Going cartless

I spent some time recently speaking with the director of pharmacy (DOP) from a large acute care facility about operations and various dispensing models. In this particular instance, the hospital utilizes a cartfill model, decentralized pharmacists in satellites to handle first doses, batched IV’s and automated dispensing cabinets for pain meds and other “PRN” medications.

At one point the conversation drifted toward a discussion of using a cartless dispensing model. The DOP wasn’t a fan. The reason cited was a fear that utilizing automated dispensing cabinets in a cartless model would create a workflow logjam in the pharmacy as the entire day would be dedicated to “massive ADC [automated dispensing cabinet] fills”. I understand the thought process, but have found through experience that this simply isn’t true. In a well-constructed workflow a cartless model is quite efficient.
Continue reading Going cartless

Cool Technology for Pharmacy

In a previous post I mused about using an automated packaging system like InSite from Talyst as a type of automated dispensing cabinet for acute care patients. InSite was designed for long-term care and would simply be too large for the needs of an acute care nursing unit, but the technology is ideal.

However, the ATP-71 (PDF) from Swisslog is a bulk packager that can hold up to 71 canisters in a relatively small footprint: 31.5 inches wide x 29.6 inches deep x 30.6 inches high. For comparison, a Pyxis MedStation 4000 2-drawer main unit is 22.8 inches wide x 26.7 inches deep x 27.7 inches high. I would say that makes the two units comparable in terms of size, and I can tell you from personal experience that a 2-drawer main isn’t very big up close.
Continue reading Cool Technology for Pharmacy

ISMP launches first self assessment of ADC safety

ISMP.org: “More than 80% of US hospitals have implemented automated dispensing cabinets (ADCs) as an important part of their drug distribution system, making the evaluation of practices surrounding this technology an essential step in ensuring patient safety. To help meet healthcare organizations’ growing need for assistance in this area, ISMP has introduced the first Medication Safety Self Assessment for Automated Dispensing Cabinets. The assessment contains 12 core elements that support the safe use of ADCs, which are based on guidelines developed by a national forum convened by ISMP comprising practitioners and vendors with expertise in the safe use of ADCs.** Many of the core elements represent system improvements and safeguards that ISMP has recommended in response to analysis of medication errors and problems identified during onsite ISMP consultations with hospitals. ” – ISMP offers some great resources and their self assessments are are a good way to see exactly where you stand against their “standards”. I would encourage every acute care facility using ADCs to complete the survey and submit their data to ISMP, confidentially of course.

Safest and most efficient distribution model

Cardinalhealth.com: “The findings of this analysis demonstrated that in a decentralized medication distribution model, as the percentage of medications in an automated dispensing cabinet (ADC) is increased, there is a direct correlation with:

  1. Decreased time to initial dose
  2. Decreased missing doses
  3. Decreased pharmacist and pharmacy technician labor
  4. Decreased non value added nursing activities
  5. Increased predictability

This is no surprise as many leaders in the pharmacy world have been trying to move to a decentralized distribution model for years. The biggest roadblock thus far has been cost and lack of automation. As automation improves and becomes more available and less costly, the decentralized scenario becomes more and more likely.