HealthNet Medication Storage - Class of 2010-11 LDA Collaborative Project Presentation
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A project to make recommendations for HealthNet of Rock County’s Pharmacy renovation.
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HealthNet Medication Storage - Class of 2010-11 LDA Collaborative Project Presentation
- 1. HealthNet Medication Storage Project Leadership Development Academy Brett Grady, Jennifer Braun, Amy Hume & Wayne Cornwell
- 2. HealthNet of Janesville, Inc. HealthNet of Janesville, Inc. opened in 1994 as the result of a needs assessment completed by the Salvation Army in 1993. The assessment identified a lack of affordable health care as one of the major problems of Rock County. HealthNet of Janesville is a free clinic serving Rock County individuals who have no health insurance, Medicare, Medicaid, or Medical Assistance.
- 4. HealthNet is at its absolute max capacity Before limited enrollment, they were accepting 30 to 40 new patients per week. HealthNet has doubled in size and services over the past four years. Last fall, HealthNet expanded its clinic by 40% to address the demand. HealthNet has: doubled the number of exam rooms created a medication dispensing area built a new space for the nursing staff and volunteers
- 5. HealthNet’s Major Accomplishments: 23,567 prescriptions worth an estimated $2,000,000 Completed 32% of treatment plans Reduced the number of ER visits for 74% Enrolled patients into the new BadgerCare Core Plus program (and/or on waiting list) when eligible Increased the number of volunteer hours by 50% over the last two years
- 6. Services Provided By HealthNet: Medical Care General primary care Mental Health care Pediatrics Vision Care Medication Dental Care Cleaning X-rays Treatment Plans Fillings Fluoride and Sealant treatments Extractions Exposed Wisdom Tooth Removal Root Canals Front Teeth Transitional Partials
- 8. LDA Group Involvement Walkthrough Research Interviews Recommendations Implementation Conclusion
- 9. Background HealthNet was undergoing a renovation More room needed to be available to store medications Our group was asked to make recommendations for storing medications
- 10. Objectives: Research best practice models for dispensing medications in a non-licensed pharmacy Develop a plan to organize medications. Help implement medication organization plan.
- 11. Research The Gifts Program Walgreens Joint Commission Resources VA Pharmacist
- 12. Interviews Mike Dow (Volunteer Pharmacist) & Susanne Altbuch (HealthNet)
- 14. LDA Interview Conclusions Alphabetized storage Nurses’ Frustration Help nurses adjust Orientation and Training
- 15. Layout
- 16. LDA Group Recommendations and Actions Based on our research and interviews, we have come up with the following recommendations. Medication Organization Plan Process Formulary Medication Disposal Follow-up Survey
- 17. Formulary Enhancement GENERIC NAME BRAND NAME ACETAMINOPHEN 500 MG TABS ACETAZOLAMIDE 250 MG TABS DIAMOX ALBUTEROL 0.083% NEB SOL'N AMPS PROVENTIL NEBS ALLOPURINOL 100 MG TABS ZYLOPRIM ALLOPURINOL 300 MG TABS ZYLOPRIM AMANTADINE 100 MG CAPS SYMMETREL AMIODORONE 200 MG CORDARONE AMITRIPTYLINE 25 MG TABS ELAVIL AMITRIPTYLINE 50 MG TABS ELAVIL HealthNet Generic Formulary June 18, 2010 BRAND NAME GENERIC NAME ACCUPRIL QUINAPRIL 10 MG TABS AMARYL GLIMEPIRIDE 4 MG TABS ANTIVERT MECLIZINE 25 MG APRESOLINE HYDRALAZINE 10 MG APRESOLINE HYDRALAZINE 25 MG TABS ATARAX HYDROXYZINE 10 MG ATARAX HYDROXYZINE 25 MG TABS BENADRYL DIPHENHYDRAMINE 25 MG CAPS HealthNet Brand Formulary June 18, 2010
- 18. After Expansion
- 19. Survey Follow -Up 11 surveys returned Comments categorized and counted Results returned to HealthNet
- 20. Survey Follow -Up Yes No 9 Additional Space/Storage 2 Shelves too high 7 Better Organized/Easier to find meds 1 Need additional med box sizes 1 Private 1 Meds filed under Generic and Brand Name 1 Better Lighting 1 Hard time finding meds 1 Layout More efficient 1 Need computer/printer access
- 22. Survey Follow -Up 3. What did you like most about the changes? Additional Space/Storage 4 Better Organized/Easier to find meds 1 Labeled Shelves 1 Height of counter 1 Lighting/Comfort 1 Privacy 1 4. What did you like least about the changes? Shelves too high/spread out 2 More and permanent space for pill sorting 1 Nothing 1 Pharmacy set up 1 Aisles too narrow 1
- 23. How can you help? Volunteer Donations Spread the Word
- 24. Questions?
Notes de l'éditeur
- Jen
- Jen
- Jen As a result of HealthNet being at max capacity, new enrollments have been limited last year to 5 new patients a week. In order for HealthNet to maintain the same level of service and expand, they needed to address this challenge. Major changes to the lighting system, air conditioner, walls, and floors Add an ADA bathroom, air handler, and update the security system.
- Jen Have provided over 23,567 prescriptions worth an estimated $2,000,000 to prevent health care crisis situations. Completed 32% of treatment plans established at the Dental Clinic. New patients receive a treatment plan on their first visit to the Dental Clinic (this plan includes all dental services needed). Reduced the number of ER visits for 74% of patients that consider HealthNet their medical home. Enrolled patients into the new BadgerCare Core Plus program (and/or on waiting list) when eligible. This new State program opened in July, 2009. They implemented a new policy for patients to verify that they are uninsured by providing a denial letter from the State program. This ensures that HealthNet is complying with contract requirements and that there is no duplication of service. Increased the number of volunteer hours by 50% over the last two years.
- Jen
- Jen 84% of Revenue comes from Donated Services and Materials. Less than 4% of expenses go to management and fundraising.
- Amy Our group decided we wanted to do something that would have a lasting impact on the community. We narrowed down several great project ideas and decided HealthNet was a worthy cause.
- Amy HealthNet was undergoing a renovation to increase the amount of space available for patient care. As part of the renovation, more room will be available to store medications. Our group was asked to make recommendations for storing medications based on research and interviews.
- Amy Using questions based on research, interview staff members to identify which method they prefer and why. Interviews can be done in person or over the phone. Mike Dow, Pharmacist Joanne Goodrich, HealthNet Susanne Altbuch, HealthNet
- Amy 1. The Gifts program arranges medication alphabetically or by the client when they bring in medication during their stay. 2. Walgreens arranges medication alphabetically. They do have what they call a Fast Track for commonly used prescriptions so they can get to them quickly. These too are arranged alphabetically in a special section of shelves and include medications they sell the most of like- Birth control, inhalers, antibiotics and children's medications. 3. “Nonrefrigerated medications should be stored in alphabetical order by generic name, as well as separated by type (topical, oral, and intravenous). Combination drugs are often stored by brand name as the exception. …Nonformulary drugs should be minimized and stored in an area separate from formulary medications.” The Handbook On Storing And Securing Medications, 2nd Edition, Joint Commission Resources, 2009. 4. Storing medications alphabetically is the easiest. There should also be an area for fast moving medications that are dispensed regularly. (Interview with VA pharmacist who also volunteers at a public health clinic similar to HealthNet.)
- Amy Generally, a pharmacist enters the orders and a nurse dispenses them. Nurses typically know medications by brand name, not generic name. Currently, it is difficult to locate meds. Meds are stored in 6 different rooms. Mike has plans drawn up to organize meds by type and alphabetically by brand name (generic if no brand name is present).
- Amy Nurses do not know generic names. JoAnn writes the equivalent brand name in marker on the generic bottles to help nurses identify the correct medication. JoAnn agreed that many of the difficulties locating meds would be remedied by having all the meds in one room. Nurses dispense almost all orders. 20-30 people in total dispense orders. The available formulary lists meds alphabetically by generic name. Brand names are provided when applicable next to the generic name. Protocols are in place to dispense medication orders when the ordered medication is not available. Assistance Program medications are allocated to one patient by the pharmaceutical company that donates the meds. These meds are not to be taken and given to other patients.
- Amy We found the nurses’ frustration with medications is largely due to the medications being stored in multiple rooms and not with the organization of the meds. To help nurses adjust to the new setup, they will need tools to help identify the medications they need when they need them. The nurses will also require orientation and training to the new layout to raise their comfort level with the organization of the medications and to encourage compliance with established protocols for dispensing medications.
- Brett
- Brett Move forward with Mike Dow’s organization plan. Organize medications by type (i.e. topicals separated from pills) and then alphabetically. Do not write the equivalent brand name on a generic medication. It can be confusing and potentially dangerous. If the wrong brand name is written on the bottle, a patient could get the wrong medication as a result. Keep the current formulary as is, but add a second that is listed alphabetically by brand name. This will allow nurses who only know the brand name of a medication to look up the generic name. Medication Disposal – Our group spent roughly 25 hours preparing medications for disposal (popping pills)
- Brett
- Brett
- Wayne
- Wayne
- Wayne
- Wayne Volunteer – HealthNet is always looking for more volunteers Donations – Give if you can Spread the Word – Let people know HealthNet is there if they need services Recognize Mike Dow (Volunteer Pharmacist) and Jean Randles (Executive Director) if they are there.
- Wayne