Category: Professional Posters
Purpose: With the growth of ambulatory surgery centers in a health system, the management of medications needed for procedures has become more difficult to manage in locations distant from the hospital hub at the Cleveland Clinic. Add in the health system acquisitions of private practice group owned ambulatory surgery centers and the medication needs for offsite locations increased greatly. We implemented a strategy to request pharmacy technician’s and pharmacy storage space/automated dispensing equipment at all procedural and ambulatory surgery centers affiliated with the main hospital.
Methods: We began to focus our efforts on newly acquired ambulatory surgery centers. A number of private practice groups were acquired over the course of several years that had ambulatory surgery centers attached. Pharmacy was brought to the table early in private practice acquisition practice to advise and make recommendations on the medication handling process. Based on the review of the types of practices that were being acquired by the Cleveland Clinic pharmacy was able to make recommendations for the quality measures that needed to be implemented with the types of medications used. These may include adding a pharmacy technician to support the practice and purchasing automated dispensing cabinets and medication quality audits. A second approach of this project was to address existing surgery centers in which pharmacy was supporting these practices through drug transfers from the main hospital. Various presentations to key stakeholders over these practices through Nursing and Physician leadership occurred to show the value of pharmacy on site in ambulatory surgery centers.
Results: Pharmacy was able to request for additional pharmacy technicians in 7 ambulatory center locations over the course of 3 years as a result of pharmacy’s methodology to having pharmacy supporting all ambulatory surgery centers. Additional automated dispensing cabinets were approved to bring to these new and existing procedural areas(s) so that every procedure room had the appropriate medication storage equipment. Drug wholesale accounts were setup for each surgery center location for next day local delivery of all medications that are stocked on site. After this initiative every off site ambulatory surgery center had a pharmacy technician either full time or part-time responsible for medications at the site bringing the total number of sites supported to 12.
Conclusion: Adding pharmacy support to an ambulatory surgery center has proved to be such a great strategy that it has now become the standard of practice for all new offsite procedural area projects. Some of the real value was also shown during a national opioid shortage in 2018 in which every ambulatory surgery center was able to eliminate the reliance on opioid procurement from the main hospital which was the old standard to better allow the hospital to maintain sufficient supplies for its patients. Having a pharmacy technician and automated dispensing cabinets in every ambulatory surgery center has freed up nursing.