1. Case Study
The Final Frontier of Automation:
Automating the Anesthesia Process
Overview enhance inventory management, improve
For a hospital that dates back over 125 control of controlled substance waste, and
At a Glance years, Saint Luke’s in Kansas City, Missouri reduce documentation time for pharmacy.”
Saint Luke’s Hospital was definitely not lagging behind the
Kansas City, MO technology curve. The hospital has a “We wanted to improve delivery and
www.saintlukeshealthsystem.org history of innovation and relies heavily on in-room access to meds beyond non-
automation to enhance their quality of care. controlled substances,” said Doug. “We
Solution Spotlight Saint Luke’s employs a patient-centered wanted a mechanism to identify high usage
integrated model where pharmacists are drugs so that when the anesthesiologist
– Anesthesia-Rx™
proactively engaged in medication selection reaches for a med, they would have it right
and management with the multidisciplinary at their fingertips, ready and available. We
care team. also wanted an automated way to track
the inventory levels to reduce stock-outs
As part of an ongoing effort to improve and have a mechanism to identify the
patient care, the hospital regularly reviewed staff accessing the medications if there
processes, and in 2009, the focus was is a discrepancy. Within the automated
on the pharmacy model and anesthesia carts, we wanted the ability to control the
dispensing process. Doug DeJong, Director medications to improve patient safety.”
of Pharmacy, explained the hospital
initiative. “At the time we were going Since the pharmacy already had several
through a review of our distribution model, McKesson products in place, including
deciding whether we wanted to continue AcuDose-Rx, MedCarousel®, Fulfill-Rxsm
with a decentralized model or go with and DataStation™, they wanted a system
a hybrid approach. We recommitted to that worked on the same platform. As Mark
a decentralized model, added additional explained, “We’d already seen the inventory
AcuDose-Rx® cabinets in the busiest units, management benefits of an integrated
and Anesthesia-Rx was the logical extension system with AcuDose-Rx and MedCarousel.
for us.” With Anesthesia-Rx, meds that need to be
restocked in the carts are communicated to
Challenges our work queue on MedCarousel. When the
Prior to Anesthesia-Rx, the dispensing meds are removed from the carousel, the
process during surgery was not well bar code can be scanned for accuracy, and
controlled and manual. “The stock that the meds are separated by each OR suite for
they used fairly frequently was inventoried delivery.”
in a red Craftsman toolbox on wheels,”
said Mark Steinbeck, Pharmacy Operations Answers
Manager. “We had a central AcuDose-Rx Due diligence was done on the products
cabinet in each operating area where available, and McKesson’s Anesthesia-Rx
controlled substances and less commonly was selected for their automated cart.
used drugs were stocked. We knew that “We had looked at a competitor’s version
automating the anesthesia process would and were not very impressed with it,” said
Automation Solutions

2. Saint Luke’s Hospital
Doug. “When I first saw the Anesthesia-Rx In terms of acceptance of the carts by
product, I found it to be very intuitive, it anesthesiology, Mark noted that, “They
had an easy interface, and I felt that it was appreciate having nearly every med they
designed with what an anesthesiologist need in the room, including controlled
would want. As an industry, we sat on the substances. They also like the fact that they
“We knew that automating the sidelines thinking anesthesiologists were a have quick access to the meds they need
anesthesia process would enhance tough group to impress, and I came back at any given time.” The hospital configured
thinking it was time to get a product like the carts with High Capacity Locked Lidded
inventory management, improve this accepted.” drawers and has seen improvements in
control of controlled substance waste, medication security as a result. “In our carts,
and reduce documentation time for And when it came time to sell it to the top four drawers are locked lidded.
pharmacy.” management, the common platform Because of the large capacity, we can store
helped. “The number one thing was that more of the controlled substances and even
it was consistent and worked with our non-controlled meds in those drawers,
suite of McKesson products.” said Doug. which has improved security overall and
Mark Steinbeck Mark seconded that and added, “The fact reduced the opportunity for diversion.”
Pharmacy Operations Manager that Anesthesia-Rx operated well on our
Saint Luke’s Hospital automation platform and utilizes the same A popular feature with the anesthesiology
software as AcuDose-Rx was a big selling team is the “My Stock” function, which
point.” As part of the AcuDose-Rx offers a provider the ability to pull out
maintenance program, McKesson provides a medication if the patient hasn’t been
regularly scheduled software upgrades, bedded. “One of the limitations of any
allowing the hospital to add new automated system is that the patient has to
functionality and keep technology up to be bedded or listed in the system. In those
date without having to replace existing urgent cases where they come in through
equipment. “We, like everyone else, have the ER, the anesthesiologist may not know
an annual capital budget and pharmacy the patient’s name, but they can pull the
has to compete with a lot of other things,” drugs out under My Stock in order to take
recalled Doug. “We had recently made the care of the patient. By the time the case is
conversion from leasing to purchasing the over, that patient should be in the system
AcuDose-Rx cabinets and after a couple of and you can pass the charges on to that
cycles of larger requests; we were able to account so they are not have charging
show that this was a direct extension of the issues on the back end. That has been very
line.” positive, as is the ability to transfer stock
to another user if cases last beyond their
The carts went live in December 2010 normal shift.”
and some results were obvious from
the beginning. According to Mark, The switch to Anesthesia-Rx has already
“We recognized that it is saving us time made a positive impact on Saint Luke’s
right away, especially in the handling processes and workflow. “It doesn’t have
of medications and manual charge the same ROI analysis that you can do
documentation capture. We have improved in your broader nursing units, but I can
our ability to optimize inventory/PAR recite a list of improvements that we’ve
levels, which has streamlined our inventory realized with this technology,” said Mark.
management processes. Our ability to “Anesthesia-Rx has reduced pharmacy
monitor drug inventory is significantly time, improved inventory control, and
better with regards to controlled substance provided drug utilization accountability by
discrepancies. We now have a record of the keeping the management of the controlled
individual who accessed each cart and can substance use and waste in the hands of
pinpoint the user involved more effectively. the user. And it has helped the anesthesia
The data collection process has helped team by ensuring ready, in-room access to
improve charge capture and identify where medications, improving patient safety and
there is charge capture loss pretty easily.” workflow.”
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