Description of Institution /Organization

Mercy Health System of Northwest Arkansas, a not-for-profit faith-based health system, provides healthcare services to residents in northwest Arkansas and southwest Missouri.  The System includes St. Mary’s Hospital in Rogers, Ark., The Gardens at Osage Terrace Assisted Living Facility and Mercy Medical Clinics in 22 locations throughout northwest Arkansas and southwest Missouri.  Our new medical campus at Interstate 540 and New Hope Road in southwest Rogers is slated for completion in January 2008.  It will include a 350,000-square-foot medical center with 200 beds and a medical office building to accommodate 90 physicians.

Pharmaceutical Services for St. Mary’s Hospital

In 2002, the Mercy Health System launched a pharmacy initiative to begin the process of Pharmacy Transformation throughout the eight strategic service units (SSUs). This initiative became know as MercyMeds. The primary objective of Mercy Meds was to improve patient safety throughout the medication use process. A multidimensional strategy was adopted as the most effective means to impact potential medication events. It was recognized that an expanded role for the pharmacist was needed in all phases of the medication use process to prevent medication events and improve medication utilization.

The transformation of the medication system or Mercy Meds has involved multiple facets which has included the following strategies:

Staff Retention and Development
• Commitment to recruit and train pharmacists for an expanded clinical role to enable a transition from a centralized role to a decentralized role.
• Addition of a clinical pharmacist coordinator to the pharmacy staff
• Development of career ladders for both pharmacist and technician staff

The majority of the current pharmacist staff have Pharm D degrees or have completed a residency. Two of the pharmacist have advance disease state certification and all but two of the technicians on staff have their national technician certification.

Medication Contracting and Distribution

A transition from a traditional drug wholesale model for purchasing of medications was completed in 2004. The Consolidated Services Center (CSC) located in Springfield, Missouri owned by the Mercy Health System is the source of supply for the majority of medications and IV solutions. The CSC packages bulk medications in bar coded unit dose packages and provides an auto replenishment service to expedite refill of the Omnicell medication cabinets. These services reduce the time required for medication distribution for both the pharmacist and technician.

Implementation of Technology

A commitment was made to invest in technology to improve patient safety and optimize the resources of the physician, nurse and pharmacist in the medication use process:

• The acquisition of technology began with the conversion to Omnicell medication stations in most of the inpatient care areas plus outpatient surgery and endoscope lab. Further expansion of medication stations is planned in 2008 for inpatient surgery and the cardiac catch and EP lab.
• An electronic medication administration record and bedside bar code scanning technology was implemented in the fall of 2005.
• Omnicell physician order scanning technology was implemented in the fall of 2006.
• An Omnicell Pharmacy Central carousel will be installed for the management and distribution of medication inventory in the pharmacy in the new hospital facility.
• Computer Physician Order Entry (CPOE) will be implemented upon the move to the new hospital facility in March of 2008. The primary order entry task for the pharmacist will change to the responsibility for medication order validation.

Clinical Role of the Pharmacist

The current clinical activities of the pharmacist include pharmacokinetic monitoring and dosing. The pharmacist monitor specific targeted medications for renal dosing as well as other high risk medications (anticoagulants, insulin and narcotics). Most recently, the medical staff approved the protocol for an inpatient anticoagulation consult service with a plan to transition to a centralized outpatient anticoagulation clinic.