Meds to Beds: Improving the patient experience
Al Jalila Children’s is the first dedicated children’s hospital in the United Arab Emirates. The-state-of-the-art medical facility was created under the directives of His Highness Sheikh Mohammed bin Rashid Al Maktoum, vice president and prime minister of the UAE, and ruler of Dubai, to affirm his belief that all children should have an equal opportunity for success in life, and the treatment of children suffering from illness or disease should not be subject to geographical chance. In 2016, the hospital made a strategic partnership with Cerner Middle East to manage its IT services and implement world-class electronic health record (EHR) system, Cerner Millennium®.
The challenge
The inpatient discharge process was lengthy in the hospital. Patients and their families had to wait a long time to leave the hospital after the discharge decision has been made, which was affecting overall patient satisfaction. Further to this, pharmacists were not able to provide adequate medication education and instructions to patients’ families prior to discharge.
The average inpatient discharge waiting time was three hours and 17 minutes. Al Jalila Children’s management wanted to improve patient experience by reducing the waiting time.
The solution
Al Jalila Children’s launched the ‘Meds to Bed’ program aimed at improving the discharge medication delivery process and enhancing the patient experience. Meds to Bed is a service wherein discharge prescriptions are delivered to the patient’s bedside before discharge. This service ensures that the patient has access to their prescriptions when they return home, resolves payment-related issues before discharge, improves medication adherence, has the potential to reduce readmissions, and prevents patients from waiting at the outpatient pharmacy after discharge. This very personal service allows patients and their parents to receive counseling from pharmacists in the comfort of their hospital room.
The Cerner EHR workflow for the discharge medication dispensing process has been optimized to make the process efficient and reduce unnecessary delays. The billing workflow has been optimized for cashiers to easily identify which drugs have been dispensed and generate the invoice. The process and workflow have been redesigned to allow pharmacists and cashiers to be notified of upcoming patient discharges in advance to prepare for patient discharge, dispense discharge medications and complete financial settlements prior to patient departure. In addition to this, patient education documentation has been incorporated into clinical pharmacist workflow.
“Meds to Bed decreases delays for parents/caregivers waiting for discharge medications. It decreases customer dissatisfaction and increases medication safety as discharge prescriptions were not always correct. It takes nursing out of the workflow and ensures a medication safety program that targets children as they transition from our hospital to their homes safely.
The program has potential to increase compliance and adherence to medications, decrease hospital readmissions to ED and increase customer satisfaction.”- Amanda O’Neil, nurse manager, subspecialty wards, Al Jalila Children’s Specialty Hospital
Post-implementation
The solution improved efficiency of the discharge medication dispensing process by reducing its waiting time by 63 percent on average. The time from discharge order to pharmacists completing verification has reduced by 71 percent. The incidents reported by patients related to pharmacy delays declined to zero. In addition, the EHR optimization also allowed clinical pharmacists to access patient records, review their clinical condition, provide patient education and document them.
