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Uploaded byJerry Fahrni
KDHCD Pharmacy Automation
Kaweah Delta Health Care District in California underwent three phases of pharmacy remodeling and automation between 2008 and 2009. The goals were to reduce medication errors, create an error-free automated dispensing system, increase efficiency, and control inventory and costs. Phase I implemented AutoPack, AutoLabel, and AutoCarousel technologies to automate packaging, labeling, and storage/retrieval of medications. This increased efficiency and accuracy of filling the medication dispensing cabinets (Pyxis). Subsequent phases focused on clean room facilities and increasing workspace. The remodel was part of a medication error reduction plan to fully automate medication distribution using barcoding technology.
KDHCD Pharmacy Automation
- 1. Kaweah Delta HealthCare District Drug Distribution Automation Jerry Fahrni, PharmD
- 2. Kaweah Delta HealthCare District Centrally located in the San Joaquin Valley, California 581 beds Offers a variety of services Inpatient Outpatient New tower opened April 2009
- 3. Five Licensed PharmaciesOutpatient Employee Pharmacy Home Infusion Pharmacy Inpatient Main Campus South Campus (Sub-acute, SNF) West Campus (Rehab, Mental Health)
- 4. Pharmacy Remodel PhaseI complete February 2008 Designed around automation Phase II complete December 2008 Designed around clean room and dispensing Phase III complete June 2009 Designed around creating more work space “ Design the pharmacy around the technology”
- 10. Pharmacy Remodel –Phase I Part of Kaweah Delta’s Medication Error Reduction Plan (MERP) All Medications will have a readable bar code prior to dispensing Patient Safety Create an error free Pyxis fill Increase Pyxis fill efficiency Automate wholesaler ordering Control Inventory - $$$
- 11. Phase I-Automation/Technology AutoPack Implemented February 2008 AutoLabel Implemented February 2008 AutoCarousel / AutoPharm Implemented March 2008
- 13. Pharmacy Remodel -Phase I AutoPack February 2008
- 14. 500 canister modelCurrently using just over 120 canisters “ Back-fill” vs. “Primary-fill” model Minimize “A” locations AutoPack
- 16. Pharmacy Remodel -Phase I AutoLabel February 2008
- 17. Circle labels Mostly for liquids unit-dosed to smaller size AutoLabel Flag labels Mostly vials and ampules Insulin for BCMA
- 18. Pharmacy Remodel -Phase I AutoCarousel March 2008
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- 23. AutoCarousel Items incarousel MUST be barcoded Full integration with Pyxis Replenishment OMNL PARx
- 24. Extending AutoPharm’s ReachStorage outside the carousel Chemotherapy Large, bulky items with high turnover Increasing storage within the carousel Refrigerated storage “Other” locations Remote ordering
- 25. Storage Outside theCarousel Consistency Large items with high turnover Take advantage of: Barcoding Inventory tracking
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- 30. Tweaks and such… Package insert holders Smaller storage bins Pyxis PARx technology Barcode scanners – newer is better Label changes
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- 32. Maximizing Storage SpaceHerman Miller (A-size subcontainer) fit perfectly in the gaps
- 33. Pyxis CUBIE /PARx Technology Implemented with Pyxis 3500 in April 2008
- 34. Barcode scanners CodeCorp CR3 vs. 3500 – no contest … really The 3500 is Faster Easier to use More forgiving Slightly tougher
- 37. Better control ofinventory on the wall and counter area Barcode solution for off campus locations Decreased fill time for main campus Not so happy at satellite location “ Interrupts” workflow Takes too long AutoPharm Pilot
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Editor's Notes
- #3 Indications: Acute Coronary Syndrome w/ or w/o PCI, recent MI, stroke, or established PAD
- #18 Discuss difficulty with insulin flag labels and work around for lot and expiration date, i.e. altering label template Insulin for BCMA …. What a hassle
- #19 http://picasaweb.google.com/jerry.fahrni/CarouselInstall#
- #25 shouldn’t store chemotherapy in it Large bulky underestimate storage space - virtually no “extra” room for future storage. What about refrigerated items?
- #26 Large items, such as our premixed DOPamine and DOBUTamine bags, metronidazole piggybacks “ static carousel” - fitted with adjustable shelving to accommodate the large blue bins that we use for storage. designated as RS1, for Remote Stock 1. shelves numbered in order from bottom to top and the bins are numbered left to right just as they would appear in the carousel - example premixed DOPamine bag (400mg/250mL) would appear as RS1-002-03-01 (Remote Stock 1, Shelf 2, Bin 3, Slot 1). Disadvantages shelves are more than 10 feet from the nearest carousel - don’t get the immediate visual feedback for an incorrect scan too easy for someone to pull an item without going through the scanning process. bypasses the safety features and creates a discrepancy -
- #29 AutoPharm’s remote ordering function. “ IVRoom”
- #33 small bins from Herman Miller (A-size subcontainer and are 2-3/16″ High x 13-13/16″ Deep x 2-1/4″ Wide) fit perfectly in the gaps. small items like opthalmic drops, otic preps, etc.
- #34 PARx in combination with our AutoPharm/AutoCarousel system . Replenishment Manual pull Decrease in fill errors