I know it was a common topic last year, but this again would be on healthcare reform policy. At the National Naval Medical Center in Bethesda, MD. We are wasting a tremendous amount of medication and money in the pharmacy. We have a large number of patients on different types of inhalers, some costing over 300$ a piece even at a government contract prices. Many nights we get many of these back because duplicates were sent up to the same patient, or the patient was discharged. Many of these inhalers had been used only once, out of a 30 day supply, meaning only 3% of that 300$ was actually used. This is because of a policy that is in place that patients can't be sent home with medications they had been given on the ward. The policy should be changed so that instead of throwing out the one they had used, they take it home instead of us simply throwing it out. Sadly it is the case many times also that the patient would not be on a single inhaler, compounding the amount that we throw away. There are also many cases of over prescribing in the outpatient clinics as well due to 'order sets,' most commonly with mothers who have just given birth. Regardless of whether or not it was a c-section or not - we still prescribe 3 additional costing us another 30$ per c-section patient who doesn't need them. I feel that if these order sets were removed, even though every prescription would have to be entered on it's own, it would ensure that no medications would be sent home with the patient that they don't need. We also waste tons of insulin, instead of sending up Stock vials for each floor to use all of, we are required to send up one for every individual patient. Insulin vials are in between 25-100$ each, and nearly every vial we get back is full yet we must simply throw it out because we have no way of knowing how long it was out of the fridge. If we were to send up single vials at a time and ensure the wards actually used them all it would save a lot of money and save a lot of a very important medication. I estimate that NNMC Bethesda pharmacy wastes around $10,000 a day in medication which is easily avoidable with simple policy changes.
Idea No. 1330