October 20, 2011

Collaboration key for safe use of medications at VUMC

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From left, Vicki Richard, MBA, R.N., Jack Starmer, M.D., and Carly Feldott, Pharm.D., are leaders of the Medication Use and Safety Improvement Committee. (photo by Joe Howell)

Collaboration key for safe use of medications at VUMC

Interdisciplinary teams coming together to enhance patient care through safe and effective medication use is what the Medication Use and Safety Improvement Committee (MUSIC) is all about and another example of how Vanderbilt University Medical Center is deserving of a second Magnet designation.

MUSIC provides a forum for the different parties involved to collaborate on issues impacting medication safety. Representatives include physicians, pharmacists, nurses, quality and process improvement specialist, informatics, risk management, evidence-based medicine specialists, systems support services and others.

“To look at medication safety issues, you have to review the continuum of ordering/prescribing, transcribing/dispensing, administering and monitoring,” said Vicki Richard, MBA, R.N., assistant administrator for the Cancer Patient Care Center.

“Providing safe administration of medication requires handover communication and collaboration by a team that includes physicians, pharmacists, IT systems and applications, nursing, process management and quality initiatives.”

MUSIC started in 2008 when a nursing and pharmacy committee identified a need to broaden its scope to ensure wide representation from different disciplines. Carly Feldott, Pharm.D., Medication Safety Program Director for VUMC, and Richard co-chair the committee with physician leader Jack Starmer, M.D.

MUSIC has monthly meetings of approximately 30 representatives to focus on needs at Vanderbilt University Hospital and The Vanderbilt Clinic. Amy Potts, Pharm.D., and Autumne Mayfield, MSN, R.N., co-chair MUSIC at the Monroe Carell Jr. Children's Hospital at Vanderbilt. The two groups communicate and collaborate on many different initiatives.

“Oftentimes, safety issues are related to some of the most basic, fundamental touch points in health care, like patient identification, correct labeling and communication at handovers,” said Richard. “Although these issues may seem simple, the volume, number of departments and handovers involved in the delivery of medication add complexity to providing safe care to every patient, every time.”

MUSIC completes a comprehensive self-assessment that goes through every phase of medication ordering, dispensing and administration to measure VUMC against best practices established by the Institute for Safe Medication Practices (ISMP).

This year VUMC participated in an ISMP self-assessment for overall medication safety as well as a pilot assessment focusing on medication safety in oncology. MUSIC uses information from the self-assessments in considering goals and priorities for the next year.

One of MUSIC’s subcommittees completes an ongoing peer review of adverse drug events involving medications deemed to be ‘high alert’ by ISMP. These include chemotherapy, controlled substances, insulin and anticoagulants, to name a few. The subcommittee looks at the main factors involved, identifies trends and sometimes suggests changes in process or education.

Other subcommittees and workgroups throughout the organization report quarterly, semi-annually or annually to MUSIC in order to share their progress and coordinate efforts with other stakeholders involved in the medication use process.

Examples include focusing on anticoagulation safety, pain management, medication management, adverse drug events involving high alert medications, summaries of medication-related event analyses, medication reconciliation, Horizon Clinical Systems and Pharmacy Informatics progress and update, and medication-related devices.

“MUSIC provides a working forum to share information and collaborate among the many groups involved in medication safety at VUMC,” said Richard.