifeLine program is available to eligible low-income consumers in every state, territory, commonwealth, and on Tribal lands. Consumers with proper proof of eligibility may be qualified to enroll.  To participate in the program, consumers must have an income that is at or below 135% of the federal Poverty Guidelines or participate in a qualifying state, federal or Tribal assistance program.

To participate in the program, consumers must have an income that is ator below 135% of the federal Tribal assistance program.

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Poverty Guidelines or participate in a qualifying state, federal or Tribal assistance program. To participate in the program, consumers must either have an income that is at or below 135% of the federal Poverty Guidelines or participate in one of the following assistance programs:The LifeLine24 program is available to eligible low-income consumers in every state, territory, commonwealth, and on Tribal lands. Consumers with proper proof of eligibility may be qualified to enroll.  To participate in the program, consumers must have an income that is at or below 135% of the federal Poverty Guidelines or participate in a qualifying state..

LifeLine program is available to eligible low-income consumers in every state, territory, commonwealth, and on Tribal lands. Consumers with proper proof of eligibility may be qualified to enroll.  To participate in the program, consumers must have an income that is at or below 135% of the federal Tribal assistance program. To participate in the program, consumers must either have an income that is at or below 135% of the federal Poverty Guidelines or participate in one of the following assistance programs:

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