In 2014, Weirton Medical Center implemented an electronic administration record system where nurses began charting patient information from computers on mobile carts. The 238-bed, non-profit, acute-care, general community hospital is located in the city of Weirton in Brooke County, W. Va. Weirton Medical Center offers health care services to the residents of West Virginia, Ohio and Pennsylvania.

As the facility’s new EHR system was implemented, nurses faced unexpected challenges when administering medications from their mobile medication carts. Management at the medical center quickly realized they needed to improve workflow efficiency between the pharmacy and nurses on the floor. The nursing staff also expressed a need for a more time-efficient medication distribution process so they could spend more time with their patients at the point of care.

Challenge
At the time of the transition, Weirton Medical Center’s pharmacy staff was distributing medications to mobile carts on each floor, conducting cart exchanges almost every day of the week. In addition, mobile carts were being deployed to transport computers so nurses could input patient information electronically. The medication carts were often in use and not in a central location so the pharmacy staff would have to search for them—creating inefficiencies in the medication distribution process. Conversely, when carts were located at a central drop off point, nurses had to travel to that drop off point—resulting in time away from their patients. Furthermore, multiple nurses often were assigned to one cart, slowing down the medication distribution process even further.

In addition to creating inefficiencies in transporting medications from the pharmacy to the patient, the use of mobile carts caused clutter in the hallways. The medication carts also had to be charged and frequently remained far from the point-of-patient care when needed.

Other issues that arose from the use of mobile carts were that drawers were noisy and caused commotion, which impacted patient comfort. Plus, the mobile carts caused security issues. The drawers often did not self-lock so nurses had to manually lock them when they walked away from the cart—even for an instant. This reduced the reaction time of the nursing staff when addressing patient needs.

In response to these challenges, Weirton Medical Center researched the feasibility of using wall cabinets to hold medications, pill crushers, syringes, and other items that needed to be stored safely.

Solution
Weirton Medical Center made the decision to store patient medications in wall-mounted workstations placed outside patient rooms rather than transport them on the mobile carts and adjust its workflows accordingly.

In the new process, the pharmacy staff delivers medications directly to each patient workstation so the appropriate medications are just steps from the patient. Initially, the pharmacy department was concerned that it would take more time to deliver to multiple locations but in fact, the process has quickened delivery.

“Delivering medications to wall-mounted workstations at each patient room actually saves time for the pharmacy and allows for less interruption in face-to-face patient care.” Robert Coram, Director of Pharmacy.

Workflow efficiency for nurses has improved, as well, because essential items are now kept near the patient’s bedside. Approximately 90% of medication needed for each patient is held in the wall-mounted workstation. Nurses can easily access the medication and quickly scan it into the computer all in one step. Plus, nurses have begun stocking each wall-mounted workstation with supplies such as pill crushers, pill splitters, flushes, IV starter kits, alcohol, and other items that are needed to administer medications. Nurses say they are more organized with daily essentials housed in one convenient location. Since medication is administered with fewer steps, less time is spent traveling back and forth to the carts and in turn more time is spent at the point-of-patient care.

“The use of wall-mounted workstations for medication dispensing has put care back at the bedside, allowing our nurses to spend more time with their patients while remaining EHR compliant.”  Susan Redish, RN.

With one wall-mounted workstation per patient compared to medication for multiple patients stored in one mobile cart, accurate medication distribution has improved. There is less room for human error by mixing up patient information or medications.

Security has improved as well. One of the major benefits of the wall-mounted workstations is the keypad lock system that allows nurses to access the cabinet with a keypad rather than keys. This not only provides enhanced security but also reduces noise, which makes for a more positive patient experience. The cabinets are self-closing and self-locking so no one has to remember to close and lock the cabinet, even if called away quickly. Plus, the smooth, quiet operation causes fewer disturbances for patients inside the rooms.

The overall work environment on each floor at Weirton Medical Center has been transformed. Hallways are less cluttered, making patient and personnel travel easier. Plus, the workstations coordinate seamlessly with the hospital’s décor.

Summary
With the use of wall-mounted workstations for medication dispensing, workflow efficiency at Weirton Medical Center has improved for both the pharmacy and nursing staff. Turnaround time to transport medication from the pharmacy to the patient has shortened. Medication distribution is more transparent. Risk of loss and mismanagement of medications is reduced. And nurses can spend more time with their patients at the point of care.

About Us
Susan Redish is an RN and Robert Coram is Director of Pharmacy at Weirton Medical Center. The medical center offers a comprehensive array of services including emergency care, acute medical/surgical care, critical care, cardiology, general surgery, orthopedics, obstetrics/gynecology, pediatrics, plastic and reconstructive surgery, skilled care, and geriatric behavioral medicine. It also offers a variety of ancillary services such as laboratory and radiology testing, pharmacy, physical rehabilitation, respiratory therapy, dialysis, home health, pain management, sleep testing, and wound treatment. Contact: (304) 797-6000 or www.WeirtonMedical.com

John Pierson is the senior director of sales and marketing at Carstens, Inc. in Chicago, Ill.  Founded more than 125 years ago, Carstens pioneered putting patient information and medication dispensing at the point of care with customized records systems and workstations. As the healthcare industry evolves, Carstens continues to expand its line of EHR support products, offering innovative solutions for paper based record keeping as well as the integration of electronic solutions at point-of-patient care. All made in the USA, Carstens’ products are designed to enhance communication and increase interaction between clinicians and patients at the point of care. Contact: (800) 782-1524 or www.Carstens.com