Guelph General’s most significant medication safety initiative is made possible by donors

As part of Guelph General’s ongoing commitment to providing the highest quality and safest care, the Hospital has been working on the most significant medication safety initiative in its history.

Donors like you have been right there, improving the safety of virtually every patient at GGH.

Just about every patient admitted to Guelph General Hospital needs some form of medication. In fact, each and every day, about 800 medication prescriptions are processed! For our nurses, administering medication is a big part of their job, one which requires a lot of time and responsibility. Your generosity is helping them carry out their medication rounds with greater ease, accuracy and confidence, thanks to the best equipment.

The medication safety initiative has taken years in research and planning with involvement across the Hospital. It involves transforming the current pen-and-paper process for prescribing, dispensing and charting into an electronic process that incorporates modern medication safety practices, dispensing equipment, and software.

Phase 1 of the initiative is complete and already being implemented. It involved customizing and implementing a software solution to allow physicians to electronically send prescriptions to the Hospital’s pharmacy.

“Transcribing hand-written prescriptions poses risk of error and so pharmacy technicians spent much of their time following up with physicians to confirm the details of prescriptions,” explained Lori Hayden, Pharmacy Project Lead. “With the new electronic prescribing process, prescriptions are received in pharmacy with complete clarity. In addition, there are many automated safety checks set up in the system to ensure physicians are prescribing the right medications in the right doses for their patients.”

Phase 2 of the initiative focuses on administering and dispensing medications. Through your caring generosity, GGH was able to purchase 70 medication safety carts so that every nurse on shift has a dedicated cart. These carts will allow the electronic process to continue seamlessly from the electronic prescription all the way through to the nurse giving medications to their patients.

Nicole Gautier Professional Practice Educator at GGH, explained how the pen-and-paper process compares with the new electronic process and medication safety carts. “In the paper system, the pharmacy staff preps medication administration records (MARs) for each patient and sends the printed MARs to the units for the nurses to use. When it’s time to give patients their medications, nurses take their MARs to a medication dispensing cabinet where they retrieve the required medications. Nurses then takes everything to a medication prep area where they double and triple check the information on the MARs and administer them to the patients at the bedside. As a final step, nurses retrieve the printed MARs and sign off that the medications were taken.”

“It can be a very stressful process. We are constantly checking that we have the right medication, the right dose; we worry about misreading or miswriting a medication; and we spend lots of time double- and triple-checking that we have everything right,” added Nicole.

The seventy carts have arrived and it’s been “all hands on deck” to receive them and get them set up.

“It’s definitely been a team effort just to get the carts here and set up,” explained Rohan.

Our Purchasing team negotiated buying the carts and helped the Information Technology (IT) team source all the computer components, such as medical grade computer monitors, keyboards and barcode scanners. Housekeeping helped receive, unpack, and dispose of the packaging. The carts all arrived in crates with lots of protective packaging, so this alone was a huge task. Facilities and Housekeeping helped clear a large area in the Hospital’s storage space where the carts are set up in an assembly line. IT has been working to install all the computer components.

“I’m so excited have our nurses try these new medication carts,” said Nicole. “Nurses will have their own dedicated cart and computer for charting during their shift. They’ll be able to take the cart to the medication dispensing cabinet to load it up with the medications for all their patients at each medication administering time. Each patient will have an assigned drawer on the cart (see Medication Cabinet Story.) These drawers will stay locked until the nurse gets to the patient’s bedside and scan the patient’s barcode on their wristband which will open the drawer. Nurses can do all their documentation right there, and then take the cart to their next patient.”

The Hospital hopes to have the carts in operation in February. Between now and then, there is lots more work to do. For example, the Pharmacy Department continues to create barcodes for every medication and in every single dose.
Informatics and IT continue to set up the software that will enable electronic Medication Administration Records (eMARs) to be generated in pharmacy from the electronic prescriptions. It’s these eMARs that nurses will be able to access from the computer on their medication safety cart. Meanwhile, the Clinical Education team is developing training materials and scheduling training dates so that all nurses have an opportunity to learn how to use the carts and the new eMARs.

As you can see, this medication safety initiative has been a massive undertaking that has required an enormous hospital-wide effort, but the effort extends beyond the Hospital walls and into our community.

The Medication Safety Carts and all the computer components to power them cost just over $3 million, funded by thousands of donations made by caring members of our community. Donations made in response to our 2019 seasonal direct mail campaign, hundreds of online gifts, proceeds from our 2020 Black Tie Bingo fundraising gala, and gifts made directly to the Together, We Care fundraising campaign for equipment and technology investments were all combined to fund these carts.

“Your generosity means so very much. It supports our exceptional team of nurses to complete one of the most fundamental tasks that they do each and every day, and it will impact every patient who comes into our Hospital. Thank you from the bottom of our hearts,” exclaimed Melissa.

Thank you!