Becton, Dickinson And Company · NYSE:BDX
Becton, Dickinson And — Conference Presentation (June 2020)
29 slides from Becton, Dickinson And's conference presentation, Jun 18, 2020
Slide 1: Implementing BD Pyxis IV Prep
Implementing BD Pyxis™ IV Prep Katie Cimmino, PharmD, BCSCP Senior Pharmacist Supervisor of IV Compounding and Research NewYork-Presbyterian Queens June 18, 2020
Slide 2: Speaker
Speaker Katie Cimmino, PharmD, BCSCP Senior Pharmacist Supervisor of IV Compounding and Research NewYork-Presbyterian Queens Disclosure: The data, views and claims within this presentation are that of the presenter. No portion of this content may be reproduced without explicit written permission. Th
Slide 3: Agenda
Agenda Introductions: Our Pharmacy Program Our Why Implementation & Timeline Features of IV Prep Metrics Lessons Learned What’s Next
Slide 4: NewYork-Presbyterian Queens
NewYork-Presbyterian Queens 535-Bed Acute Care Facility Community hospital Affiliated with Weill Cornell medicine
Slide 5: NYPQ Pharmacy
NYPQ Pharmacy Pharmacy provides services 24/7 Pharmacy staff includes 69.8 FTE (with per diems have 90 staff members) • All staff members: understanding of USP <797> and training in USP <800> • 60 staff members: understanding/ training clean room practices • 40 staff members: compounding competenc
Slide 6: NYPQ Pharmacy Operations & Strategy
NYPQ Pharmacy Operations & Strategy 2012 2014 2016 - 2018 2018 - 2019 2019 2020 New Pharmacy Pyxis ES, Pyxis IV Prep ISMP Grant Built w/ Clean Pyxis IV Prep BD HD Check, Intelliguard, Upgrade to Room & 3M Clean Trace Codonics 2.49 Swisslog robots
Slide 7: Journey to Zero Harm: For patients and employees
Journey to Zero Harm: For patients and employees Implementation of technology for patient safety & employee confidence BD Pyxis IV Prep helps us close the gap in barcode scanning compliance & uses gravimetrics
Slide 8: Why Implement an IV Workflow Management System?
Why Implement an IV Workflow Management System? Best practice recommended by ISMP1 Studies show manual compounding can have error rates of up to 9%2 Standardizes process and documentation Integrates barcode scanning, image capture, gravimetric analysis Pyxis IV Prep provides metrics and perfo
Slide 9: Why implement BD IV Prep?
Why implement BD IV Prep? Safety: hard stops during compounding to correct potential errors Technology: gravimetric verification, barcode scanning, image capture Documentation: audit trail of compounding process Inventory Management: remainders, stock batch, returns Compliance: USP 797 and USP 800
Slide 10: Implementation Timeline
Implementation Timeline Upgrade to v2.44 Upgrade to v2.44 • Expanded to pediatric & high-risk Go-live compounded drugs v2.40 • Drug library includes • 2 weeks (incl. test 85% of Validation & training of staff) compounded (2w), • Expanded to all workflow equipment hazardous drugs setup (3d), • 50 dru
Slide 11: Compounding Hazardous Compounding
Compounding Hazardous Compounding
Slide 12: IV Prep Example
IV Prep Example 1 = Transfer of thiamine injection 100mg roa De
Slide 13: One Step Label Set Up Two Step Label
Label Set Up One Step Two Step Label
Slide 14: Emergency Management with IV Prep
Emergency Management with IV Prep Out of range room certifications • IV Prep quickly allows you to set global settings if beyond use date must quickly change Clinical Trial NYPQ remdesivir site under emergency use authorization supply Management of important medication usage
Slide 15: Implementing now: Pyxis IV Prep & USP 797 task tracking
Implementing now: Pyxis IV Prep & USP 797 task tracking New task management function with workflow hard stops enforce compliance & documentation of tasks • Recording USP compliant related tasks such as: Environmental activities (pressure, temperature, humidity) Cleaning activities Room Certifi
Slide 16: Benefits of Pyxis IV Prep - Data
Benefits of Pyxis IV Prep - Data
Slide 17: Big Picture Metrics
Big Picture Metrics Average number of preparations made per day 200 10% 180 9% 160 8% 140 7% 120 6% 100 5% 80 4% 60 3% 40 2% 20 1% 0 0% Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19 Jul-19 Aug-19 Sep-19 Oct-19 Nov-19 Dec-19 Jan-20 Feb-20 Mar-20 Apr-20 Gravimetric Volumetric Dispensed Confirmed (b
Slide 18: Who is becoming a natural super user?
Who is becoming a natural super user? Who is utilizing the system? Who is compounding quickly?
Slide 19: Metrics by Drug Level
Metrics by Drug Level Time to Compound by Drug 400 350 300 250 seconds 200 150 100 50 0 multivitamin norepinephrine vasopressin DOXOrubicin trastuzumab DOCEtaxel CISplatin CARBOplatin pantoprazole Nov-2018 Dec-2018 Jan-2019
Slide 20: Can workflow be adjusted to optimize system?
Can workflow be adjusted to optimize system? November 2018 to April 2019 Bypass by Hour 80 70 60 # of compounds bypassed 50 40 30 20 10 0 12am 1am 2am 3am 4am 5am 6am 7am 8am 9am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm Nov Dec Jan March April
Slide 21: Percent Bypass by Drug (Dec 2018)
Percent Bypass by Drug (Dec 2018) 100% 80% 60% 40% 20% 0%
Slide 22: Productivity
Productivity From initial go-live Time spent compounding has decreased (average 132 seconds per gravimetric compound for 2019) Accuracy of gravimetric compounds has increased Review of all gravimetric preparations for time period showed an average dose deviation of 0.50% per compound. Product
Slide 23: Streamlining workflow
Streamlining workflow Streamlined pharmacy workflow and thus reduced pharmacy compounding waste 2019- Average $3,500 waste reduction per month Saved at-least 25 minutes compounding time per day Downward trend in cost-savings is due to the fact that metrics have allowed us to change workflow t
Slide 24: Safety Features
Safety Features In 2019, out of 62,265 preparations IVWMS detected and stopped 7.5% errors. This is lower than the national average estimate of 9%2 Of those errors, only 21.9% could have been detected prior to IVWMS. Not all errors have significant clinical impact
Slide 25: Key takeaways on how to develop metrics
Key takeaways on how to develop metrics Post Go-Live examine metrics: Continuous Metrics • by user-compounding speed, • Begin to set department goals as a whole compounding accuracy and bypass rate • If you are not meeting those metrics see if • by product-speed, accuracy, and it is due workflow o
Slide 26: Lessons Learned
Lessons Learned Rollout implementation vs. Big Bang Soft go-live with equipment Getting the right equipment Importance of Super Users Continuous education beyond Pharmacy & sharing our success internally
Slide 27: What's next for NYPQ Pharmacy
What’s next for NYPQ Pharmacy Pyxis IV Prep: Enterprise -Upgrade to 2.49 Pyxis IV Prep: Standardization- Assembly/ Premix BD Action Epic migration in policies, Workflow Manager June 2021 procedures, practices -Final library USP Compliance expansion
Slide 28: References
References 1. ISMP. Maximize benefits of IV workflow management systems by addressing workarounds and errors. 2017 Sept. https://www.ismp.org/resources/maximize- benefits-iv-workflow-management-systems-addressing- workarounds-and-errors 2. Flynn, EA, Pearson, RE, Barker, KN. Observational study of a
Slide 29: Thank you!
Thank you! Replay: BD.com/BDInstitute BD, the BD Logo, BD HealthSight, and the BD HealthSight Logo are trademarks of Becton, Dickinson and Company. © 2020 BD and its subsidiaries. All rights reserved. 29
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