To keep up with increasing nationwide shortages in generic medications, rising demands for medications due to near full census at HUP, and a continuous pursuit to improve safety and efficiency, Pharmacy needed to expand its inpatient operations. With the support of senior leadership -- and the help of many departments throughout HUP -- a newly renovated and expanded space on Ground Rhoads now houses these services, along with a state-of-the-art robot that offers substantial improvements over the previous one.
But they did it. “We basically moved a 10,000-square-foot department -- with thousands of doses of inpatient medications -- out of the main pharmacy, along with our inventory and storage units,” Miranda said. “All while our staff continued to prepare 3,000 doses out of the IV room.”
“It took months of planning -- and a lot of labor -- but we were extremely successful in making the move invisible to the rest of the organization” said Rick Demers, RPh, Pharmacy director. “And it was a team effort to get it all done – Design and Construction, EVS, Information Services, and so many more.”
The new suite, designed from a “shelled” space, will improve workflow for Pharmacy staff. The department’s main storeroom, unit dose robot, controlled substances distribution, sterile intravenous production, and traditional compounding functions are now located in adjacent spaces. “The workers in these operations can now take advantage of the efficiency of working more closely, so there should be less waste and better inventory control,” said Miranda.
The space also features a new compliant sterile IV compounding room and a negative pressure chemotherapy compounding room for chemotherapy preparations. New automated inventory control technology will be added later this summer to further support safety and efficiency.
At this time, the administrative offices for the Pharmacy will remain in the basement of the Silverstein building.
The new robot has already made a significant improvement in the Pharmacy’s efficiency. Before the transition to the new space and robot, a cart fill (a 24-hour supply of unit dose medications for every inpatient filled overnight) averaged 8,600 doses a night and took from 10 to 12 hours to complete. In the first week after the move, the time to dispense approximately 10,000 doses decreased to six to eight hours. “The new device dispensed 2,500 first doses during the day and evening shifts,” Miranda said. “This task was not possible with the previous robot.”
Miranda said the new robot can handle over 5,000 line items, process 53,280 doses, package 700 oral solids per hour, and dispense 1,050 oral solids per hour, “a substantial increase” over pre-move numbers. In addition, the device dispenses products in standardized unit dose packages. The previous robot repackaged unit dose medications in packets, requiring nurses to open two packages. “This is much more convenient and efficient for nurses,” Miranda said, adding that this feature also allows Pharmacy to purchase medications in bulk, a cost effective approach.
Another important feature of the new technology is a plastic ring that holds the 24-hour supply for an individual patient supply of medications. “This ring should decrease the chances of losing doses in the medication drawers,” Miranda said.
Demers said the staff are excited to work in this new environment, a considerable change from their former home in the Silverstein Basement. “We appreciate the support of senior leadership and the help of everyone who helped us get this done.”
A New Space for Inpatient Pharmacy
To improve efficiency and support patient safety, Pharmacy recently moved all of its inpatient operations from the Silverstein Basement to a newly renovated space in Ground Rhoads, including:
- Central Inpatient Pharmacy (a 24/7 service area for Silver (including ED), Ravdin, Dulles, Rhoads buildings.
- Sterile Products production area (24/7 service)
- Controlled Substances Storage Room (24/7 service)
- Pharmacy Purchasing office
- Medication storeroom
- Pharmacy robotics and packaging room
- Manufacturing & Compounding group