Speed of drug delivery questioned at WakeMed

July 7, 2009 5:00:13 AM PDT
Two workers who approached Eyewitness News about concerns about cleanliness in areas of the pharmacy at WakeMed hospital also say the pharmacy is slow delivering drugs to patients.The whistleblowers showed investigative reporter Steve Daniels documents that they say show the pharmacy isn't meeting its goals.

WakeMed says emergency medication orders for babies in intensive care and other critical care areas should be filled in about 30 minutes. Documents obtained by Eyewitness News show the monthly averages between April and December of 2008 ranged between 88 minutes to 158 minutes.

"In one case here, the monthly average is five times longer than it should be," Daniels pointed out.

"That's consistently well over what it should be," said the worker who provided the information.

"Why is this happening?" Daniels asked.

"Incompetence, inability, lack of communication," the worker responded.

The WakeMed vice-president in charge of patient safety agrees there's a problem. Dr. Meera Kelley says doctors started expressing concerns about it last summer.

"We are not at our goal. We want to be doing better. We are focused on it as an organization and we're going to get there," she said.

"You acknowledge that as unacceptable?" Daniels asked.

"I acknowledge that as unacceptable," said Kelley.

"And we're talking about people in critical care environments who need that medication quickly?" asked Daniels.

"The good news is that we also track patient outcomes, patient safety events, medication errors, delays, what happens with them and it is very, very rare that we actually have an impact on a patient. Where we see something that could have made a difference," said Kelley. "So that makes me feel better, it doesn't , it's not saying this is good enough, this is not good enough and it needs to be better."

After that interview, the chief operating officer at WakeMed - Deb Friberg - told Eyewitness News that sick patients were not waiting for drugs, that nurses in critical care areas give the first dose of medication, and the scorecard we saw only represents a small number of the drugs given to patients.

The WakeMed whistleblowers also brought us documents showed problems with a pharmacy refrigerator that holds IV drugs.

The document says the temperature should always be between 36 - and 46 degrees. It says "take corrective action for temps out of range" and report "to engineering immediately."

The document shows - for 17 days in March - the refrigerator was below 36-degrees - and sometimes below freezing.

"Is that a concern having drugs stored in a freezing environment?" Daniels asked Kelley.

"As soon as the problem was identified it's been since corrected," she said.

Kelley said WakeMed called the companies that make the drugs stored in the refrigerator to see if improper temperatures had an impact on the medication. In one case, the drugs were thrown out.

"This is important. We need to be keeping better track of it. We are keeping better track of it, but we also know it has not posed a risk to our patients," she said.

"You've worked in a number of different hospitals during your career, is this any different than any other hospital?" Daniels asked one of the whistleblowers.

"Yes it is, and that's one reason why I am here right now because I feel they are not giving the standard of care that people in this area expect and deserve," the worker said.

WakeMed has hired organizational improvement consultants from outside health care to help improve the pharmacy process.

Click here for part 1 of Steve Daniels reports on the WakeMed pharmacy


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