Xiangya Hospital Balances Controlled Substance Access and Security in the OR

Founded in 1906, Xiangya Hospital of Central South University is an important center for clinical care, medical education and scientific and technological innovation in China. With 3,500 beds registered, it received an average of 2.96 million outpatients and emergency visits, discharged 138,000 inpatients every year. It enjoys a good reputation both at home and abroad for its superior techniques of diagnosis and treatment, outstanding scientific and educational strength, and profound cultural background.

The hospital performed an average of 74,000 operations a year. The operating room (OR) setting is a high-stress area, and medication administration can be time-critical. The anesthesia care provider has multiple functions that must be performed, including manually calculating doses, administering doses, monitoring patients and equipment, dealing with distractions, documenting, and other tasks. Therefore, the entire medication-use process in the OR setting is significantly different from that in other areas of the hospital.

With traditional medication cabinets, the hospital mostly relied on manual processes, in which human error posed significant risk for the patients, leading to patient harm and death. The most frequently cited critical incidents were anesthesia administration errors. The hospital had a dedicated pharmacist in the operating suites to decrease medication errors in the perioperative setting. However, the challenges of controlled substance management for the hospital had compounded due to dramatic growth in operations.

In this high-cost, highly regulated environment, our solutions helped Xiangya Hospital promote safe, efficient procedures in pre-surgery, surgical preparation process, intra-surgery and post-surgery. In Xiangya, hospital leaders worked closely with us to transition from a manual OR medication management environment to adopting the Controlled Substance Management Cabinet. The smart cabinet securely stores and manages all the medications and supplies needed for the whole surgery in convenient places. Depending on the usage environment, different types of medicine bins can be selected and configured to accommodate a variety of dosage forms: vials, ampules, and syringes.

From an anesthetist perspective, the workflow is much simpler. Before surgery, the authorized anesthetists log in the system to choose the medication package includes all the medications and supplies needed. Advanced duo biometric authentication and near expiration reminder ensures the medication safety.

Thanks to the barcode and automatic counting technology, once the nurse picks medication from the cabinet, the system automatically records the quantity change of the medications without any error-prone manual entry process. It offers the leading fully automated unit dose narcotics dispensing system, which eliminates the need for countbacks and the time it takes to resolve discrepancies.

Integrated with the Anesthesia information systems (AIS), our system will automatically check the billing record of the patient with the actual usage record. This way, stock follow-up, expenditures and revenues are brought under control. The software system provides predictive and prescriptive analytics through BI Analytics and AI Analytics from the data collected by the terminals. By displaying all the analytical reports, the closed-loop data platform empowers staffs to gain a full view of medication inventory with a dashboard.

Despite a particularly challenging timeframe, the hospital experienced immediate benefits from the advanced technology: improved storage capacity, increased security, and enhanced workflow. Following Controlled Substance Management Cabinet implementation, the rate for medication errors fell to just 1.2%, with many months containing zero reported errors. When asked how NuboMed’s product compares to the other cabinets used in the past, one of anesthetist said, “It’s way easier than others. It really improves workflow and ensures safety.”