St. Augustinus Group published, in its company magazine, an interview with Anette Woermann, Director of Pharmacy at Marienhospital Gelsenkirchen, describing the benefits of the ‘Next Level’ project.
Future-oriented solution for medicines therapy safety
Closed Loop Medication Management
The Closed Loop Medication Management (CLMM) process with electronic prescribing, pharmaceutical validation and unit-dose supply is considered by experts to be the gold standard for solving procedural problems in medications supply. The Marienhospital Gelsenkirchen will in future – as the first company nationwide – rely on a partnership with the Italian company Deenova. And thus on future-oriented solutions to ensure even greater patient safety in medicine therapy. Closed loop medication management is to be successively implemented at all six hospital locations belonging to the St. Augustinus service network.
The Italian company Deenova is the leading provider in the field of combined mechatronic (robotics and automation) solutions for closed loop medications and RFID-based medical devices traceability in healthcare.
Anette Woermann, chief pharmacist of the Marienhospital Gelsenkirchen, describes the advantages of the new system.
What do the readers of this publication mean by the term Closed Loop Medication Management?
Anette Woermann: Closed Loop Medication Management is a system for optimising the entire medication process – from prescription to administration. With CLMM we want to enhance the already very high level of medication safety at the Marienhospital Gelsenkirchen. Currently, medication is checked by the pharmacist on admission. Digitalisation, automation and the resulting better structured cooperation of the various professions in the hospital can systematically further increase medicine therapy safety at all process levels.
What added value do electronic prescribing and pharmaceutical validation bring?
Anette Woermann: There are about 60,000 different medicines on the German market. Digitalisation gives us a tool to make prescribing safer. In the case of allergies, intolerances or other problems, a warning notice and a recommendation of alternative preparations appear to the doctor. In addition, thanks to electronic access, the pharmacist has the opportunity to look at the medications and contribute his medication expertise not only during the admission process, but throughout the entire hospital stay.
How does patient-specific medication work?
Anette Woermann: The electronic prescription is sent to the hospital pharmacy. There, three devices are purchased for the pharmacy, in which individually packaged medicines, so-called unit doses, are produced and provided with a barcode and a lot of information about the medicine. These unit-dose medicines are stored in electronic cabinets on the wards. When the nurses dock their trolley to the automated cabinet before their ward rounds, the medication prescribed in the software is individually filled into a drawer for each patient. Before administration, the bedside nurse scans the patient wristband and the barcode of each medicine. Through this process, each medication administration is checked against the electronic prescription – ensuring that it is the correct medication. The loop is closed by electronically documenting the administration and can thus be digitally tracked at any time.
How will the new system affect staff and patients?
Anette Woermann: In addition to even greater patient safety, CLMM also means an enormous relief for the various professional groups. Doctors will be able to see directly in the system, among other things, medicine dosages that are adapted to the laboratory values. Likewise, all necessary information is immediately available. A considerable relief for the nursing staff results from the fact that the time-consuming preparation of the therapies is taken over by the machine. This gives the staff the capacity to devote themselves even more to the nursing tasks – in other words, to the people. This results in maximum safety for the patient. In hospitals that already work with a unit dose system, the error rate has been reduced to zero. That is also our goal.
What is the concrete advantage of the system offered by Deenova compared to similar, already existing procedures?
Anette Woermann: The fact that the medicines are only collected for the patient at the moment of the medicine round gives the doctor the opportunity to make changes a few minutes beforehand if necessary. That was quite decisive for us. With the classic unit-dose systems, on the other hand, the pharmacy prepares the medicines for the next 24 hours once a day. If the dosage is then changed during the ward round or another medicine is prescribed, this is often only possible with a lot of effort.
When will the system be put into operation at the MHG?
Anette Woermann: The infrastructure will first be prepared by February 2022. This includes a stable WLAN and the implementation of new pharmaceutical software. The first vending machines, in which the medicines are blister-packed into sachets, will arrive in our hospital pharmacy at the end of February 2022. We will then start with a two-month lead time in the pharmacy. The first pilot station is to be launched in May 2022 if possible. If everything works smoothly, the other wards in the MHG will follow successively, and then also all six hospitals affiliated to the service network.
You visited some hospitals in Italy that are already equipped with this system. What impressions did you gain there?
Anette Woermann: I looked at the system in Bergamo, Vimercate and Piacenza under everyday conditions and I am totally enthusiastic. Everything worked smoothly, and not only that. Special solutions have been developed for many special cases that occur in the wards. Many questions have already been thought out. Concepts were developed to cover many special features that simply exist in our multi-faceted company.
WHAT IS CLOSED LOOP?
The Closed Loop system consists of four quadrants. The key factor here is Digitalisation from the first to the last step, with constant safety comparison with the quality indicators.
- electronic admission and prescription
- pharmacist can also look at the medication during the patient’s stay in hospital if necessary
- delivery of medicines tailored to the patient’s individual needs
- safe patient administration thanks to individual barcode