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Pharmacy Quality Initiatives

Our certified, registered, and highly trained pharmacy technicians support our pharmacists, allowing the pharmacy department to provide valuable services to the hospital and focus on patient care. Our technicians
are trained to participate in several advanced services:

  • Decentralized Service - This technician team provides deliveries, responds to missing drug inquiries, inspects nursing units and medication rooms daily, and tracks the use and quantity of non-formulary medications and patient's medications brought into the hospital.
  • Medication Reconciliation - This team collects and documents medication histories for emergency department admissions, as part of the medication reconciliation process. They conduct patient interviews and call doctors offices, nursing homes, and community pharmacies to obtain complete and accurate information.
  • Anticoagulation Program - Under the direction of the program's Medical Director, selected patients on anticoagulant medications are seen in clinic by pharmacists who adjust their dose based on lab results. Pharmacists also review of critical medication information about these agents with each patient.
  • Antimicrobial Stewardship - These technicians conduct a preliminary screen of laboratory reports and medication profiles for bug-drug mismatches.

The Rex Pharmacy staff has worked to create standards to improve the quality of care all patients receive. Here are some of the programs currently in action:

  • Drug Delivery Turn Around Times - Rex inpatient pharmacy exceeds benchmark for delivery times, providing medications to patients in less than the average time compared to other hospitals surveyed.
  • Medication Room Discharged Patient Medication Audits - Goal of all discharged patients' medications removed from the medication room as quickly as possible to prevent potential medication errors.
  • Medication Security Audits - Medication storage rooms in patient care areas are inspected on average of every 48 hours to assure medications stored securely.
  • Free Text Allergy - Pharmacists concurrently correcting allergies that are entered as free-text by the nurse. Selecting from a drop-down box allows automated cross-checking of medications against the patient's allergy. The database then notifies physicians and pharmacists in the event a medication is ordered to which the patient is allergic. This provides an enhanced layer of safety for the patient.
  • Chemotherapy Preadmission Process - working with Rex Hematology Oncology and CCNC offices to improve pre-admission ordering of chemotherapy. The goal is to streamline the drug dispensing process and reduce wait time for the patient. Goal is to receive orders in advance for 100% of planned admissions.
  • Missing Dose Requests - Pharmacy evaluated the number and type of missing dose requests from nursing co-workers to the pharmacy. New processes were implemented to better communicate the status of a missing medication dose to the requesting nurse.
  • Patient Education - Pharmacists provide individualized patient education on several high risk medications, including warfarin, enoxaparin, sotalol. This helps the patient better understand the reason for the medication and adverse effects that may be associated with the use of the medication.
  • Antimicrobial Stewardship Recommendation Acceptance Rate - This program was started in order to best utilize antimicrobial agents by reducing adverse effects from the drug to individual patients, and to decrease antimicrobial resistance within the hospital.
  • Out-Date Inspection Completeness and Accuracy - Pharmacy technicians inspect all medication storage areas on a monthly basis to pull short-dated medications before their expiration date.
  • IV to PO conversion project. The goal of this initiative is to switch patients from the intravenous to the oral form of medications to reduce the risk if IV adverse reactions and to reduce cost.

Rex Department of Pharmacy Services was recognized by UNC School of Pharmacy as the Wake Area Health Education Center (AHEC) Preceptor Site of the Year in 2008, 2009, and 2010.