Medication Safety Challenges in aGreenfield HospitalRabih Dabliz, PharmD, FISMPManager, Quality & Medication Safety ServicesCleveland Clinic Abu Dhabi

International Medication Safety ConferenceOctober 1st 2015

“We cannot change the human condition, but we can change the conditions under which humans work.”

– James Reason

Cleveland Clinic Abu DhabiQuick Facts

A Medical Campus

Acute Care288 Beds

Critical Care72 Beds

Conference Center

Diagnostic & Treatment26 Operating RoomsSwing Wing

Office Space; Supports Bed

Expansion

Ambulatory Clinic242 Exam Rooms

GalleryPublic Spaces

CCAD Physicians

73%Institute Chiefs

with CCF experience

24%Physicians with CCF experience

76%Physicians hold Academic ranks

175Physicians

9,000+Physician Applicants

69%Physicians USA

Trained or Board Certified

CCAD Nursing and Allied Health

13Critical Care and Acute

Inpatient Unit Floors

5,000+ Applicants interviewed

1,000+Nurses & Allied Health

Professionals

10Countries visited for

Recruitment

52%Western Trained

37Nationalities

24Clinical Caregivers with CCF

experience

12 Institutes 30+ Specialties 50+ Subspecialties

• Emergency Medicine

• Critical Transport

• Infectious Disease

• Allergy &

Immunology

• Dermatology

• Rheumatology

• Psychiatry

Heart & Vascular Institute

• Neurosurgery

• Neurology

• Neurorehabilitation

Digestive Disease Institute

Neurological Institute

• Pulmonology

• Critical Care

Medicine

• Colorectal Surgery

• Gastroenterology

• General Surgery

• Cardiac Surgery

• Thoracic Surgery

• Vascular Surgery

• Vascular Medicine

• Cardiology

• Ophthalmology • Dentistry

• Otolaryngology

• Plastic Surgery

• Urology

• Gynecology

• Endocrinology

• Hematology

• Hospitalist Medicine

• General Internal

Medicine

• Nephrology

• Anesthesia

• Pain Management

• Pathology

Surgical Subspecialties

Institute

Respiratory & Critical Care

Institute

Eye Institute

Pathology & Laboratory Medicine

Institute

Anesthesiology Institute

Emergency Medicine Institute

Medical Subspecialties Institute

Quality & Patient Safety Institute

• Radiology

• Interventional

Imaging Institute

Department of Medical Informatics

Excluding: Pediatrics (pediatric ophthalmology offered) • Obstetrics & Maternity • Trauma •  Orthopedics

Medication Management at a Glance

Medication Safety & Risk MitigationOur Strategies at a Glance

10

Hierarchy of Risk Reduction Strategies

10

High

• Constraints• Forcing functions• Technology

Medium

• Standardization• Redundancies• Checklists

Low

• Policies and procedures• Education• Vigilance

Barcoded Medication Scanning

It’s a Patient Right!!!!Used throughout different applications & processes

Embedded with:Green Rain Code

Expiration Date/Lot Number

Useful for tracking:Recalls

Medboard™

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RECALL

CCAD PHARMACY

Smart Infusion Pumps

Updated wirelessly

One central Adult library initially + one Pediatric

Bi-weekly updates

Additional libraries

Heart & Vascular Institute

ICU/OR/ED/Royal

Ambulatory

Neurology

Med/Surg

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Smart Infusion Pumps

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START infusion IF:Concentration, Rate & Weight match between:- MAR- IV bag label- Pump- Calculator

EVERYTHING MUST MATCH!

Limited Patient Workspaces

RN Dual Sign-off for High-Alerts

Caregiver Information Rights

16

Standardized Concentrations/Information

Standardized/Centralized Information

Standardized/Centralized Information

Simplification of Vaccine Ordering

20

• DTaP allowed when selecting the medication for ordering• Full name spelled out in the actual order• The “+” symbol added for all combination products • Standardized sequence in name for DTaP:

• DTaP then H. Influenza then Hepatitis B then Polio

DTaP/DTwP Combination Products

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DTaP/DTwP Combination Products

22

Standardized/Centralized Information

23

Standardized Labels

24

Easily identifies the DAY to change it

Standardized Labels

25

Included reminder to use DD/MM

Standardized Patient Label

26

Integration of High-Alert logo

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In Progress

Focus on Visuals & DesignSimplification is key!

Pump Screenshot on MAR

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