Hospital leaders at New England Baptist Hospital (NEB) in Boston, MA discovered that nearly one-third of each pharmacist’s time, or 2.5 hours of each 8-hour shift, was devoted to resolving problems related to incomplete, unclear or illegible medication orders. The result: the hospital was spending $155,000 a year on clarifying such orders.
To help eliminate medication errors and create a real time, problem solving system, NEB called Value Capture for help. The staff began using Lean principles to connect pharmacists to physicians to produce results. On the medical unit, for example, the median time to process a medication order fell rapidly, to less than five minutes today. Now only 38 orders per month, or 0.02%, on average are put on hold for further clarification. As a point of comparison, about 2%, or 200 orders, were being put on hold each month for the same reason hospital-wide.
Better yet, those benefits were transferred to other areas of the hospital. When a redeployed satellite pharmacist was introduced in the Post-Anesthesia Care Unit (PACU), the number of problems with post-op orders that pharmacists encountered dropped from 34% to 10%. This is notable as 70% of medication orders at NEB are immediate post-op medication orders. A goal here was to see how quickly a patient in immediate need, following surgery, gets his or her medicine. Meanwhile, the number of post-operative medication orders placed on hold by nurses for unclear orders dropped by 42%. And the number of calls to MDs to clarify an order plummeted by 85%.