Tuesday, 30 September 2008

Unit Dose Roll-Out Part III

Another key element to our success: Bring candy to nurses. Not only do you make nurses happy because they get candy, but you're also showing that you understand their culture and are at least a little bit willing to move yourself closer to it.

Just make sure you don't buy only "granny candy". As project managers and senior nurse educators, we tend to be closer to the end of our career than to the beginning. Don't forget that a significant number of nurses nowadays carry iPhones and have a huge number of friends on Facebook.

Sunday, 28 September 2008

Unit Dose Roll-Out Part II

The machines we're using to package the medications are the FastPak EXP from Automed (AmerisourceBergen). They have an awesome pre-installation support team. The front-end sales people were so-so -- your mileage will vary, of course, depending on the region. The sales team was Western Canada; the pre-installation support is for all of Canada.

The machines themselves have a number of quirks. Nothing that can't be worked around, but don't believe that you won't have to make any decisions yourself. Also, since we're running three machines, we've written our own little database scripts to keep the data in the machines synchronized. There's no way you should try to do it by hand, although I suspect that's what most people do because the vendor doesn't have anything to help.

The main competition to Automed are the Pacmed machines from McKesson. There are some differences between the two that will require a change to your extract or interface from whatever Pharmacy Information System you're using. Nothing big, but in software even a small thing can cost a lot of money. It's worth looking into the interface in detail if you're looking at switching from Pacmed or running both in parallel.

Because we're packaging all regularly scheduled oral solids (with some exceptions) we've found that our Pharmacy Information System wasn't really set up to handle some of the scenarios. Our distribution model seems to be different from the typical hospital pharmacy, but I don't have enough experience with hospital pharmacies to say if these challenges would generalize to other installations.

Saturday, 20 September 2008

Successful Unit Dose Roll-Out Part I

We've begun to roll out a just-in-time unit dose medication distribution system at GF Strong, UBC and Vancouver General Hospitals. Just-in-time unit dose medication distribution increases patient safety by making it easier for nurses to do what they always do: provide quality care, including medications.

Nurses are loving the new approach. "You just saved me ten minutes", "I really like it", and a big two thumbs up are some of the comments I've heard as I provide go-live support on a pair of medical nursing units.

I'd say there are two major reasons why it's going so well: First, the system is intrinsically good for nurses. Nurses are over-worked, under-paid, and totally committed to their patients. Anything that improves patient safety while making their job easier is going to be a hit.

The second reason is the excellent communication and training by our team of nurse educators. We have to train about 3,000 nurses. We started four weeks before the first units went live, and will continue up to the last go-live week in December. With four nurse educators giving a half-hour session, we're reaching 100 percent of the nurses on most nursing units, and well over 80 percent on the rest.

On any future front-line health care projects I may do, I'm going to insist on the budget to adequately listen to and train the front-line health care providers. This has been so key.

I've been the project manager on this project for just over a year. It's been a complicated, multi-faceted project with a lot of challenges. It's totally satisfying to see a successful start to the roll-out. We're phasing in nursing units for the next three months, so I'm sure there'll be some challenges along the way, but it's clear that we've got a winner.

Stay tuned for future posts about why this project is so successful, and what the challenges have been.

Tuesday, 2 September 2008


According to this, in a test of browsers against media intensive sites, Microsoft Internet Explorer 8 takes more memory than Windows XP does (did). Bill (or Steve or whoever): That's not what's meant by the phrase, "the browser is the operating system."