Streamlined Medication Management Saves More Time for Care at Arrow Senior Living

After completing my LPN program, my first job was at a skilled nursing facility where I quickly realized the environment wasn't the right fit for me. A colleague suggested I look into assisted living, a concept I was unfamiliar with at the time. Despite my initial uncertainty, I applied for a position, and since then, I've never regretted my decision.

The job was at Arrow Senior Living Management. When I joined more than a decade ago, the company had only three communities. Today, we have 33 with several communities in various phases of new development and acquisition; we manage over $1.75 billion in assets and are the 46th largest operator in the US. Several of our communities are Joint Commission accredited, and our goal is for our entire portfolio to be Joint Commission accredited and Memory Care certified by the end of 2024.

At Arrow, we hire for heart and train for skill. Someone can learn the skills to be a good director or department head. But you can’t teach people the qualities of an exceptional nurse: kindness, empathy, and enough curiosity to be a lifelong learner. Arrow recognized those qualities in me and gave me the skills to progress from night nurse to Managing Director of Wellness Integration.

I describe my role as bridging the gap between wellness and technology. Part of my role includes managing acquisitions and opening new developments, and I’m responsible for the analytics tools that track our wellness KPIs. Another big part of my job is overseeing vendor relations, which includes fostering relationships with rehab vendors, pharmacies, podiatry groups, and the like. We are willing to push the boundaries of what assisted living can be. We love technology, we embrace diversity, and that attitude makes it an energizing place to work.

Strained Relationships and Medication Availability

For years, Arrow used Yardi for our health record system and QuickMAR as our eMAR solution. Our Yardi contract was set to expire in 2018, which prompted us to switch to PointClickCare, the industry-leading cloud-based software provider. The word-of-mouth reviews for PointClickCare were its best advertising. As I interviewed prospective community wellness directors, I couldn’t tell you how often people asked, “Have you considered using PointClickCare?” If that’s not a sign, I don’t know what is.

We loved QuickMAR, so we kept it even as we adopted PointClickCare. QuickMAR was so simple; you could give someone a quick orientation, and they would be ready to go. It made communication with the pharmacy easy, too.

Unfortunately, we started having issues with PointClickCare’s EHR system and QuickMAR not talking to each other (this was before PointClickCare acquired the platform). We knew we wanted resident records and medication orders all in one platform. That’s why we made the jump to PointClickCare’s eMAR.

We gained some efficiency by having one system for our eMAR with our EHR. Still, it wasn’t as user-friendly as I’d hoped, and we missed the two-way pharmacy communication we enjoyed with QuickMAR. Nurses had to spend a lot of time managing and confirming orders. Time spent on the system took nurses’ time away from residents. These issues compounded until we started experiencing delays in medication availability.

It also opened a division between Arrow and the pharmacy. In our quarterly partnership review surveys, wellness directors’ satisfaction with our pharmacy partners started to drop. To see dissatisfaction creep into an almost two-decade long relationship was painful and something we did not take lightly.

I raised these concerns with the PointClickCare team. They said, “If you liked QuickMAR, you’ll love our upcoming solution: Pharmacy Connect.”

Time Savings, Fewer Errors, and Peace of Mind

Arrow isn’t afraid of trying new things, and knowing how big of a problem we were trying to solve, I almost immediately said yes to PointClickCare’s suggestion. We started with two communities as a pilot in early 2023, adding four more communities later in the year. 

Pharmacy Connect is an incredibly turnkey system that allows staff to approve, manage, and discontinue orders in one easy-to-use wellness workspace. The increased automation, including Pharmacy Connect’s integration with PointClickCare’s EHR, eliminates the need to manually click through antiquated tabs. The way this improves overall workflows is huge for us.

Time is our biggest asset. There’s a nursing shortage, and we have to get the most out of our nurses' precious time as we possibly can. So, when I heard—and saw—how easy it is to train staff on Pharmacy Connect, and the time savings that result from that, I knew we were onto something.

Everyone fears the liability of medication errors. The consequences of an error can have disastrous results. The previous ordering process was complex, increasing the likelihood of mistakes. Pharmacy Connect simplifies this process significantly, reducing the number of steps and making it easier to detect errors. This reassures staff, ensuring they can confidently avoid administrative mistake while administering medications.

Our old tech stack led to delays in medication availability, but Pharmacy Connect addressed that pain point. Our six pilot communities have experienced a 40% reduction in these errors, and the time nurses spend managing orders has been cut by 50%. We’re wildly excited about that.

Our pharmacy relationship has also improved. When we initially saw the downturn in satisfaction, we knew it wasn’t really a pharmacy issue and that something had to change. Today, all Pharmacy Connect communities have reported increased pharmacy satisfaction scores. 

Improvements That Delight Residents

That satisfaction has extended to other areas of the organization. Residents have noticed they now have more time with nurses, who are more attentive. We haven’t made staffing or scheduling changes during this time, so we link these improvements to Pharmacy Connect and giving our staff some time back in their days.

I have an unofficial “Back to the Bedside” campaign, which is about giving nurses what they want. As a former floor nurse, I know nurses don’t go to nursing school to sit behind a computer all day, wasting time on mundane tasks. We want to spend our time helping people, so when we talk about efficiency, halving the time spent on managing medication orders is more than numbers on a spreadsheet. It translates to more time spent with residents.

Residents aren't just noticing the results of my campaign; they are also delighted we can now provide them with that same level of service they experienced when living independently. If you or I go to urgent care, we fill our prescription and start taking our medicine the same day. In community living, there's a lot more steps to follow due to insurance, regulations, order approval, etc. and delays are frequent. Pharmacy Connect solves a lot of these challenges.  

A Solution That Revitalizes Partnerships

I like to operate with a “Yes, and” mentality: I start by saying “Yes,” and then follow with the clarifying questions. I didn’t know much about Pharmacy Connect at first, but I’m grateful to have had the opportunity to pilot it.

This solution has reinvigorated two critical relationships for Arrow. The first was our relationship with PointClickCare, who took a weak spot and completely turned it upside down. They gave us the product we wanted and needed, that integrated seamlessly with what we already had.

Second, Pharmacy Connect has helped restore and strengthen our pharmacy relationship. Without that relationship, none of this would be possible. EverSpring Pharmacy, the pharmacy for the majority of our communities, shares Arrow’s excitement for change. Their reaction to Pharmacy Connect was the same as mine; it was never a question of whether we should try it, but when to start. Now, they’re asking when we can migrate more communities to this solution to create more efficiency across the board.

Other wellness directors may be hesitant to adopt something new—especially around medication management—but we should approach every change by asking, “Why not?” We can’t afford to be complacent. If assisted living operators are afraid to try new things, then the assisted living industry will not survive. As our population ages, we need forward-thinking communities where residents, nurses, and other staff can thrive. We have an opportunity to shine—to show we’re better than the alternatives and can incorporate technology in ways that benefit our business, our staff, our partners, and most importantly, the people in our care.