Iredell Health System’s Director of Pharmacy Steve Critz retired last week, leaving behind a legacy of innovation and positive change in pharmaceutical services for the county’s only nonprofit health system.
Critz led Iredell Health’s implementation of new medication management utilizing the automation dispensing system Omnicell. Iredell pharmacists use state-of-the-art dispensing technology to ensure patient safety and augment the accountability of everyone involved from the time the pharmacy receives and stores medication to when it is dispensed and placed in Omnicell stations throughout Iredell Memorial Hospital.
“The best way to describe it is as an ATM machine that dispenses drugs,” Critz said.
He had the machines installed in every patient-care area of Iredell Memorial, and the majority of the hospital’s medications are managed through the system.
During his time at Iredell, Critz placed a large focus on patient safety, and the Omnicell implementation was a big part of that initiative. The medication management system includes two large carousels with shelves holding the drugs. The pharmacy department prepares a schedule to restock stations in different areas of the hospital.
Physicians enter drug information into the computer operating system, from which hospital pharmacists review the order to confirm drug choice, strength, interaction, accuracy, and scheduling. After pharmacists have verified the order, nurses can gain access to the drugs of their patients through fingerprint recognition. The nurse scans the drug and the patient’s armband, closing the loop and ensuring that the right patient has received the right drug.
A drug is bar-coded five times before getting to the patient.
Iredell Health System hired Critz in 2015 after seeking candidates with automation experience. After joining the health system in April, Critz began implementing Omnicell in May.
“That was a huge system to implement,” he said. “I knew what I was coming in to do.”
The year Iredell Memorial’s pharmacy changed its automation to the new distribution system, it also moved locations within the hospital. Critz designed the new pharmacy and reformed its workflow, which changed with its relocation.
“It was a lot of work and a lot of fun,” he said. “That year is kind of a blur as I look back on it. But we did it. It was a good year, and we got a new distribution system.”
Critz also started Iredell Health System’s medication reconciliation program. As part of the program, the pharmacy places one of its medication reconciliation technicians in the emergency department from 7 a.m. to 11 p.m. When a patient comes to the emergency department, the medication reconciliation technician interviews the patient and reviews their medication history. They verify with physicians’ offices electronic medical records to learn what medications the patient was on during previous hospital admissions, and contact pharmacies to obtain a list of medications that have been filled.
After the medication reconciliation technician documents the list of medications in the electronic medical record, the provider reconciles the list by choosing to continue a medication, discontinue a medication or make adjustments.
“It’s really important that we know what the patient was on before they came here,” Critz said. “Sometimes they may go to multiple doctors, so it’s hard for the family doctor to keep up with it. They may have a family doctor here, a urologist in Charlotte and an ophthalmologist in Hickory. There’s a lot to it.”
Before Critz implemented the hospital’s medication reconciliation program, nurses were responsible for gathering the patients’ medication information and performing the necessary research on top of their other duties. Critz effectively transitioned those responsibilities to Iredell Memorial’s medication reconciliation technicians.
“We use all our resources to make sure we have an accurate listings of the medications,” he said. “It’s been a very successful program.”
Critz also decentralized Iredell Memorial’s pharmacy.
“Instead of the pharmacists being down in the central pharmacy, we have them up on the floors,” he said. “I was glad to get that going, decentralizing the pharmacists. That’s building our clinical pharmacy program. We’re here for the patients.”
The pharmacy staffs a pharmacist in the critical-care unit and on each medical-surgical patient floor, with the intention to keep a pharmacist on every unit each weekday. Pharmacists are also in the central pharmacy to handle other areas of the hospital, including operating rooms, the emergency department and infusion-care services.
Pharmacists are regularly interacting with nurses and providers who can ask questions more conveniently. Being decentralized allows the pharmacists to provide patient medication education at the patient’s bedside.
Critz is a graduate of UNC Eshelman School of Pharmacy. He is on the Theatre Statesville board of directors, where he is on stage once or twice a year. He is involved in his church choir, participates in competitive bridge and enjoys traveling.
Iredell Health System’s new pharmacy director is Randi Raynor, who joined the health system in August. Raynor was most recently an operations manager at Novant Health Presbyterian Medical Center.
“Randi is the right person, and I am confident she will do a great job,” Critz said.