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Pharmacy chief spent eight years on zero-error system

There is no room for error when distributing medication. In the world of pharmacy, how do medical providers help prevent human error?

At the University of Rochester Medical Center, pharmacy director Curtis Haas has spent eight years working with technology to create a zero-error automation system.

He has introduced robots into pharmacy clean rooms, created automated workflow management systems, overseen the automation of medication stockrooms and computerized supply-chain management systems.

“(The automated workflow) uses all types of digital image confirmation and gravimetric confirmation, which basically means you weigh everything that goes in to confirm that all the doses are correct,” Haas said. “Going through this workflow process … really greatly reduces the likelihood that somebody can make an error because if the computer is not satisfied that you made it absolutely correctly, it won’t give you a label for the product.”

These innovations help improve the accuracy of medicine distribution while simultaneously freeing up pharmacists’ time to be more active in patient care.

Haas can make things happen. His ability to invoke change is extremely important, colleagues said.

“Curt is clearly a thought leader within our discipline,” said Michael Maddux, executive director of the American College of Clinical Pharmacy. “He brings a broad perspective but also the ability to focus his thinking and to articulate it very clearly and concisely. He’s an excellent leader and I would say a very exceptional manager, so he displays both the courage necessary to lead and the attention to detail to be able to implement.

“If you don’t have the pull-through you can have all the great ideas in the world, but if you’re not able to implement them that’s a problem,” he added.

Intravenous medications are also a fo-cus for Haas. They are handled manually, making the risk of error just too high.

“If you think about IV medications, they’re all clear solutions in a bag with a label on it, so they all look the same,” Haas said. “If you have a pharmacy technician who prepares a product and then it’s supposed to be checked by a pharmacist before it’s released for use by a patient—unless you’re literally going to stand there and look over the shoulder of the technician through every step that they take in preparing that, there’s no way to know with any degree of certainty what’s in that bag.”

URMC now has five robots that can make IVs to help streamline the process.

Technology is a priority for the medical center, Haas says.

“Technology in the clean rooms is really just now starting to enter in any serious way into the marketplace,” he said. “The purchase of equipment and software that we made here at Strong at the time we signed the contract last year was the single largest purchase in the history of the company on the equipment front, so it just tells you that we’re on the front end of this.”

Haas has over 30 years of experience as a pharmacist. He has been a long-time member of the American College of Clinical Pharmacy, serving in a variety of roles, including three years as president.

The challenge Haas finds is keeping up with a health system with an ambiguous future. “As we’re shifting from a fee-for-service to a fee-for-value type of environment where the focus is increasingly shifting to quality and outcomes, how does the profession of pharmacy contribute to those improved outcomes and quality of care in an evolving health care system?” Haas said.

“It’s going to shift away from getting the right pill in the bottle and to the patient,” he added.

The role of a pharmacist has evolved in the last few decades to mean more involvement in patient outcomes. Patient care will always be his focus, Haas said.

“My emphasis and my interests are really in the idea of moving pharmacists to higher-value activities in what they do,” he said. “And I find that there’s a greater probability to have a positive outcome on the quality and outcomes of care. I see that one of the important elements of making that happen is through properly harnessing the capabilities of automation and technology.”

3/20/15 (c) 2015 RBJ Health Care Achievement Awards. Rochester Business Journal. To obtain permission to reprint this article, call 585-546-8303 or email rbj@rbj.net.

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