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Skilled Nursing


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Resource Savings Start at Med Pass

September 19, 2023

When you’re seeking opportunities for cost savings, the med cart is a good place to start. It may be challenging to find the time to step back and observe the medication pass process, but the investment of time can reap multiple benefits.

Take these five steps now to put resource savings in action:

  1. Start with your med pass team. Ask people doing med pass where they see opportunities to make the process more efficient. Are there ways to streamline it? For instance, are they spending time crushing meds and putting them in applesauce? Are a number of residents on meds that are administered twice or more daily? Could they give twice a day meds for all or some residents at the same times? Is the cart stocked and medications organized in order It is helpful to look at how medications are being distributed. Sometimes if a staff member is just going down a list, they could be running all over the building, taking extra time and creating additional stress.
  2. Engage the consultant pharmacist as ‘detective.’ Have them observe and view the med pass through their pharmacy lens. They may be able to identify opportunities to change dosing or dosage forms or recommend therapeutic substitutions that will help make med pass more efficient while ensuring quality care. You can get some great data from observation. It can help identify processes that need to be changed. The pharmacist also can look at medication profiles for opportunities to improve efficiencies as well as prevent adverse drug events such as falls or weight loss.
  3. Minimize interruptions. Med pass already takes up the most time for nursing staff. Slowing the process not only ties up resources longer, which can lead to frustration, but it can also result in costly medication errors. Whether background noise or conversations, family member questions, or technology alerts, look to reduce distractions. Facilities can borrow best practices from hospital pilots designed to eliminate unnecessary interruptions such as turning a light on at med pass time at the nurses’ station, having nurses wear red lanyards during med pass, or using door hangers on residents’ rooms to show med pass is in process.
  4. Relationship building with residents is key. This can help staff get to know those individuals who often refuse medication. This is important, as it can be problematic when nurses have to spend valuable time trying to convince residents to take their medications. If staff develop these relationships, it builds trust and can make adherence and cooperation easier. At the same time, staff should be aware of when residents have therapy or activities scheduled during peak med pass times. This can enable them to get their meds first, cutting down on time spent tracking down these individuals, interrupting therapy or activities, and returning people to their rooms to get their medications.
  5. Make sure change is sustainable. This isn’t a one-and-done effort. When you identify processes or activities that need to be changed, set a strategy and a timeline for those changes and identify who will be involved. It’s not enough to change processes or introduce new technology or communication tools. It’s essential to make sure everyone gets adequate training and understands their roles. Monitor new processes over time to ensure they are working, then tweak or change things as necessary. Also watch for staff who may need additional training or guidance.

When processes are more efficient and opportunities for improvements are identified and addressed, savings can come from many sources. Ultimately, taking a fresh look at the med pass is win-win-win. It can result in more efficient processes, less polypharmacy, and nurses who can focus on quality bedside care.

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