1.
.Story Board - In-patient Pharmacy Supply (Dispense) and Administer
1.1 Medication Order Accepted and Supplied
Purpose
This storyboard covers a basic physician order, pharmacist supply (dispense) and nurse administer and
electronic medical record in an inpatient situation where there are separate information management
systems for physician medication management, pharmacy supply, nurse administration and
institutional electronic health record.:
Diagram:
See visio (Interactiondiaginpatientorder.vsd
Story Board:
Adam Everyman was admitted to Good Health Hospital (cardiac care unit – CCU) from the Emergency
Department with a diagnosis of myocardial infarction.
Dr. Hippocrates prescribed Wonderdrug 20mg tablets, 1 orally mane for the duration of the inpatient
admission. (Pharmacy Combined Order Activate, Fulfilment Request (PORX_?????1) When
received by the pharmacy a record of the order is made in the EHR (Pharmacy Combined Order
Activate, Notification (PORX_?????2)
Susie Supply, the Hospital Pharmacist, reviews and approves the medication order and checked
medication availability, local prescribing guidelines and the appropriateness of the substance, form,
strength, route and dose. She forwards an electronic copy of the signed administration order to the
CCU. (Pharmacy Administration Order Activate, Fulfilment Request (PORX_IN?????3)
Bill Pillfiller, the Pharmacy Technician) prints out a medication label for the unit dose trolley, loads the
Wonderdrug tablet into the correct container on the trolley. Susan Supply checks his work and sends a
record of the supply to the prescribing system and to the EHR (Pharmacy Supply Event Complete,
Notification (PORX_IN?????4
Florence Nightingale, the CCU nurse, does the drug administration round next morning and checks the
physician’s order, electronic signature, the patients identity. She opens the appropriate container,
visually checks the tablet and administers it to Adam Everyman. She records the administration on the
electronic drug chart (Pharmacy Administration Event Complete, Notification (PORX_IN?????5) and
a copy of this is forwarded back to pharmacy and doctor.
Message
No:
1
Real World Event
Initiator
Receiver
Name
Prescribe drug
Dr
Pharmacist
2
Prescribe drug
Dr
EHR
3
Check
administration
order
Dispense drug
Pharmacist
Ward
Pharmacist
Dr
Pharmacy Combined
Order Activate, Fulfilment
Request (PORX_?????1)
Pharmacy Combined
Order Activate,
Notification
(PORX_?????2)
Pharmacy Supply Order
Complete, Notification
(PORX_IN?????3
Pharmacy Supply Event
Complete, Notification
(PORX_IN?????4
4
Comments
4a
Dispense drug
Pharmacist
EHR
5
Administer drug
Ward
Pharmacist
5a
Administer drug
Ward
EHR
5b
Administer drug
Ward
Dr
Pharmacy Supply Event
Complete, Notification
(PORX_IN?????4a)
Pharmacy Administration
Event Complete,
Notification
(PORX_IN?????5
Pharmacy Administration
Event Complete,
Notification
(PORX_IN?????5a
Pharmacy Administration
Event Complete,
Notification
(PORX_IN?????5b
1.2 Medication order rejected.
Purpose
This storyboard explores potential responses to the medication supply order where the response is other
than administer the order exactly as requested.
Diagram: See-Interactiondiaginpatientorderrejection.vsd
StoryBoard:
Adam Everyman was admitted to Good Health Hospital (cardiac care unit – CCU) from the Emergency
Department with a diagnosis of myocardial infarction.
Dr. Hippocrates prescribed Wonderdrug 20mg tablets, 1 orally mane for the duration of the inpatient
admission. (Pharmacy Combined Order Activate, Fulfilment Request (PORX_?????1) When
received by the pharmacy a record of the order is made in the EHR (Pharmacy Combined Order
Activate, Notification (PORX_?????2)
Susie Supply, the Hospital Pharmacist, reviews the medication order and checked medication
availability, local prescribing guidelines and the appropriateness of the substance, form, strength, route
and dose. Based on the medication record held in the pharmacy information system the patient is
allergic to Wonderdrug. Susie refuses supply (Pharmacy Combined Order Activate, Rejection
PORX_IN?????6)
Message
No:
1
Real World Event
Initiator
Receiver
Name
Prescribe drug
Dr
Pharmacist
2
Prescribe drug
Dr
EHR
6
Refuse supply
Pharmacist
Dr
Pharmacy Combined
Order Activate, Fulfilment
Request (PORX_?????1)
Pharmacy Combined
Order Activate,
Notification
(PORX_?????2)
Pharmacy Combined
Order Activate, Rejection
PORX_IN?????6)
6a
Refuse supply
Pharmacist
EHRr
Pharmacy Combined
Order Activate, Rejection
PORX_IN?????6a)
Comments
1.3 Variations on Pharmacist response to supply order.
Purpose
Diagram:
StoryBoard: