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Wireless Drug Ordering- Pilot project

Wireless Drug Ordering- Pilot project. Colin Ward Lead Pharmacist – Cancer Services & Duane McLean Clinical Effectiveness Pharmacist. Background (1). Royal Derby Hospital comprises 4 satellite pharmacies undertaking aseptic and tablet dispensing each with own dispensary stock holding

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Wireless Drug Ordering- Pilot project

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  1. Wireless Drug Ordering- Pilot project Colin Ward Lead Pharmacist – Cancer Services & Duane McLean Clinical Effectiveness Pharmacist

  2. Background (1) • Royal Derby Hospital comprises 4 satellite pharmacies undertaking aseptic and tablet dispensing • each with own dispensary • stock holding • stock checks • stock top-ups • potential for economy of scale • Main dispensary houses a robot • capacity to increase use

  3. Background (2) • Traditional method of ordering named patient medicines appears cumbersome • Delays getting orders from ward pharmacy team to dispensary • Legibility of orders • Further delays • Risk • Fixed delivery times to wards from satellite dispensaries

  4. More background • Chemotherapy satellite pharmacy has competing pressures related to day case chemotherapy • Oral dispensing • Aseptic dispensing • “Releasing Time to Care: The Productive Ward” project showed that drug rounds were often extended as medicines not in bedside lockers • Medicines were on ward but had not been unpacked • Does not help support self administration • “Right drug in the right place at the right time” • May result in repeat dispensing activity • ££ • Time • Pressure on OOH • service

  5. The Idea • Order named patient medicines using JAC at ward level via laptop & wireless network • Orders dispensed by robot • Ward trained pharmacy team • deliver to ward • “reconcile” against in-patient chart • place directly in bedside locker • counsel patient (if appropriate)

  6. Aims • To better understand flow of “traditional” method of ordering named patient medicines • To test an alternative model of ordering named patient medicines • To test the concept of remote ordering pre-EPMA • To test the concept of using the robot to dispense more of the in-patient workload

  7. “Traditional” Workflow (PTS)

  8. Time of Porters vs. Dispensing

  9. Orders arrive in dispensary earlier & dispensing is instant Wireless Pilot

  10. Comparison of Approaches

  11. “Issues” during pilot • As only a pilot, staff unable to “reconcile” urgent orders late in the day • Competing workload/staffing pressures could cause delays in distribution • Pilot only one ward, so chemo satellite still functioning as a dispensary for other wards • Robot in-line labelling • Wireless black-spots • Need for a trolley for the laptop • Can’t dispense specials remotely (need BN)

  12. Pharmacy Staff Satisfaction

  13. Summary • Medication was dispensed by the robot by the time that order cards would arrive in the satellite dispensary under the traditional approach • When other members of the team were asked whether we should revert back to the traditional model there was a resounding response of “No” which would imply that the pilot was successful • Pilot demonstrated proof of concept for remote ordering • Potential to interface EPMA to pharmacy stock control system

  14. The future… • Recently rolled out across all three cancer wards • Looked at use of wireless terminals already on most wards (often under-utilised) but issues with installing JAC on these • Delay whilst approval to purchase toughbook laptops • Reducing stock holding in chemo satellite now workload moved to robot • Considering use of robot to dispense pre-chemo anti-emetics (planned workload) • Potential to • Manage stock returns to JAC “live” • Top-up “live” • Awaiting EPMA

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