Background Implantable medical devices (IDs) management in the hospital is a complex process, with a large scope for improvement that satisfies technical, logistical, economic and clinical needs.
Purpose Integrate into a single process all the activities and interests related to the use of IDs.
Material and methods Project in a highly specialised hospital with scheduled surgical activity. Designed by a multidisciplinary group and integrated into the hospital information system (HIS). It uses an external company that ‘certifies’ (technical and economic criteria) IDs and providers for insurers and surgeons. Pharmacy service (PS) manages all IDs in the hospital.
Stages have been: creation of multidisciplinary working group, SWOT-analysis and pilot economic study. Project approval by the hospital. Software development and IDs data mapping (hospital and company). Providers and insurers were informed. Pilot project was started for 6 months with two surgical departments (SD). The OR-pharmacist was responsible for providing the information, training and incorporation of SDs.
Results A simple and effective procedure has been designed. Surgical procedure (SP) is scheduled by the doctor in the HIS (patient, SP code and date) recording IDs expected in an electronic form. Doctor’s signature generates automatically two orders: a ‘devices submission proposal’ which is sent by PS to the provider. and an application for ‘economic authorisation’ that the company will manage with the insurer before SP. Pharmacy receives IDs temporary deposits that are registered and sent to the surgical area. All ID are recorded (optical reading of product code, batch, expiration date). When SP is completed OR-pharmacist checks unused IDs with those received and returns the surplus material, issuing an order for IDs implanted to the billing department. Company controls economic agreements between providers, insurers and the hospital. An implant file associated with SPs has been created for safety, results analysis and cost studies. Logistic traceability helps to schedule activity in the surgical area (average delivery time ID/supplier 2–3 days). This procedure ensures the conformity of ID’s cost before surgery, avoiding claims. Nineteen per cent of the spending has been reduced.
Conclusion Process integrated into the SD’s activity and the HIS. It incorporates in a sequential way habitual tasks. A multidisciplinary work with a vision and global resolution has been the leadership by the OR-pharmacist.
No conflict of interest
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