Q&A: How UMC of Southern Nevada saved $750K in drug waste
Harvey Riceberg, inpatient pharmacy supervisor at the University Medical Center of Southern Nevada tells Healthcare Finance News Editor René Letourneau how the organization saved $750,000 in drug waste costs by implementing a new technology into their drug administering process.
Q: How did UMCSN achieve such large savings in a one-year period?
A: When we drilled down to it, drug waste and duplicate inventory were creating a significant expense for UMC. We also faced a challenge for intravenously administered drugs in the technology we used for reconstituting and delivering drug doses – the vial adapters we were using were not compatible with all the types of IV bags the hospital relied on for patient care. As a result of this incompatibility, we had to order a greater number of IV bags to ensure that UMC had enough duplicate inventory on hand.
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To address this incompatibility challenge, we looked for a technological solution and have had success through a needleless vial adapter system that is compatible with drug vials and IV bags from any manufacturer, including those available through automated dispensing devices located on critical care floors.
We can attribute a significant amount of our $750,000 savings to this change in technology. Now, once a prescription order is in the system, clinicians can go to one of the automated dispensing systems on the floor to retrieve the dose needed for the patient, rather than wait for the hospital pharmacy to fulfill and deliver the order. Our clinicians are then able to administer the drug dose to the patient immediately.
Since clinicians are able to obtain these drug doses immediately before administration, the risk of a dose going unused is slim. With fewer unused drug doses and less wasted drug product, pharmacy technicians are preparing and delivering far fewer replacement doses. This time savings meant fewer technicians were needed in the IV room, which resulted in substantial cost savings to the hospital.
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Q: Can you explain the basic principles of the technology used to reconstitute drugs at the bedside?
A: When considering the technological options in the healthcare market today, it’s important to understand what your organization needs, and where the cost challenges come from. For UMC, we decided on a technology called Vial2Bag from West Pharmaceutical Services, which is a needleless vial adapter system with universal connectivity. Since the Vial2Bag connected to standard IV bags through the IV set port, allowing it to be used with all manufacturers’ IV bags, clinicians can reconstitute powdered or lyophilized drugs directly into IV bags at the patient’s bedside.
The clinician connects a drug vial to the Vial2Bag system with a standard vial adapter, and the diluent is transferred from the IV bag to the vial for reconstitution. The reconstituted drug is then transferred from the vial back to the bag. In applications where multiple drug additions are needed, the attached drug vial can be removed from the IV solution bag to allow access to the integrated needle-free valve injection port. Standard syringes can also be connected to this system.
Q: What is the biggest pharmacy supply chain challenge you are currently facing?
A: A significant supply chain challenge we are facing is shortages of crucial drug products. When facing a drug shortage, the pharmacy clinicians must allocate additional time and resources towards selecting an alternative treatment and ensuring this information is accurately communicated to other healthcare professionals. In addition, pharmacy managers must accommodate for extra expenses incurred from alternative medications, which can be more expensive.
Q: What is your best advice for supply chain managers at other hospitals?
A: Making a change in technology can be a significant investment of time and energy. Be sure to consider all the options available to find a drug delivery solution that meets the specific needs of your healthcare facility, while optimizing cost and reducing waste and duplicate inventory. Also, ensure that clinicians are able to adequately adapt to changes in drug delivery by providing them with training and educational materials that share guidance and demonstrate proper use of the new delivery solution.
Most importantly, be thorough in understanding the regulations of our industry. In order to maintain compliance with safety standards established for preparing and delivering drug products, it is vital that pharmacy managers review USP guidelines to make sure clinicians are in compliance with drug delivery safety standards while continuing to provide a high level of care.
