You notice a commingled tablet on visual verification of a prescription select which steps

At CVS Health, the health and well-being of our patients is our number one priority. We are not only focused on creating a place where patients receive expert care and counsel, but also ensuring the quality and safety of our products and dispensed medications.

We have developed several programs and initiatives to help ensure that the prescription medications that we dispense are safe, high-quality and cost-effective. All of our pharmacy operations, including the pharmacies in our retail stores, and our mail order and specialty pharmacies, follow comprehensive quality assurance processes for prescription safety and accuracy and every prescription we dispense undergoes a multi-step review by a pharmacist prior to being dispensed to a patient.

In our retail pharmacies, well-defined processes have been put in place to ensure accurate dispensing, including on-screen computer messaging, bar-coded prescription labels, electronic prescribing, automated prescription filling technology, electronic pill imaging and quality assurance training for all pharmacy staff. Our mail order and specialty pharmacies utilize extensive quality control measures when dispensing medications as well, such as enhanced quality control, electronic imaging, quality procedures for compounded prescription items, drug utilization reviews and final quality assurance checks.

To further ensure patient safety, we include a description of what the medication looks like on each and every prescription label. We advise patients to check their medication to make sure it matches the label information indicating color, shape and markings. Our labels also include information about side effects and detailed instructions on how to take the medication properly. Prescription medications also include a detailed drug description information sheet that contains helpful information about side effects, drug interactions and what to do if a patient misses a dose. These labeling practices apply to all prescription medications dispensed by CVS Health.

We also engage independent industry experts, such as PSO Advisory, a patient safety organization, to evaluate our quality and safety procedures as part of our commitment to continually enhancing our systems and processes to help ensure that prescriptions are dispensed safely and accurately. PSO Advisory has supported our advancements in safety, such as quality performance metrics and electronic prescribing.

Medication Adherence: The Communicators

But our greatest resource is our team of dedicated pharmacists who provide face-to-face consultations and are truly on the front lines of health care.

  • #1

Any thoughts on new QA verification tray? Anyone started using it? I like the idea where we can see all the pills but won't help verifying 500 scripts in a day using that.

  • #2

Slow us down a lottttt

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  • #3

I'm checking about the same speed after about 5 days using it. Just takes some new muscle memory. Feel more confident with product verification. I'm loving it

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  • #4

Before I left CVS I wrote an article for the monthly QA newsletter about a case of mixed Armour Thyroid pills in a vial. The article was accepted for publication so I imagine y'all CVS'ers will be seeing it soon. It was edited extensively by the QA team and one of the modifications was to point out how the use of the visual verification tray would have prevented the error [didn't exist in my market at the time of the error].

  • #5

Before I left CVS I wrote an article for the monthly QA newsletter about a case of mixed Armour Thyroid pills in a vial. The article was accepted for publication so I imagine y'all CVS'ers will be seeing it soon. It was edited extensively by the QA team and one of the modifications was to point out how the use of the visual verification tray would have prevented the error [didn't exist in my market at the time of the error].

They need to make the armour's different colors. Trazadone too.

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  • #6

Has been quite useful...I don't know what the hell someone was thinking at QP, but they decided to mix Klor Con with Potassium...same size, both white [almost same shade], with similar looking imprints. I don't know if some techs are blind or just get distracted too easily or are trying to set me up for failure.

Other incidence with someone pouring lamotrigine 150mg with lamotrigine 100mg...similar to armour thyroid example. We've been using the trays for over 2 years

  • #7

Has been quite useful...I don't know what the hell someone was thinking at QP, but they decided to mix Klor Con with Potassium...same size, both white [almost same shade], with similar looking imprints. I don't know if some techs are blind or just get distracted too easily or are trying to set me up for failure.

Other incidence with someone pouring lamotrigine 150mg with lamotrigine 100mg...similar to armour thyroid example. We've been using the trays for over 2 years

You need better trained techs. This only happens if they don't scan everything. If you count it, you had better have scanned it....

  • #8

You need better trained techs. This only happens if they don't scan everything. If you count it, you had better have scanned it....

Yes, the dilemma is I do not have time to train techs on a bare bones schedule & they are not properly trained enough in a pharmacy setting before working. PIC doesn't train them; I would literally have to train them on off days without pay. This is likely a common problem for most stores [high turnover, constantly having to train new hires despite doing modules or being "trained"].

  • #9

The tray was introduced in ohio last summer. We had mandatory unpaid training meeting about it. We also had to go through all open bottles in the pharmacy to inspect to make sure there are no co mingled tablets. We did get additional rph hours one week to help complete this project.

  • #10

It's not just the techs. A night rph made a dispensing error with co mingled tablets. He was working with no tech.
The script pro has been the source of error the last two times I have caught co mingled tablets.

  • #11

What is a cvs verification tray?

  • #12

What is a cvs verification tray?

Put the pills in the wide end. Look to see if they are all the same. Pour them back into the bottle at the narrow end. Looks like this:

  • #13

It's not just the techs. A night rph made a dispensing error with co mingled tablets. He was working with no tech.
The script pro has been the source of error the last two times I have caught co mingled tablets.

People also putting the wrong RTS sticker on vials. Won't be caught without visual verification.

  • #14

Sounds like it would take forever. I mean just a few seconds, but seconds add up when you're doing >500 a day.

wagrxm2000

Walgreens enthusiast. Called the peak in Bitcoin.

  • #15

What's the purpose of this exactly? In all my years I have never been told there was a wrong pill in someone's bottle.

  • #16

Put the pills in the wide end. Look to see if they are all the same. Pour them back into the bottle at the narrow end. Looks like this:

You take lo loestrin out of its plastic?! What a savage!

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  • #17

What's the purpose of this exactly? In all my years I have never been told there was a wrong pill in someone's bottle.

Never? Not even once has a low skilled tech or trainy comingled some tablets? Or applied an RTS label to the wrong bottle? I have caught that error many many times, many times more than I should have had to. Maybe you aren't checking throughly enough?

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wagrxm2000

Walgreens enthusiast. Called the peak in Bitcoin.

  • #18

Never? Not even once has a low skilled tech or trainy comingled some tablets? Or applied an RTS label to the wrong bottle? I have caught that error many many times, many times more than I should have had to. Maybe you aren't checking throughly enough?

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Errors have occurred here and there. I said I've never been told by a patient there was a wrong pill mixed with the correct ones. Now could they just have not noticed it? Sure but no one has ever mentioned they received a wrong pill.

So I don't see the point of this. It sounds like you have a training issue if you find this useful.

  • #19

Errors have occurred here and there. I said I've never been told by a patient there was a wrong pill mixed with the correct ones. Now could they just have not noticed it? Sure but no one has ever mentioned they received a wrong pill.

So I don't see the point of this. It sounds like you have a training issue if you find this useful.

The point is to make it easier to do a through product review.

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wagrxm2000

Walgreens enthusiast. Called the peak in Bitcoin.

  • #20

The point is to make it easier to do a through product review.

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It shouldn't be needed though. I might be eating my words later but I don't see Walgreens doing this.

  • #21

You take lo loestrin out of its plastic?! What a savage!

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That's not me. It was posted on Reddit as "am I doing this right?"

  • #22

I think it's one of the changes at CVS that is actually worthwhile. All it's doing is protecting your license and the patients. Now scanning your credentials just to open a profile is a stupid update and pisses me off.

  • #23

I think it's one of the changes at CVS that is actually worthwhile. All it's doing is protecting your license and the patients. Now scanning your credentials just to open a profile is a stupid update and pisses me off.

So nobody sees which celebrity is overdosing on opiates this week

  • #25

A bunch of inventors from rhode island are in the process of a patent application for the visual verification tray.
//www.patentsencyclopedia.com/imgfull/20160000656_01

I was searching for the existing verification tray online and came across counting trays for sale on Amazon. Based on the customer reviews tons of people are actually buying counting trays to double count their prescriptions at home, lmao.

Heist

MD Attending Physician

  • #26

I was searching for the existing verification tray online and came across counting trays for sale on Amazon. Based on the customer reviews tons of people are actually buying counting trays to double count their prescriptions at home, lmao.

Dealers?

  • #27

My impression was old/weird/paranoid people with nothing better to do based on the reviews. I'm sure there are dealers buying them too though.

  • #28

I can find counting trays but not a visual verification tray on amazon

  • #30

It took 7 people to invent that dustpan without a broom handle lolz. sighhhhh

Im pretty sure that's just the whole QA team [at the time].

  • #31

i still don't use it. imagine all the tablets dusting off onto the tray, then the next, and the next, hundreds and thousands of different tabs dusting off and mix together. this mixing of meds is dangerous. imagine capsules being poured into the tray and catching all those dusts of drugs. who is crazy enough to let this happen?

  • #32

i still don't use it. imagine all the tablets dusting off onto the tray, then the next, and the next, hundreds and thousands of different tabs dusting off and mix together. this mixing of meds is dangerous. imagine capsules being poured into the tray and catching all those dusts of drugs. who is crazy enough to let this happen?

I don’t care whether you use it or not. But your reasoning...

You can wipe it off periodically, just like a counting tray. This is not a hard one.

  • #33

i still don't use it. imagine all the tablets dusting off onto the tray, then the next, and the next, hundreds and thousands of different tabs dusting off and mix together. this mixing of meds is dangerous. imagine capsules being poured into the tray and catching all those dusts of drugs. who is crazy enough to let this happen?

No different than the counting tray the techs use. Your employer will fire you if they catch you. I think this thing is *****ic, but I use it every time, because that is what my employer requires......

  • #34

Verification tray is dumb. That's what the accuracy scanner is for. How does this tray help inspect liquids? If it's 4 capsules of vitamin d or 4 viagra tablets do you still bother to pour it out? I have lost numerous tablets having to pour them out. I wouldn't bother with it for c2s that you count yourself but cvs still wants you doing it.
Do target rphs have these ?

I can't read the tablet imprints when they are on the tray but I can read when I have the bottle up close and pour a couple tablets inside the cap or on hand.

  • #35

Also ironically I have read about misfills still happening with the tray and no punishment for rph. One was trazodone inside bottle for tramadol.

  • #36

i still don't use it. imagine all the tablets dusting off onto the tray, then the next, and the next, hundreds and thousands of different tabs dusting off and mix together. this mixing of meds is dangerous. imagine capsules being poured into the tray and catching all those dusts of drugs. who is crazy enough to let this happen?

  • #37

I find it most useful for checking ScriptPro prescriptions- I regularly find drugs where the tablets are broken/split [registering as two or more tablets] and would otherwise have shorted the patient on their medication by several days.

  • #38

I find it most useful for checking ScriptPro prescriptions- I regularly find drugs where the tablets are broken/split [registering as two or more tablets] and would otherwise have shorted the patient on their medication by several days.

Naproxen 500 Ugh!

  • #39

In my experience most of the time patients say they have the wrong meds in their bottle it's because they mix them themselves. Never knew this was a thing but wonders never cease.

  • #40

Comingled tabs is just risk some gotta take, no time to inspect every pill in each bottle, simply too many scripts

  • #41

I dump every tablet just to look for anything different it takes one second. I dump it once I scan the label because theres a second lag to next page and at end I pop bottle makw sure it matches. Some of you got issues blindly verifying stuff then get mad when your techs half ass **** too.

  • #42

Is this QA tray nationwide now?

  • #43

Is this QA tray nationwide now?

It's been that way for a year.

  • #44

In my experience most of the time patients say they have the wrong meds in their bottle it's because they mix them themselves. Never knew this was a thing but wonders never cease.

i came across a scriptpro cell with mixed meds in that cell. as it is scriptpro, it affects multiple patients! please don't blame patients for errors that is yours! around this area RTS vials are allowed to be used in scriptpro cell replenishment and that leads to errors. if u work for cvs, blaming patients for errors is a new low.

  • #45

Dude, trailerpark is talking about situations like where the ***** patient claims commingled tablets for prescriptions they get regularly but the different prescriptions are separated temporally [filled weeks apart] and physically [e.g., MTX may be stored nowhere near folic acid]. He works for WM like me. We don't have automation inside the pharmacy, 400/week or 4000/week.

  • #46

i came across a scriptpro cell with mixed meds in that cell. as it is scriptpro, it affects multiple patients! please don't blame patients for errors that is yours! around this area RTS vials are allowed to be used in scriptpro cell replenishment and that leads to errors. if u work for cvs, blaming patients for errors is a new low.

First of all I don't have a automatic fill machine or work for CVS and it's 100% the patients fault in most cases. Trying to blame the pharmacy for your own error is a new lower for some patients.

  • #47

around this area RTS vials are allowed to be used in scriptpro cell replenishment and that leads to errors. if u work for cvs, blaming patients for errors is a new low.

Script Pro has a specific process for using RTS vials. You have to scan the barcode, verifying the NDC's are the same before you can add them to the cell. Chains vary, but with my company a pharmacist has to be the one adding the meds into the cells.

This complaint is weak sauce.

  • #48

Script Pro has a specific process for using RTS vials. You have to scan the barcode, verifying the NDC's are the same before you can add them to the cell. Chains vary, but with my company a pharmacist has to be the one adding the meds into the cells.

This complaint is weak sauce.

in this area the techs are allowed to do Scriptpro replenishment. i've seen techs do this at multiple stores. and with RTS vials, a lot of pharmacists/techs are still mixing pill bottles together. hence the error. both practices were banned years ago where i was from. but ppl are still doing it here in this area.

  • #49

in this area the techs are allowed to do Scriptpro replenishment. i've seen techs do this at multiple stores. and with RTS vials, a lot of pharmacists/techs are still mixing pill bottles together. hence the error. both practices were banned years ago where i was from. but ppl are still doing it here in this area.

Are you sure it's allowed? Or is it just commonly done?

  • #50

Are you sure it's allowed? Or is it just commonly done?

Probably yet another thing the techs do around her because they know they can get away with it

What should you do if a customer decides to wait for a prescription?

Politely advise the customer that it will be a short wait and you will call them when the prescription is ready.

What do you look for in a prescription?

Definition/Introduction.
Date of issue..
Patient's name and address..
Patient's date of birth..
Clinician name, address, DEA number..
Drug name..
Drug strength..
Dosage form..
Quantity prescribed..

What are waiting bins used for?

1. Use the Waiting Bin Report to identify all Return to Stock prescriptions. prescriptions from the waiting bin area.

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