Hospital improves patient safety with automatic drug distribution system

For the better part of a decade, administrators at Chambersburg Hospital, Chambersburg, Pa., have wrestled with ways to improve patient safety and reduce medication errors.

The hospital moved one step closer to attaining its goal when Grant became the director of pharmacy and respiratory care in 2002. He helped form a medication safety team made up of nurses, pharmacists, doctors, and information services specialists who reviewed and revised hospital policies and processes to improve patient safety. But a technological solution remained elusive.

An automatic warehouse

The WorkflowRx 5.0 solution used by the south-central Pennsylvania hospital enables pharmacy staff members to perform various tasks simultaneously, such as drug dispensing and inventory maintenance. The hospital also uses an electronic medication administration record/bedside medication verification (eMAR/BMV) system from Westwood, Mass.-based MEDITECH, to improve patient safety.

The combination of the two systems, Grant said, has dramatically reduced the time it takes to fill medication carts. The systems also have helped reduce dispensing errors and improve patient safety. Grant said the hospital's error rate dropped from 0.05% in January 2006 to 0.03% in September 2006. Dispensing errors during that period fell from 12% to 3%, he added.

Omnicell's WorkflowRx system integrates an automated storage and retrieval carousel with a tablet/capsule repackaging device called SafetyPak, according to the company. The carousel, which has up to 32 shelves to store medications, can reorder drugs based on past usage. After a patient's medication dosage is entered into WorkflowRx, the system's SafetyPak component individually packages the drug, applies a bar code to it, and prints the patient's name on the package.

"It's really acting in some ways like a warehousing system in that it orders [drugs], receives them, stocks them, and picks them," said Wendell Wenjen, product marketing manager for WorkflowRx at Omnicell. "At a high level, that is what goes on in a hospital pharmacy."

Saving time

Before Chambersburg Hospital started using WorkflowRx in April 2006, pharmacists and technicians typically spent 16 hours a day filling patients' medication orders. The orders, printed on a ream of paper, would be divided by nursing unit and then hand-picked by a technician, Grant said. That process usually took around eight hours.

Once the technician finished hand-picking the 1,200 to 1,400 orders, a pharmacist would then check the orders for accuracy. That process also took eight hours.

"When you have such a long cart-fill time, during the whole time you are filling orders, there are [medication] changes going on and new orders coming in," Wenjen noted. "By the time you finish the process, you basically have to start all over again."

Pharmacists and technicians haven't had to start the process over again for more than a year now. The latest version of WorkflowRx-used by the hospital for the past several months-has cut the medication order-fill time from 16 hours to 90 minutes, giving pharmacists and technicians the ability to spend more time tending to patients' needs. Grant said the solution has helped streamline the hospital's drug-dispensing process and enhance patient safety.

Besides improving patient safety, WorkflowRx helps hospital pharmacists improve the productivity of their staff and better manage inventory. "There's an operational benefit," Wenjen explained. "But it really helps improve patient safety and reduce medication errors. The pharmacists themselves now can do more value-added consulting with doctors and patients."