Hospital Pharmacy Question: What's your turnaround time?

[psychoandy]

I know, I know, not a glamorous topic, but very necessary...
Lately I've been dealing with a lot of medication management issues and as a student interested in hospital pharmacy I'm pretty curious about what it's like outside of my little bubble. Currently at my hospital we have no set rules or standards for turnaround time.

So I ask...What's your turnaround time for meds? You can just talk about average time overall or go more specifically like PO/IV stats, regularly scheduled things, new orders, etc.

Anyways, I work in a large academic medical center and our overall average medication turnaround time is about 2 hours; obviously compounding something or making a propranolol drip takes a while but it seems like turnaround time at my hospital ranges from 20 minutes to several hours. We primarily tube new orders and IVs, and physically bring up scheduled meds (but not into a pyxsis or anything). For us, stat meds just means that it should be done in under an hour; of course, it sounds easy to pick something/make something in less time than that, but anyone who has ever stepped foot into a hospital knows...well...hospital culture. Stat colace/sudafed/stupid med orders don't help either...

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[pharmacogenomic]

Are you asking turn around time for things that are not in Pyxis?

If so, its 15 min. We do QA on it & have pretty good numbers on how well we perform.

But, the key here is training your hospital staff on the proper use of "stat". Its hard with new house staff, but when its an obviously inappropriate use of "stat", we contact the prescriber & rewrite the order so we make it fit hospital policy. In some cases, we have P&T authority to automatically change orders (ie - DSS is never stat).

The big places place your efforts are ER (streptokinase), perinatal (hemorrhage) & transitional step down units. I guess it could also be peds - I don't work with peds so I don't know.

Critical care, OR, L&D should have everything they need in their Pyxis & they should have a pharmacist available by pager/cell phone.

 

[tussionex]

i'd say our turnaround is about 1-2 hours. anything that's truly, truly stat...we can get out as soon as it's ready [ie, 3 minutes, tops on a levophed drip....give us some more time on spinal-protocol solumedrol]

we make deliveries every hour. for anything that a nurse may want/need before the next run; they are welcome to come down and pick up/send someone to pick up [tech, secretary, transporter, patient]...they often WANT to come down...it gives them an excuse to get off the floor for a few minutes!

we are putting up 3 more pyxises in critical care areas next week...so that should cut down on delivery times for first dose abx, etc...

 

[Epic]

Profile driven automated drug dispensing system such as Pyxis should allow a turn around time of 5 to 10 minutes as soon as the physician order is scanned to pharmacy. Most of the time at my previous hospital, orders were processed as soon as they were received. Of course IV admixtures would take a little longer..

 

[psychoandy]

Are you asking turn around time for 1things that are not in Pyxis?

If so, its 15 min. We do QA on it & have pretty good numbers on how well we perform.

But, the key here is training your hospital staff on the proper use of "stat". Its hard with new house staff, but when its an obviously inappropriate use of "stat", we contact the prescriber & rewrite the order so we make it fit hospital policy. In some cases, we have P&T authority to automatically change orders (ie - DSS is never stat).

The big places place your efforts are ER (streptokinase), perinatal (hemorrhage) & transitional step down units. I guess it could also be peds - I don't work with peds so I don't know.

I mean things not in a pyxsis. For my hospital 15 minutes is quick for a stat...figure it takes a minute or three to check/enter/verify the order in the computer system, have a tech drop what they're doing and instantly pick it off the shelf/draw it up/whatever, and then have another tech scan and deliver. Not bad if you think about it, I think 15-30 minutes should be our standard for stat meds. However, my concerns are more with routine medication delivery and how long it takes.

As far as the last part, 90% of our floors have emergency stuff that they could legitimately need, i.e. the ED and ICUs all have floor stock alteplase. Although there are some places that could use some work...hmm

Profile driven automated drug dispensing system such as Pyxis should allow a turn around time of 5 to 10 minutes as soon as the physician order is scanned to pharmacy.

That would be nice IF our CPOE interfaced with our automated dispensing machines...but it doesnt

i'd say our turnaround is about 1-2 hours. anything that's truly, truly stat...we can get out as soon as it's ready [ie, 3 minutes, tops on a levophed drip....give us some more time on spinal-protocol solumedrol]

we make deliveries every hour. for anything that a nurse may want/need before the next run; they are welcome to come down and pick up/send someone to pick up [tech, secretary, transporter, patient]...they often WANT to come down...it gives them an excuse to get off the floor for a few minutes!

Man I really want to work in your hospital...floors SENDING people down for meds! That sounds fantastic...at my job RNs only do that if they're really really pissed b/c they haven't gotten something.

Thanks for your input though...as a lowly student I can't do much about operations but I'm trying to come up with some ways to improve things.

 

[tussionex]

That would be nice IF our CPOE interfaced with our automated dispensing machines...but it doesnt



Man I really want to work in your hospital...floors SENDING people down for meds! That sounds fantastic...at my job RNs only do that if they're really really pissed b/c they haven't gotten something.

.

no way it doesnt interface! HL7 is HL7...anything is interface-able!

it's not always nice when they come down...they seem to think that they can just pop up whenever they want for whatever they want. on the flip side, we like it when our favorite nurses come and visit!