Compassionate stock management in a Medical Day Unit

Hyun Jung Kim

BPharm, MSHP | Foundational Resident Pharmacist, Canberra Health Services

[Pharmacy GRIT article no: 20241408]


In the Medical Day Unit (MDU), managing stock for compassionate-use medications had long been a challenge due to inconsistencies in recording and discrepancies in inventory. To address these issues, a new compassionate stock management system was developed and implemented. This system aimed to ensure that critical medications were readily available when needed, while also improving stock accuracy, reducing wastage from expired medications, and enhancing the unit's overall efficiency.

This research reflection article outlines the research process I undertook, the challenges I encountered and ultimately, the lessons I learned.

The research process and strengthening our existing systems

The development of the new compassionate stock management system involved multiple iterations to refine the methodology. Each iteration incorporated feedback and real-world testing to address operational challenges and ensure compatibility with our existing workflows. This iterative process was crucial in tailoring the system to meet the unique requirements of the MDU, while also maximising the system’s effectiveness and usability.

One of the key strengths of this project was the structured approach to improving data accuracy. Before implementing the new system, there were significant inaccuracies in the compassionate stock inventory, with approximately 70% of stock being incorrectly assigned. Through the introduction of structured recording procedures and comprehensive staff training, these inaccuracies were significantly reduced. Another strength of the project was its focus on environmental sustainability, which aimed to reduce waste and improve stock management practices.

Challenges along the way…

The project, however, also faced considerable challenges, largely due to the lack of a pre-existing structured system for compassionate stock management in the MDU. Developing a new system from scratch required extensive consultations with various stakeholders, including staff responsible for stock management, senior pharmacists, and my mentor. This collaborative approach was essential in understanding the diverse needs and perspectives within the unit but brought with it considerable challenges, such as coordinating conflicting solutions among different parties and ensuring that the solutions I found were acceptable to other parties while accommodating everyone.

Maintaining consistent data entry practices among all personnel involved in compassionate stock management was another significant challenge. Variability in data recording methods and adherence to protocols across the organisation posed risks to data accuracy and operational efficiency. To address this, we developed comprehensive training programs, established clear guidelines, and provided ongoing support to reinforce standardised practices.

Moving forward

If I were to undertake a similar project in the future, I would prioritise earlier and more frequent engagement with all management teams to gather collective input rather than developing the methodology independently. This approach would help identify potential issues and resistance early on, allowing for a smoother implementation process. Additionally, a phased rollout might be more effective in managing the transition and addressing technical issues as they arise.

This project introduced a more systematic approach to inventory management and data recording, which was new to our unit. The experience of developing and implementing these methods was invaluable, offering insights into how systematic data management can significantly improve operational efficiency and accuracy.

As a researcher, this project was a profound learning experience in change management and the practical application of quality improvement (QI) methodologies. The process of training staff, troubleshooting issues, and analysing the outcomes of our interventions has prepared me to undertake future research projects with greater confidence and a clearer understanding of the complexities involved in implementing systemic changes.

This experience has better prepared me to handle future research projects by enhancing my skills in project management, stakeholder engagement, and data analysis. The insights gained from this project will be instrumental in planning and executing future QI initiatives.


Acknowledgements

I would like to acknowledge my residency mentor, Hameda Lane, and my project supervisor, Rachel Berry, for guiding me through my first-ever research project.


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