Patient-centred medication management: How to enhance patient safety and reduce the work burden for medical staff by digitalised closed-loop cabinets
Abstract
Medication management is both an economic challenge and a patient safety issue. In German hospitals between 19 per cent and 35 per cent of all failures causing harm to patients are attributable to medication errors. As a consequence, an estimated 15,000 patients die each year. In addition, about 14 per cent of the average length of stay is assignable to unplanned drug interactions. Independent of patient risks, health impairments and outcome deficits, every non-fatal medication error leads to additional costs totalling €3,000 on average. Nurses, in particular, who typically suffer from work overload, are affected by error-prone medication logistics. Between 26 per cent and 44 per cent of all failures occurring in the medication administration process result from activities in which nurses are substantially involved. International best-in-class hospitals like the Mayo Clinic (Phoenix), Scripps (San Diego), OLVG (Amsterdam) and Guy’s and St. Thomas’ (London) have been using automated dispensing systems (smart cabinets) for medication safety reasons for many years. Moreover, in the USA, automated medication dispensing cabinets are ubiquitous in various types of hospitals and have an implementation rate of 89 per cent. But in German hospitals, this technology is still nowhere to be seen. In 2020, the German government, via legal act, decided that all hospitals must implement a closed-loop medication administration system in combination with a unit dose drug delivery by January 2025 in order to minimise medication errors. Otherwise, a penalty of 2 per cent of the total hospital revenue would have to be paid. Derived from best-practice reports in the literature, this paper explores the benefits of smart cabinets in terms of economic efficiency, patient safety, reduced work burden and employee acceptance. Furthermore, the reasons why many German hospital decision makers refuse to implement smart cabinets are presented and analysed. Finally, based on all this information, a generic medication administration process has been developed to provide a blueprint for a successful implementation of smart cabinets as an electronically based backbone in a closed-loop medication administration system.
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Author's Biography
Maximilian C. Von Eiff Dr med. Maximilian C. von Eiff, Assistant Physician Urology, studied human medicine at the University of Pécs Hungary (dr med in neurology) and completed a doctorate in orthopaedics and traumatology at the University of Leipzig, Germany. His main research areas are digitalisation in healthcare, health technology assessment, cost-benefit analyses of clinical processes and the impact of the healing environment approach on medical quality, patient outcome, length of stay and costs. Dr Maximilian completed a Six Sigma Training and worked on different studies aiming at process optimisation and quality improvement.
Wilfried Von Eiff Univ.-Prof. Dr Wilfried von Eiff (Münster) is Professor of Health Care Management and Regulation at HHL Leipzig Graduate School of Management and Director of the Center for Hospital Management, a research institute linked to the University of Muenster (Germany). Both institutions are well known for their international and national research, consulting and government advisory activities in various fields of healthcare and hospital management as well as health service research. Dr Wilfried’s research focuses on the international benchmarking of hospitals and healthcare systems. He holds two doctoral degrees, one from the faculty of medicine (University of Gießen) and the other from the faculty of business administration (University of Tübingen). In the clinical field he works as a member of the board of directors of Kerckhoff Clinic Heart and Lung Center, Bad Nauheim (Germany). Dr Wilfried chairs the special interest group on international best practices and process optimisation, an initiative of the EHMA European Health Management Association (Brussels). He was previously managing director and member of the board of the University Clinic of Giessen. He is co-editor of International Best Practices in Health Care Management (Emerald Books 2015) and Boundaryless Hospital (Springer 2016).
Mohamed Ghanem Priv-Doz Dr med Mohamed Ghanem, MBA (Leipzig, Germany), is Senior Consultant of Orthopaedic Surgery in the Department for Orthopaedics, Traumatology and Plastic Surgery and Chairman of the Department of Physical Therapy and Rehabilitation, University Hospital Leipzig. Dr Mohamed graduated from the Medical School of Cairo University and went on to do his postgraduate studies and practice at the University hospital of Paris as well as at the University hospital of Leipzig. He completed his studies in business administration at the HHL Leipzig Graduate School of Management in 2010 and later continued his scientific contributions at the HHL Graduate School of Management as visiting lecturer for international healthcare management.
Citation
Von Eiff, Maximilian C., Von Eiff, Wilfried and Ghanem, Mohamed (2023, December 1). Patient-centred medication management: How to enhance patient safety and reduce the work burden for medical staff by digitalised closed-loop cabinets. In the Management in Healthcare: A Peer-Reviewed Journal, Volume 7, Issue 2. https://doi.org/10.69554/UGJX4948.
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