Outpatient Surgery Magazine - Subscribers

Battle Post-op Pain Without Opioids - April 2016 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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A P R I L 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 6 1 consider the time and waste they save. They can also take up more space in storage — an issue for facil- ities dealing with tight quar- ters. Additionally, you may not be able to — or want to — get every drug you need from an FDA-inspected 503B compounder. Some compounder drugs — like propofol — have much shorter shelf lives than the drugs you get from pharma- ceutical providers. But when you consider all the factors, including, by the way, the vast improvement in FDA oversight of com- pounders that's come about in the last few years, pre- filled and pre-packaged meds are clearly an idea whose time has come. OSM pharmacy consultant to develop an accurate cost analy- sis, based on what you're doing now vs. what you might consider going forward. That means looking at more than just the obvious. For example, now you have to buy drugs, you have to buy needles and syringes, you have to buy labels, and you probably have to buy small IV bags to put drugs in. And then there are the costs relat- ed to extra time — with both nurses and anesthesia providers. Those may not be as easily identifiable, but they're interrupters. Consider also the temptation that exists to bend the rules. A busy facility may decide to mix drugs well in advance, instead of doing so on an as-needed basis, as close to administration time as possible. It pays to eliminate that temptation. Ultimately, when you look at all of those costs, and consider, too, that some compounders' prices may be negotiable and have group purchasing structures, the price gap may really narrow. Pre-filled meds may still be a little more expensive, but there are more factors to consider — the cost of having something go wrong in terms of patient and family impact, legal costs, costs to your reputation or maybe the cost of an injured staff member. That may be all the discussion you need before deciding on this extremely important quality- assurance measure. — Sheldon S. Sones, RPh, FASCP Mr. Sones (shelsones@aol.com) is a pharmacy and safe medication consult- ant to surgical centers, and a member of the Outpatient Surgery Magazine editorial board. Dr. Vitcov (stevevit- cov@gmail.com) is the medical director of the Presidio Surgery Center in San Francisco, Calif.

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