Managing medication in ambulatory surgery centers

As the demand for health care institutions to provide safe, high-quality, and cost-effective and efficient care continues to increase, so too has the presence of ambulatory surgery centers (ASCs). ASCs present an opportunity for surgeons to focus on various aspects of performing safe and efficient operations, including medication management.

A priority issue for surgeons

Surgeons should make medication management a priority at their ASC. Developing an effective and safe medication management system is critical in eliminating any potential patient harm that medications might cause. A drug management system addresses an institution’s medication processes based on the care, treatment, or services it provides. A reliable system requires that multiple services and disciplines within an ASC work together, especially when it comes to maintaining safe, efficient, and orderly medication administration.

According to an article in the June 2014 issue of Outpatient Surgery Magazine, medication carts should be organized for easy access by separating look-alike and sound-alike medications, and pre-drawn syringes should include appropriate industry-standard required labeling and expiration dates and comply with Joint Commission standards. Surgeons also should ensure that single-dose vials are used only on one patient and that the proper policies and procedures are in place for discarding unused/unneeded medications.* Complying with these standards can help staff to more easily and efficiently prepare and administer medications, especially during surgical procedures or emergencies, potentially reducing errors, delays in administration, and misuse.

Framework for managing medications

In addition to these precautions, The Joint Commission outlines several medication management (MM) standards in its ambulatory health care accreditation manual to help ASCs develop a framework for a safe and effective MM system. ASCs may incorporate the following standards into their system:

Planning: The ASC plans its medication management process and safely manages high-alert and hazardous medications.

Selection and procurement: The ASC selects and procures medications.

Storage: The ASC safely stores medication and manages emergency medications. It also safely controls medications that patients, families, or licensed independent practitioners bring into the facility.

Ordering: Medication orders are clear and accurate.

Preparing and dispensing: The organization reviews the appropriateness of all orders for pharmaceuticals to be dispensed in the ASC and safely prepares medications. The facility safely obtains and dispenses medications when it does not operate a pharmacy and safely manages returned medications.

Administration: The ASC safely administers medications and safely manages investigational medications.

Monitoring: The ASC monitors patients to determine the effects of their medications and responds to actual or potential adverse drug events, significant adverse drug reactions, and medication errors.

Evaluation: The organization evaluates the effectiveness of its medication management system. This evaluation includes reconciling medication information.

As surgeons increasingly perform operations at ASCs, it is important to focus efforts on making patient safety a top priority. Establishing a MM system is invaluable in reducing and eliminating the potentially devastating consequences that could result from medication errors.

For more information regarding The Joint Commission’s Ambulatory Health Care Accreditation Program, go to The  Joint Commission website.

*Outpatient Surgery Magazine. Anesthesia alert: Keys to a safe and orderly anesthesia cart. June 2014. Available at:–06-14. Accessed January 12, 2015.

The Joint Commission. Comprehensive Accreditation Manual for Ambulatory Health Care: The Official Handbook. Oak Brook, IL: Joint Commission Resources, 2015. (Available on members-only website.)

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