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P52 - Challenges and Triumphs - BCMA and Navigating Surgical Patient Care Center Variants in Implementation

Just an ordinary medical center in an extraordinary world, striving to standardize medication administration across the ambulatory care enterprise - including complex surgical and wound care clinics. This presentation will discuss the process used to successfully implement barcode edmedication administration (BCMA) in the surgical ambulatory patient care centers of an academic medical center despite challenges presented by the global pandemic, decreased staffing the global pandemic, increased clinic volumes, and multiple medication administration variants identified for this unique patient populationin the surgery patient care center (PCC) at Vanderbilt. This discussion will include strategies utilized to address for hardware and workflow challenges that led to a successful implementation that reduced clicks by 31% for nurses. These areas presented with medication and workflow variations not seen in previous BCMA clinic implementations. Little data exists in the literature regarding ambulatory BCMA best practices and none specially for surgical clinics. Very few organizations have ambulatory care BCMA to serve as benchmarks and to reference. The interdisciplinary teams (analysts, pharmacists, and nursing informaticist) partnership with operational leaders was crucial to innovating a solution. This presentation will explore how existing BCMA practices and vendor processes such as therapy plans were pivoted to fit the wound care area workflows. Special challenges (medication ranges, multidose vials, compounded medications prepackaged from companies without bar codes, mixed syringes, topical medications, billing and compliance issues, recurrent ordering practices) were addressed.

Discussion will include six-month post implementation return on investment metrics that will be discussed include scan rates, leveraging 340 B pricing, provider order entry accommodations, linking of therapy to wound and healing process, nurse satisfaction, compliance, and increased reimbursement.

Problems and barriers encountered will be shared to provide guidance on how to optimally design and transition to a new model of nursing informatics support. Improvements made and lessons learned will be explored and participants will be given an opportunity to share their thoughts and ideas.

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