Conclusions and Recommendations

     The results of this research lead me to conclude that a POU system is feasible at Landstuhl Regional Medical Center.  However, it is difficult to justify the purchase of this system if solely based on cost reductions and revenue increases.  All benefits, particularly non-monetary, must be considered in order to justify this system.  In the DoD health care system, business decisions are often based primarily on financial cost to the organization, but the hidden value of POU technology lies in the qualitative benefits to all users of the health care system.  Information regarding implementation of POU at large, high volume, tertiary care medical facilities in the AMEDD is readily available.  One such model predicted a break even within the first year and a ROI of 195% over a five-year period (Pyxis, 2002).  The impacts of POU at smaller facilities and in the outpatient setting are less well known.  Similar results can be achieved, although on a smaller scale.

     Although the ideal point of use system would be deployed in every hospital area where supplies and pharmaceutical items are dispensed, the organization quickly realizes a diminishing return on its investment due to the cost prohibitive nature of placing POU technology in every patient, procedure, and supply room.  Lower volume clinics that are less supply and pharmaceutical intensive would realize a smaller return on investment and take much longer time for the system to pay for itself. 

Recommendations

     I recommend implementing supply and pharmaceutical POU at Landstuhl Regional Medical Center, particularly in the operating rooms and inpatient wards.  Critical to realization of potential benefits of this system is the implementation of bar code technology and medication verification.  Any solicitation and proposal or purchase should include provisions for employing this technology in all areas where patients are provided medications.  Patient care operations should incorporate POU technology in the following areas (see Table 4).  These areas will benefit the most because of high volume of both supply and pharmaceutical usage.

Table 4

Areas Recommended for POU

     Although funding may not be available to purchase the complete system, the requirement should identify all areas where deployment of POU technology is possible.

Implementation and training costs associated with fielding a POU system in a facility are significant and clinical procedures must be well documented to provide users a standard operating procedure.  In order to minimize disruption to daily operations, a phased implementation of the system is recommended.  The equipment, once purchased, should be installed on an inpatient ward in order to work through any facility specific issues that arise before undertaking additional installation in other areas.

     POU technology continues to improve and evolve.  This technology represents a paradigm shift in the provision of patient care at Landstuhl Regional Medical Center.  Although POU technology is expensive to obtain and implement, this technology presents an opportunity to improve processes, increase efficiencies, reduce cost and waste, and improve safety and patient care.  Both leadership and staff must maintain a concerted effort to successfully implement POU.

Appendices   Back    Home