Jerry Fahrni

A friend from Talyst stopped by the pharmacy and spent the greater part of Monday afternoon and Tuesday morning taking a look at what it means to work in an acute care hospital pharmacy. We have several pieces of Talyst automation and technology in our pharmacy and he was interested in how we used it and how it fit into the general scheme of things. As we roamed the pharmacy, I began describing our Pyxis system, how we handle our replenishment, how we put our order away, how we package bulk medications, how we barcode syringes, how we handle an IV batch, how we handle infusions for our smart pumps, and so on and so forth ad infinitum. It was a good exercise for me as it often improves my understanding of something when I try to explain it to someone else.

As we walked around the pharmacy and I began explaining how things worked I noticed that I frequently had to move to another location in the pharmacy to make better use of a visual aid to explain myself. Sounds benign enough until I realized that the movement created a disjointed and often times awkward workflow. I was all over the place.

Basically, the workflow that we initially designed prior to installing the carousels had gone out the window in favor of a haphazard method of making sure that things get accomplished in the pharmacy. Some call it organized chaos, but I’m not too sure about that. Chaotic? Yes. Organized? Uh, well, not so much.

The initial workflow design called for drugs entering the pharmacy to be identified, barcoded and added to the AutoPharm, Pharmacy and Pyxis systems prior to making their way to the carousels for storage. In reality, newly received medications that are not in the system are discovered during the restocking process. Therefore, our workflow is centralized at the carousels themselves, not at the back of the pharmacy as originally thought.

This isn’t the only area that appears to have gone sideways from the original plan. Several areas in the pharmacy have morphed into something completely different than originally designed. The unfortunate result is a very inefficient workflow with poor communication secondary to groups of people working in silos; not good.

So, I took some time and did what every red-blooded American does when something like this happens: I got a Diet Pepsi and started surfing the internet in search of answers. I ran out of Diet Pepsi without finding a decent solution to my problem. I used every trick in find-anything-you-want-on-the-internet bag of tricks and came up empty handed. Apparently people don’t publish this information openly on the internet. I realize that every pharmacy workflow will be different, but don’t you think there would be some general guidelines out there somewhere? Yeah, me too.

Anyone have any suggestions? Anyone? Bueller? Bueller? Bueller?