PROCUREMENT

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PROCUREMENT DISTRIBUTION INTEREST GROUPAutumn
Symposium 2007
http//www.pdig.org.uk/
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Automated Cabinetswhy bother?

• Ann Jacklin
• Chief Pharmacist Hammersmith Hospitals
• and
• Visiting Professor The School of Pharmacy
  University of London
• November 2007

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Automated Cabinets

• What benefits are there is using automated
  cabinets
• Where should automation be used
• Are they value for money
• Why bother?

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The Hammersmith story

• 1992 USA visit
• 1993-94 Meditrol experience LD
• 2002 to date MDG ServeRx
• 2005 MDG night cabinet
• 2006 Pyxis Med stations for CDS only
• 2007 CII safe dispensary automation
• 2008 plan rollouts

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Drivers for automation

• Safety
• Efficiency
• Cost saving
• Space saving
• Modernisation
• Security
• Or
• Because we want to?
• Because we are afraid of being left behind?

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What have we learnt?
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ServeRx
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ServeRx our findings

• Safety yes
• admin errors reduced by 40, patient identity
  checked 81 vs 17, pharmacists saw 100 drug
  charts reduced wrong patient errors, increased
  nurse observation of drug taking to 24 cf 4
• Efficiency no
• Time most tasks same or increased
• Cost saving no
• Space saving ?
• Modernisation yes
• Security ?

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ServeRx

• Because we want to? Yes
• Because we are afraid of being left behind? yes

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ServeRx night cabinet
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Night cabinet preliminary findings

• Safety ?
• Efficiency yes
• Cost saving no
• Space saving yes
• Modernisation yes
• Security probably

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Night cabinet

• Because we want to? Yes
• Because we are afraid of being left behind? yes

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Pyxis Medstation
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Pyxis Medstation our findings

• Safety no
• Efficiency yes
• Order pattern improved vis a vis evening and
  weekends, stock holding reduced 23 lines average
  pre and 15 post , nurses estimated 2 15 mins
  per dose pre and 1 -5 mins post, checks 98 mins
  per week pre and 13 mins post
• Cost saving no
• Space saving ?
• Modernisation yes
• Security probably

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Pyxis ctd

• Because we want to? Yes
• Because we are afraid of being left behind? Yes

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CII Safe

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CII safe - our preliminary findings

• Safety no
• Efficiency yes
• Cost saving no
• Space saving yes
• Modernisation yes
• Security ?

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CII safe

• Because we want to? Yes
• Because we are afraid of being left behind? Yes

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Common features of systems

• Staff love them
• Not looking for keys fabulous
• remote stock control advantageous
• Can reduce inventory
• Reporting facilities need to be developed
• Can be installed incrementally
• Can reduce stock outs
• Easier to find meds
• ?Might enable direct from wholesaler delivery
• ?improved security
• ?reduce selection errors
• ?reduce omissions

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So where next.

• Supplies applications
• Emergency departments
• Night cabinets
• CDs probably
• Full ward systems not without developments

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Automated cabinets

• Will require investment
• May require you to retrofit your business case
• Good luck!

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A little history..
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Med errors US vs. UK 1960ssame problem
different solutions

• USA product focus
• retain order stationery
• remove floor stock
• Introduce unit dose
• Introduce pharmacy profiles ( for billing)
• Automate unit dose driven by profiles
• Concentrate on IPs
• CPOE

• UK paper focus
• introduce drug chart
• retain floor stock
• pharmacy IT systems for directorate based drug
  budgets
• Automate dispensing (OPs and TTOs)
• Ward based automation
• CPOE

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CII safe

• Advantages
• Reduced errors
• Speeds up the process
• Staff satisfaction
• Tighter control
• No Keys
• Easy to read register
• Bright, clean tidy!

• Disadvantages
• cost
• One user at a time
• First NHS hospital
• Rebuild CD dispensing area