Podcast
Questions and Answers
What is one of the key features of the hospital pharmacy operation at Piedmont Athens Regional Medical Center?
What is one of the key features of the hospital pharmacy operation at Piedmont Athens Regional Medical Center?
Which of the following medical services does Piedmont Healthcare NOT provide?
Which of the following medical services does Piedmont Healthcare NOT provide?
What is an essential operational requirement for the pharmacy work environment at Piedmont?
What is an essential operational requirement for the pharmacy work environment at Piedmont?
How many hospitals are part of the Piedmont Healthcare system?
How many hospitals are part of the Piedmont Healthcare system?
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What recognition did Piedmont Healthcare receive in 2023?
What recognition did Piedmont Healthcare receive in 2023?
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Which of the following is NOT a component of the hospital pharmacy's emergency operations ability?
Which of the following is NOT a component of the hospital pharmacy's emergency operations ability?
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What type of residency program does Piedmont Athens Regional Medical Center offer?
What type of residency program does Piedmont Athens Regional Medical Center offer?
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Which area of healthcare is associated with the Marcus Heart Valve Center at Piedmont Healthcare?
Which area of healthcare is associated with the Marcus Heart Valve Center at Piedmont Healthcare?
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What is a primary goal of safety huddles in medication safety?
What is a primary goal of safety huddles in medication safety?
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What proactive measures can a pharmacy technician suggest to prevent selecting the wrong medication, such as confusing Levetiracetam with Levofloxacin?
What proactive measures can a pharmacy technician suggest to prevent selecting the wrong medication, such as confusing Levetiracetam with Levofloxacin?
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Which of the following USP standards is associated with hazardous medications?
Which of the following USP standards is associated with hazardous medications?
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Which of the following roles is NOT typically performed by individuals involved in purchasing?
Which of the following roles is NOT typically performed by individuals involved in purchasing?
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In the context of verifying a patient's medication dose, what is a key step the pharmacist should take if the calculated dose of enoxaparin seems unusually high for a small elderly woman?
In the context of verifying a patient's medication dose, what is a key step the pharmacist should take if the calculated dose of enoxaparin seems unusually high for a small elderly woman?
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What is a benefit of using automated dispensing cabinets (ADCs)?
What is a benefit of using automated dispensing cabinets (ADCs)?
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What is an effective strategy for managing the shortage of lorazepam 2 mg/1ml vials in the pharmacy?
What is an effective strategy for managing the shortage of lorazepam 2 mg/1ml vials in the pharmacy?
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How does the use of automation with carousels enhance pharmacy inventory management?
How does the use of automation with carousels enhance pharmacy inventory management?
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What is the primary goal of medication safety in a pharmacy setting?
What is the primary goal of medication safety in a pharmacy setting?
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What does 340B purchasing primarily aim to achieve?
What does 340B purchasing primarily aim to achieve?
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What key benefit does barcode scanning provide in a pharmacy environment?
What key benefit does barcode scanning provide in a pharmacy environment?
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What does Medication Use Evaluation measure?
What does Medication Use Evaluation measure?
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Which of the following is NOT considered one of the 'Five Rights' of medication administration?
Which of the following is NOT considered one of the 'Five Rights' of medication administration?
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How many people in the US are estimated to die each year due to medical errors, including medication errors?
How many people in the US are estimated to die each year due to medical errors, including medication errors?
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What is the primary focus of debriefings in the context of medication safety?
What is the primary focus of debriefings in the context of medication safety?
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Which entity audits compliance with the 340B purchasing program?
Which entity audits compliance with the 340B purchasing program?
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Which medication safety practice involves confirming orders via verbal or telephone communication?
Which medication safety practice involves confirming orders via verbal or telephone communication?
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What is the purpose of TALLman lettering in medication safety?
What is the purpose of TALLman lettering in medication safety?
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What does CPOE stand for in the context of medication safety?
What does CPOE stand for in the context of medication safety?
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Which process is required for all medications to ensure their safe use in a pharmacy?
Which process is required for all medications to ensure their safe use in a pharmacy?
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What is a common consequence of alert fatigue in computerized medication ordering systems?
What is a common consequence of alert fatigue in computerized medication ordering systems?
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Study Notes
Institutional Pharmacy Operations
- The presentation is about institutional pharmacy operations at Piedmont Athens Regional, focusing on operations, staff, and medication safety.
- The director of pharmacy, Don Tyson, Pharm.D., BCPS, is the presenter.
- The organization is Piedmont Healthcare, a private, not-for-profit healthcare system with 23 hospitals, 65 urgent care centers, and 25 quick care locations.
About the Presenter
- Don Tyson, Pharm.D., BCPS, is originally from Tifton, GA.
- He holds a Bachelor of Science in Pharmacy (BS Pharm) and a Doctor of Pharmacy (PharmD) from the University of Georgia (UGA).
- He also completed a residency at UGA/ARMC.
- Tyson has 13 years of experience as a clinical pharmacist/coordinator and 14 years as a director of pharmacy.
- His hobbies include volunteering in landscaping, gardening, and he is an active member of Hull Baptist Church.
About Piedmont Healthcare
- Piedmont Healthcare is a private, not-for-profit healthcare system that provides cardiac care, transplants (including LVAD), open heart surgeries, and heart valve procedures.
- Piedmont partners with the Cleveland Clinic for transplant care, including kidneys, livers, and pancreas transplants.
- The system offers cancer care in partnership with MD Anderson Cancer Center.
- Other services include women's health, orthopedics, neurology, spine surgery, pediatrics, neonatology, and home health.
- Piedmont employs over 44,000 individuals, more Georgians than any other company.
- The company received recognition in 2023 as one of America's Greatest Workplaces for Diversity and as one of the Greatest Workplaces for women.
- It was ranked by Forbes in 2022 as one of the best large employers in the USA.
Piedmont Athens Regional Medical Center
- The medical center has 391 beds and is expanding.
- The hospital pharmacy operates 24/7.
- It employs 80 staff members with a PGY1 residency program.
- It offers ambulatory clinics, retail pharmacy services, and home infusion services, with specialities in pharmacy.
Pharmacy Work Environment
- Crucial requirements of the pharmacy environment include safety, efficiency, and customer/patient satisfaction.
- A centralized, high-security main operation is needed to store and manage inventory for sterile and extemporaneous compounding.
- The system must be equipped to handle major system failures (power outages, network issues).
- The pharmacy must be easily accessible to patient care areas and must have a tube system.
Staffing
- FTEs (full-time equivalents) are adjusted based on workload, statistics of charged doses and adjusted admissions.
- The ratio of pharmacists to technicians is crucial for skill mix.
Medication Safety
- Medication safety is paramount.
- Medication errors are a significant issue, causing deaths and serious health problems, with 250,000 people annually affected.
- Medication errors can often be preventable, and preventing them should have the highest priority.
Medication Use Process
- The medication use process requires multiple checks (prescribing, dispensing, administering, and monitoring) to prevent errors.
Medication Safety - Error Prevention Tools
- The presented tools include peer checking, coaching, debriefing, ARCC (asking questions, changing course of action, voice concern, stop the line, chain of command), validate and verify, STAR (stop, think, act, review), no distraction zones, effective handoffs, reading and repeating back, asking questions, clarification and alpha-numeric language, and SBAR (situation, background, assessment, recommendation).
Medication Evaluation
- Medication use evaluations must be data-driven and assess appropriateness, cost-effectiveness, of each product and service with OIF (DNV, JCAHO).
Compounding
- The presenter emphasizes adhering to USP standards.
- This includes complying with standards for non-sterile compounding (USP 795), sterile compounding (USP 797), and hazardous medications (USP 800).
- Conformity to compliance standards requires following specific guidelines.
Purchasing
- Purchasing is a vital function performed by multiple individuals.
- Duties include managing inventory, handling contracts, addressing shortages, processing invoices, managing vendors (primary wholesalers, fluid vendors, sterile compounding vendors), and utilizing 503A and 503B standards.
- The presentation also addresses 340B purchasing qualifications, disproportionate share hospitals, critical access hospitals, discounted prices (50% AWP), qualified outpatients, and HRSA audits.
- There are frequent medication shortages, and these should be handled with proper attention and care.
Automation
- The presentation highlights automated dispensing cabinets (ADCs) that streamline medication dispensing minimizing errors and enhancing safety.
- Automated dispensing cabinets (ADCs) are important tools for effectively managing medication dispensing.
- The presentation also highlights automated systems for anesthesia, which include tracking drug use and waste, while printing labels for syringes ("pulled up" process).
- Carousels for inventory are also implemented to enhance inventory management turns with barcode scanning for product output during turns.
Case Studies
- Case studies involving newly trained pharmacy technicians making medication errors.
- A case study about a pharmacist verifying a dose of enoxaparin, where a calculating issue potentially endangers a patient, given that patient's condition and age.
- A presentation of significant medication shortage of lorazepam, a common medication.
Medication Safety Measures - CPOE
- CPOE (computerized physician order entry) helps standardize care and aids in reducing errors associated with handwritten orders.
- It creates the opportunity for unique medication errors.
- Patient errors, including incorrect patient weights (Kg and Lbs) are potential issues, plus alert fatigue.
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Description
This quiz focuses on institutional pharmacy operations at Piedmont Athens Regional. Led by Don Tyson, Pharm.D., the quiz covers topics such as operational practices, staff roles, and medication safety in the context of Piedmont Healthcare's extensive network.
