(Management Case Study) Multi-State Remote Order Verification (ROV) to Support Acute Care Inpatient Pharmacies Across an Integrated Delivery Network (IDN)

Purpose: It was identified that support of a ROV Pharmacist team could improve clinical workflows of onsite pharmacists as well as reduce overall pharmacist labor costs through improved efficiencies.  This case describes the considerations, process and methods utilized to operationalize this department and maintaining and measuring success.

Methods: A Director of Pharmacy and 15 Pharmacist FTEs were hired internally to stand up a system supported ROV department.  A year-long emphasis on driving standardized clinical processes was made to help with consistency in order assessment, verification, and dosing.  Hours of availability/predictive scheduling was determined, standards for communication/feedback were established (e.g., liaison roles, daily video conferencing lines, feedback loop, etc.) and site and system-level reference documents were created.  Ongoing feedback was collected from ROV staff through use of internal messaging software, weekly individual check-ins, and staff meetings to adjust and improve processes in real-time and ensure that information and tools necessary were readily available.  Formal feedback was collected from both ROV associates as well as site leaders 3 months into the program, through use of a survey, to evaluate the data from pharmacists supporting the sites and those that are receiving the service.  The surveys were intended to also help guide expansion of centralized services that could be of most benefit in the future.

Results: ROV service was sequentially rolled out in hospital groupings over the course of 3 months.  Ongoing engagement of both site level leads and pharmacists as well as ROV staff has contributed to the ongoing success of this newly established department.  Initial goal of 25% overall market support, during the hours of availability, was reached within the first 4-6 weeks following initiation in each grouping.  Internal survey results have indicated a 94% ROV associate satisfaction rate and 90% site pharmacy leader satisfaction rate of the services provided by ROV.

Conclusion: Use of standardized processes and technology to enhance communication standards as well as transparent, timely bidirectional feedback is essential to success of a team of remote ROV pharmacists.