Centralized Parenteral Nutrition Compounding Yields Cost-Savings

Centralizing parenteral nutrition compounding offers several advantages for health care systems, including efficiency and cost savings, according to a speaker at a Baxter-sponsored tech talk held at the ASHP Midyear 2016 Clinical Meeting and Exhibition.

Mark Barricklow, RPh, who is Pharmacy Manager at Indiana University Health, led the discussion on optimizing operational efficiencies in parenteral nutrition compounding.

He noted that although there are several advantages to centralizing PN, there are challenges involved as well, including transporting PN in a timely way, "especially in weather extremes," as there are concerns about insulation and the containers in which the PN are shipped. Click here to hear Dr. Barricklow describe some of the challenges involved in establishing a centralized compounding parenteral nutrition program.

Regardless of those challenges, Dr. Barricklow noted that his system, which is comprised of 16 hospitals ranging from large academic settings, to rural locations, has seen success with centralized PN compounding, which in their system occurs at Methodist Hospital in Indianapolis.

Benefits associated with centralized PN that Dr. Barricklow noted included a single dataset, which allows acces to order information as patients move through their health system. Other benefits include: standardized electronic medical records and electronic order forms for all patient types, a specialized staff that oversees production, and standardized warning limits. The warning limits are important, he said, because there are "a lot of patients, particularly in the pediatric world with very robust needs." The warning limits allow the pharmacists in their system to "maximize the use of our back order products," he explained.

Managing the centralized PN process within a health system is multifaceted, Dr. Barricklow said, noting that it demands:

• Formulary review for PN ingredients, weekly system phone meetings,
• A process for implementing warning limits,
• Strong IT support.