2026 Southeastern Residency Conference

Title: Impact of a System-wide Pharmacy Clinical Decision Support Council on Pharmacist-Facing Medication Warning Alerts
Authors: Benny Zhang, PharmD; Craig MacDonald, PharmD

Background: Clinical decision support (CDS) is a powerful tool that provides clinicians with knowledge and patient-specific information, filtered or presented at appropriate times, to ensure safe and effective patient care. Medication warning alerts can support clinical decision-making, reduce medication errors and adverse drug events, and improve adherence to evidence-based practice. However, redundant or inappropriate medication warning alerts can lead to alert fatigue and result in unintended consequences that may compromise the safety and quality of patient care. In our system, medication warnings are supplied by a third-party vendor and can appear during order entry, verification, or medication administration and impact providers, pharmacists, and nurses. The formation of a system-wide pharmacy clinical decision support council aimed to optimize medication-related alerts to ensure front-end clinicians are seeing relevant and important warnings across a large health-system. The purpose of this study is to evaluate the impact of a system-wide pharmacy clinical decision support council on the volume of pharmacist-facing medication warning alerts.

Methods: This was a retrospective pre-post analysis conducted using EHR extracted data from 2023 to 2026 in a single health-system. Medication warning alerts presented to pharmacists were evaluated. Trends in alert volume (per 1,000 orders) were analyzed over time to assess changes following decisions made by the pharmacy clinical decision support council.

Results: In Progress

Conclusion: In Progress

Background:
Accurate inventory management is essential for operational efficiency, yet traditional models relying on periodic third-party counts limit real-time visibility and delay error correction. Over the previous years, several audit processes have been trialed, each with varying trade-offs related to ease of use, time requirements, utility, and interruption of standard workflows. A significant amount of time was spent after the counts were completed, reconciling discrepancies in the third party data including medications that could not be accurately identified based on barcode scans. Our institution recently transitioned from a biannual, vendor-supported inventory process to an internally managed model, revealing workflow inefficiencies and gaps in issue identification due to reliance on delayed data systems and fragmented scanning processes. To improve workflow and data integrity, a real-time barcode scanning tool was developed and iteratively refined to facilitate live inventory validation.

Methods:
The tool enables immediate feedback during both full inventory counts and targeted audits. Key development considerations included optimizing data refresh processes, accommodating large and variable datasets, and enhancing usability through simplified visual indicators to reduce user fatigue.  Over time, improvements focused on minimizing error rates and improving workflow integration.

Results:
Implementation of the tool improved operational efficiency by reducing the need for dual auditors and minimizing workflow interruptions. The system enhanced auditor autonomy by removing the need for individual assignments and enabling users to validate counts independently in real time. It also decreased duplication of counts and enabled immediate identification and correction of discrepancies, reducing the number of recounts required.

Conclusions:
A real-time barcode scanning approach to inventory management enhances efficiency, accuracy, and staff autonomy. This solution addresses key limitations of traditional inventory processes and supports proactive discrepancy resolution. Ongoing evaluation during a full live-count inventory will further quantify its impact on time savings and error reduction.