(1247) Impact of Implementation of Smart Pump Interoperability and Drug Library Optimization

Introduction: A systematic review at a large multi-facility academic medical center evaluating the use of smart pumps and interoperability revealed opportunities to reduce medication error rates through decreasing the number of unnecessary alerts, mitigating workarounds, and optimizing drug library use. The objective of this project was to implement continuous quality improvement processes throughout the smart pump continuum to impact drug library compliance, alert override reduction, and interoperability success.

Methods: This is a descriptive analysis of infusion pump metrics before (October 1st, 2021 – April 30th, 2022) and after (May 10th, 2022 – present) smart pump interoperability implementation at a large multi-facility academic medical center using data from DoseTrac® Infusion Management Software and the EHR. With collaboration from the infusion pump vendor, a multidisciplinary team initiated a quality improvement process which included examining monthly infusion metrics, comparing institutional data to established benchmarks, observing nursing workflows, performing clinical rounding, and identifying auto-programming challenges. Interventions to optimize interoperability included modifying drug library limits that exceeded a 10% override rate and providing education to produce successful auto-programming.

Results: The number of monthly medication deliveries on an infusion pump increased from an average of 24,600 infusion deliveries pre-interoperability to 48,500 infusion deliveries post-interoperability. Infusions that were auto-programmed by nursing staff reached a monthly average of up to 99% (with daily rates reaching 100%), including a first-attempt success rate as high as 98%. The drug library override rate decreased from 13.4% to 6.8%. Additionally, drug library compliance increased from 97.84% to a sustained 98.96%, which exceeds the industry average of 81%.

Conclusions: The continuous quality improvement process which accompanied smart pump interoperability implementation resulted in improved patient safety, illustrated by high levels of auto-programming and drug library compliance. Through drug library optimization, override rates, and the associated risk of alert fatigue, were reduced.