Each participating provider took a slightly different approach to choosing and utilizing a medication management system, and shared the factors that led to their success. Below is a summary of lessons learned and advice from the most recent as well as previous CAST medication management case studies:

Planning and Implementation
 

• Introducing technology into processes that have been historically paper-based requires a significant culture change for many care providers.  Creating a supportive and safe technology-embracing culture throughout the workforce helps achieve a smooth and successful transition to any new technology implemented.

• The ability to access medication records, analytics, and reports from anywhere, at any time, presents LTPAC providers and their management with unprecedented insight into care operations and opportunities to improve care quality and efficiencies.

• A team-based approach to implementation of medication management technology, auditing and ongoing feedback with education leads to a high level of staff satisfaction. Down the road, the team can develop into a true support system to discuss what’s happening with the technology, why and brainstorm the best approach to success. 

• An implementation team should be comprised of representatives from all functional areas of the organization involved in medication management in one way or another so that hand-offs, transitions and processes that cross departmental functions can work more effectively together. 

• The adoption of new technology requires the effort to review existing policies, procedures, and workflow practices to identify where current policies and practices require modification. In addition, a careful review of existing policies and practices is required to identify gaps in these areas for the development of new practices related to the adoption of a new system like EMAR.

• A new workflow that takes advantage of electronic medication management technology is a key foundational element of implementation that would help providers attain and maintain an excellent level of care.

• Creating eMAR templates that the nurses were already comfortable with can help with pre-populating fields, speeding up the process, and ease the transition to an electronic system.

• Having a schedule in place and timelines for the implementation process can help the team manage issues around time management and resource commitment.

• During planning and implementation, providers should make sure to take advantage of advanced functionalities in their medication management system such as alerts, reminders and clinical decision support, to ensure best practices, continuous quality improvement, and deliver the highest quality care.

• Having a team member as the point person for the project is highly recommended.  This person should have a thorough working knowledge of your systems software and have a clinical foundation.  A strong clinical leader is also necessary to coordinate and provide training and guide table and form building.

• Communication is vital to the success of any technology implementation project.  There are many stakeholders– residents, nurses, physicians, the pharmacy, medical records, etc. – and appropriate communication as needed will keep the project running smoothly. 

• Order sets are invaluable to the success of a CPOE implementation. This can be accomplished by taking the vast First Databank (FDB) database, simplifying it and delivering its care quality standards and protocols from within the solution.

• Management should re-distribute workloads as needed, and ensure best practices are being followed by all staff, especially for specific drugs associated with increased risks.

• When starting the roll-out of any electronic medication system, providers should allot sufficient time to ensure things are done correctly. Audits must be conducted as part of the implementation and ongoing use to assure compliance and allow benchmarking.

• Encourage adoption by key stakeholders and empower staff to fully adopt and utilize the system.

• Medication adherence technologies can increase a patient’s awareness of the importance of their medications, improves patient engagement with their overall health care and enables self-management, which in-turn lead to improve their outcomes.

• Clinicians should be encouraged to drive the process (rather than having EHR adoption be driven by the IT department); this emphasizes that clinical buy-in is crucial to the success of any e-Prescribing initiative.

Training
 

• Educating the staff is not a one-time exercise. Start educating early and continue throughout and beyond go-live with education and ongoing communications. 

• Create champions and internal experts as the first line of contact, with additional staff as backup, to better manage system training internally.

• Ongoing training will help you discover who uses the system proficiently and who needs re-education.  It can also help you identify and recognize the more experienced staff so that they can share their knowledge and assist the other staff in elevating their skill levels.

• Planning for adequate training before implementation and follow-up training after implementation will help ensure a smooth transition.

• Do not allow too much time between training and implementation, as it can render your training program less effective.

• Using super users and remote training capabilities may help you roll-out their training program across multiple sites in a short window to help increase the retention of information.

• Provide the right education to the right staff at the right time. 

• Daily basis audit of the previous day’s documentation can identify what is missing and those who need follow up. Encouragement of compliant staff may gently push non-compliant ones to do better. One-on-one follow-up training and education with any staff not in compliance can improve outcomes and performance.

• Make sure you have the proper high-level administrative support in place to assure that attendance of key staff in training and educational programs is mandatory.