Medication Dispensing Errors – Policies & Procedures – Pharmacy Consulting

Medication Dispensing Errors – Policies & Procedures:

Medication dispensing errors are a Pharmacy “fact of life” and we all deal with them. Having Policies and Procedures in place to assure that your Pharmacy adheres to current best practices is a must. This pertains to both preventing medication dispensing errors, as well as dealing with the documentation and reporting of errors that do occur.

A study performed over a 7 month period at a major hospital revealed the following regarding medication dispensing errors:

-A total of 140,755 drug dosages were prepared by Pharmacy technicians and 3.6% contained an error.
– 0.75% of the medications prepared left the Pharmacy with an error after verified by the Hospital Pharmacist. The Pharmacist “caught” only 79% of the medication errors using the hospital’s “routine verification” procedures.
– 23.5% of the medication errors that left the Pharmacy undetected could have resulted in an adverse effect if given to the patient. Of these, 28% were considered “serious” and 0.8% were classified as “life threatening”.
– The results of the study then revealed that the dispensing errors were:
Incorrect Medication: 36%
Incorrect Dosage or Strength: 35%
Incorrect Dosage Form: 21%

Many medical professionals found these numbers to be “scary” and “unacceptable”. It was noted that had the Hospital Pharmacy instituted up to date policies and procedures with better documentation, that a majority of the medication dispensing errors would have been “easily avoided”. This study directly ties in to the latest data released recently by The Institute for Safe Medication Practices (ISMP). ISMP diligently works to identify major medication safety issues, plus promoting the sharing of procedures and strategies that would lead to a reduction & prevention of medication dispensing errors in order to protect patients and consumers.

At ASHP Midyear, ISMP revealed the classes of drugs most frequently documented for errors and suggested that safety strategies were the key factor that we all must develop and adhere to going forward.

Darryl S. Rich, PharmD, MBA, FASHP, medication safety specialist for ISMP, presented the top 5 high-alert medication classes based on data from 2016. Opioids, antithrombotics, and insulins topped the list, followed by antipsychotics and antibiotics. Rich noted that data pegged wrong dosage as the top reason for adverse events in most cases, except in the use of antibiotics, for which wrong drug was the top reason.

The point is that it is now critical that all Pharmacies develop Policies and Procedures that both minimize the occurrence and potential for medication dispensing errors, plus have a plan in place to deal with the errors that inevitably will occur. This is being called “the Age of Documentation” by many and everyone must show that they have “best practices” in place, PLUS follow these “best practices” to the best of the their ability. Without doing this crucial documentation, not only will the occurrence of medication dispensing errors increase, but liability will exponentially increase as well.

We at HCC strongly advise that you develop Policies and Procedures that ensure “best practices” are implemented at your Pharmacy operation immediately. In addition, document and report all medication dispensing errors that occur (and we all know that they will). Another instance of the old cliche that “an ounce of prevention is worth a pound of cure” that we here at HCC have been advising our clients to adhere to for over 27 years now.

As always, please contact us here at HCC if you have any questions regarding development of policies and procedures related to medication dispensing errors. If you already have them in place, perhaps a review by an objective (and experienced) third party is a good idea? With over 27 years in the Pharmacy Consulting business, HCC can assist with expert advice in any area of your pharmacy business or practice. We urge you to contact us today to see how our Pharmacy Consulting services can help. With a full-time staff of in-house Pharmacy Consultant specialists, HCC can answer any questions that you may have in all Pharmacy settings. Contact us online or call us today at 800-642-1652 for a free consultation.


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Independent Pharmacy Home Delivery Services On the Rise

Independent Pharmacy Home Delivery Services On the Rise:

A local independent Pharmacy displays a large new sign: “Need your prescriptions delivered to your home or office? Delivery service available at no additional charge (with a guarantee!)”. Made me reminisce about growing up in an era when Doctors actually made house-calls. We here at HCC Pharmacy Consulting constantly tell our clients that offering new services to patients and customers is the key to both retention of your existing client base, as well as growing your business by attracting new revenue streams. Pharmacy home delivery services on a local level seems to be a viable and economic service to accomplish both goals.

So I decided to research this trend and can share with you what I found:
1. Although no dependable studies were found to cite actual numbers, our best on-line resource (Wikipedia) estimates that currently about 10% of independent Pharmacies are offering this service. Plus this number has steadily been growing on a national level for over 6 straight years. The largest growth has been occurring in rural and less densely populated areas. The smallest growth seen is in large cities and metropolitan areas throughout the USA.
2. Independent Pharmacies were on average seeing an increase in total revenues of roughly 6 to 8% after about 3 to 4 months from initiating a Pharmacy Home Delivery service. An interesting side note on this is that the 6 – 8% sales volume increase was NOT attributed to an increased prescription volume, but to an increase in OTC medications and “ancillary” items requested by customers to be delivered along with their prescription medications! In fact in certain areas it was noted that patients requested Home Delivery of goods and items from a Pharmacy even though their “order” actually did not contain a single prescription at all.
3. A consumer survey that was conducted by the nationally renowned firm JD Powers on the subject revealed  three very interesting facts:
– By far the largest “payoff” after initiating a Pharmacy Home Delivery Service was attributed to patient/customer/client retention! The common feedback centered around the fact that patients that utilized local Independent Pharmacies were more interested in service than in price. Several patients made statements that reflected the following theme according to JD Powers in its final report: “Patients are a name, even family, at these pharmacies—not a number”. Aren’t these the type of customers that everyone wants to attract to their Pharmacy businesses?
– Most patients interviewed by JD Powers who have their prescriptions delivered stated that they were more likely to use them better as directed by their doctors. In  other words, patients were saying that they were actually more compliant in regards to taking their medications as prescribed, thus leading to better management of chronic conditions. It has been proven via numerous studies over the years that patient compliance is the number one reason that prescription medications don’t work as they should. An increase in prescription compliance by patients would benefit everyone (including the insurance companies who have been spending billions on patient education to improve patient compliance). The end results would of course, be both an increase in patients’ health and improved profitability for both the manufacturers and the Pharmacies.

Take a moment to review an excellent example of the non-compliance problem supplied to HCC by the American Heart Association. Their estimates are that failing to take medications as prescribed leads to 125,000 patient deaths and costs $300 billion annually in additional emergency room trips, doctors’ office visits and hospitalizations.
4. Consumers stated that Pharmacy Home Delivery has led to increased consulting with their Pharmacy/Pharmacist regarding drug usage and prescription information, Either too busy to take the time at the Drug Store when picking up their medications, embarrassment regarding their questions at the time of pickup, or simply that the “Pharmacist looked to busy to interrupt with questions”  do not “come into play” with Pharmacy Home Delivery services. The patient is more likely to feel comfortable in their own home, not need to worry about other customers being present, plus have given JD Powers feedback that the employee making the delivery can concentrate on them as a specific individual (and not as just another person to get in & out of the store as quickly as possible.

Now we all know that  Pharmacy Home Delivery is really not anything new, but has been a service primarily utilized by the major Pharmacy Mail Order Houses and  several of the large Pharmacy Chains for well over a decade or more. What has kept many patients & consumers from utilizing Pharmacy Home Delivery Services at all (and prevented customers from using them more frequently) was also revealed by the JD Powers survey. In our next Blog post, HCC will share these with you. Plus we will discuss both how to overcome these challenges AND plan, execute and maintain a “First Class” Pharmacy Home Delivery Service for your patients and Pharmacy business!

As we tell everyone who will listen, Healthcare Consulting is a nationally renowned full service Pharmacy staffing and consulting firm that has been in business for over 27 years. Owned, managed and staffed by full-time in-house Pharmacists, HCC offers a full range of Pharmacy Consulting Services that other firms simply cannot offer. Contact us on line or call us today for a Free Consultation at 800-642-1652 to discuss how we can help you.


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