Evaluation of a facsimile (fax) transfer system for medication order delivery

Delivery of medication orders for initial processing is often slowed by distance between the nursing unit and the pharmacy. Messengers and pneumatic tubes are not always available or reliable. Facsimile (fax) machines are able to transmit photocopies of medication orders in seconds. An initial evaluation of available fax machines led to selection of three models for a trial installation. Criteria for fax evaluation included medication order turnaround time (TAT), percentage of orders requiring more than 2 hours to be received by the nursing unit, and number of orders recopied by nursing personnel for pharmacy use. An initial review identified the time required for order processing using a reliable pneumatic tube system to deliver orders to the central pharmacy. The number of orders recopied by nurses into the chart to provide working copies of misplaced or lost orders for pharmacy was also recorded. The fax system was installed and the initial data collection process was repeated. Statistics focused on the total time required to transmit an order to pharmacy and provide the initial dose to the nursing unit. Analysis of the mean (+/- SD) showed an initial TAT of 1.59 (+/- 1.30) hours (n = 92). TAT after initiation of fax transmission was 1.36 (+/- 1.15) hours, P = 0.20 (n = 104). This improvement is greater than it appears because 1.10 hours of both of these times are fixed times involving pharmacy order processing. The percentage of orders that required more than two hours to provide medication to the nursing unit was reduced from 29% (27/92) to 18% (19/104) P less than 0.05. The average number of nursing recopies into the chart was reduced.