Results. The estimated labor savings comparing the preimplementation and postimplementation time studies for automated dispensing cabinet (ADC) refills, first-dose requests, supplemental cart fill, and medication procurement totaled 2.6 full-time equivalents (FTEs). After departmental reorganization, a net reduction of 2.0 technician FTEs was achieved. The average turnaround time for stat medication requests using CDT was 7.19 minutes, and the percentage of doses filled in less than 20 minutes was 95.1%. After implementing CDT, the average accuracy rate for all dispense requests increased from 99.02% to 99.48%. The inventory carrying cost was reduced by $25,059.
Conclusion. CDT improved the overall efficiency and accuracy of medication dispensing in a university medical center pharmacy. Workflow efficiencies achieved in ADC refill, first-dose dispensing, supplemental cart fill, and the medication procurement process allowed the department to reduce the amount of technician labor required to support the medication distribution process, as well as reallocate technician labor to other areas in need.Â â€
I still work in the pharmacy on occasion. It keeps me up to date with changes that Iâ€™ve made to various pharmacy systems and gives me the opportunity to make sure my pharmacist skills havenâ€™t evaporated. One thing it doesnâ€™t do is get me away from my current technology related duties. In fact it puts me closer to the action and even more accessible to pretty much everyone, which means I spend a majority of my â€œstaffingâ€ time dealing with things related to our automation; carousel picks and loads, packager fills, compunder checking, labeler input and checking, minor troubleshooting, etc. Itâ€™s not that someone else canâ€™t do it, but thatâ€™s the way it works out.
Prior to the days of a clean room, most pharmacies had a designated area with one or move laminar flow hoods where they compounded intravenous (IV) medications. For lack of a better term this area was cleverly called the “IV Room”. The laminar flow hoods created a sterile work environment from which the pharmacy technicians could work. It was not uncommon for anyone making an IV preparation to simply leave the “IV Room” and wonder around the pharmacy looking for supplies when they ran short.
During my recent trip back east I had the opportunity to drop in on the inpatient pharmacy at Northwestern Memorial Hospital in downtown Chicago. The reason for the visit was simple. I was already in Chicago for the ASHP Summer Meeting and Northwestern utilizes some of the same pharmacy automation as Kaweah Delta. One would think that the same automation would equal the same procedures, but nothing could be further from the truth. This is one of the fundamental problems with hospital pharmacy in general. Lack of standardization equates to the inability to share information across multiple facilities. Best practice is elusive when talking about automation in pharmacy.
If you float something out over the internet, someone is going to see it and keep you honest. Remember what I said, “There is always someone smarter, harder working, more motivated and better informed than me, and those are the people I want to hear from.” Well, those people have responded with some great information pertaining to barcoding and pharmacy automation.Â
Pyxis PARx: “The Pyxis PARxÂ® system automates the pick-check-delivery process to provide increased security during medication replenishment throughout the hospital. The system utilizes bar code scanning technology for real-time tracking and monitoring of medication handling, pharmacist review and delivery of medications. By providing a complete chain-of-custody on medications during distribution to the nursing unit and helping to ensure the right medication is getting to the right station and the right pocket in the station, the Pyxis PARxÂ® system is a valuable technology that provides improved patient safety and supports compliance with Joint Commission requirements.“
In March of 2008 our hospital implemented a system to meet a district wide initiative for 100% barcoded medications in the pharmacy. The barcoding project for the pharmacy was immense, involving a pharmacy remodel, hundreds of thousands of dollars and hundreds (if not thousands) of man hours.
The project included the implementation of an automated bulk packager capable of creating unit-dosed, barcode ready medications (AutoPack), a barcode labeling system (AutoLabel) and an automated medication storage and retrieval system (AutoCarousel with AutoPharm software). All products were purchased from Talyst, who is headquartered in Bellevue, WA.