UNC Healthcare operates a shared service center (SSC) in Durham, NC. As part of a larger goal to move high volume, non-clinical activities from the individual hospitals to the SSC, UNC identified pharmacy kit replenishment as a prime candidate for standardization and centralization.

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The Challenge

The tedious, manual tray replenishment process took pharmacy staff away from important clinically oriented tasks, in addition to having significant safety and operational implications across the system. Dr. Kriss Petrovskis, Clinical Manager for Pharmacy Supply Management, was a key player in the effort to implement Kit Check for standardizing and centralizing emergency kit restocking.

(Two hospitals in the UNC system were already successfully using Kit Check, which helped Dr. Petrovskis determine that this would be a useful solution for implementing a central processing model.)

“Because of the hub-and-spoke model of the shared services center,” said Dr. Petrovskis, “we saw an opportunity to both standardize the emergency kits and centralize the processing, reducing the need to manipulate and process trays at the local level.”

Key Advantages

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Moving to a centralized model presented several key advantages for UNC Healthcare, including allowing local staff to focus more on the clinical tasks they were trained for, optimizing inventory for to help weather shortages, reducing drug waste and spend due to expiration, and freeing up space in the pharmacy.

Analysis and Implementation

Dr. Petrovskis started the process by looking at UNC Healthcare’s emergency tray data as a whole. The participating hospitals each had different trays, so the analysis involved looking at all of the contents of every tray across all facilities. A clinical pharmacy working group comprising representatives from each hospital was formed to coordinate this effort. In addition to agreeing on par levels and tray layout, the group also needed to standardize within specific medications. For example, dopamine bags come in 3-4 concentration varieties, so the hospitals needed to reach agreement for a single bag size.

Analyzing all of this data was not a trivial undertaking—in fact, it took six months of discussion, input, and review to come to a final consensus.

“Because of the hub-and-spoke model of the shared services center, we saw an opportunity to both standardize the emergency kits and centralize the processing, reducing the need to manipulate and process trays at the local level.”Dr. Kriss Petrovskis, Clinical Manager for Pharmacy Supply Management

Compounding the already challenging nature of this undertaking were industry-wide drug shortages, which had an impact on what was available to be stocked in trays. Also, because of the challenges inherent in updating code trays, there was significant input during the decision process from the local level, which then rolled up to the system level.

Once the new tray layout and medication levels had been agreed upon by the clinical pharmacy working group, the updated structure was rolled out at the local hospitals.

The Results

The combination of centralizing and implementing Kit Check for tray replenishment benefits everyone involved. “We can make sure everyone is doing it the same way, every day, every time,” said Dr. Petrovskis. “This gives us peace of mind, both in the hospitals and across the entire system.”

Ultimately, seven hospitals opted to make the change to updating their crash cart trays and automating replenishment with Kit Check, with the others expected to implement within the year. The overall response has been positive—in fact, those who are still waiting to implement keep asking Dr. Petrovskis, “When are we getting Kit Check?”