Abstract
Pharmacy robots and automated dispensing cabinets are commonly used to distribute medications to inpatient units efficiently and safely. Decisions regarding the use of these technologies are often made without full knowledge regarding system effects. This paper determines a cost effective and safe way to distribute medications to patients across a hospital system by minimizing the distribution cost and missing dose rate. A mathematical model is formulated which captures key aspects of the pharmacy distribution process to determine a primary pathway to distribute each medication and dose type to each unit. The model focuses on three primary distribution pathways: cart fill via pharmacy robot, cart fill via pharmacy technician, and automated dispensing cabinets. The problem is solved using a complete year of data from the Geisinger Medical Center. The model results demonstrate the trade-off between pharmacy technician and nurse workload and missing dose rates that occur as hospitals move from a centralized pharmacy to automated dispensing cabinets. These results demonstrate the importance of evaluating the labor effort and missing dose rates when determining the best method to distribute medication.
Similar content being viewed by others
References
Greth P, Tester W, Black H (1965) Decentralized pharmacy operations utilizing the unit dose concept. II. Drug information services and utilization in a decentralized pharmacy substation. Am J Heal Pharm. 22:10.
Hertig JB, Jenkins M, Mark SM, Weber RJ (2011) Developing Patient-Centered Services, Part 1: A Primer on Pharmacy Practice Models. Hosp Pharm. 46:1. https://doi.org/10.1310/hpj4601-61
Pickette SG, Muncey L, Wham D (2010) Implementation of a standard pharmacy clinical practice model in a multihospital system. Am J Heal Pharm. 67:9. https://doi.org/10.2146/ajhp090283
Baker J, Draves M, Ramudhin A (2010) Analysis of the Medication Management System in Seven Hospitals. San Diego, CA: CareFusion; 2010. https://pdfs.semanticscholar.org/41f4/3351373e853379f7f6d5f64f24fa9ad1d16c.pdf.
Microsoft & Omnicell (2012) Healthcare System Cuts Medication- Distribution Time by 85 Percent. https://www.omnicell.com/Success_Center/Case_Studies/South_Jersey_Healthcare_System_Cuts_Medication-Distribution_Time_by_85_Percent.aspx.
Tsao NW, Lo C, Babich M, Shah K, Bansback NJ (2014) Decentralized automated dispensing devices: systematic review of clinical and economic impacts in hospitals. Can J Hosp Pharm. 67:2. http://www.ncbi.nlm.nih.gov/pubmed/24799724.
Hussey AP, Cook BM, Quane AD, Sweet SR, Szumita PM. (2014) Implementation of an Automated Dispensing Cabinet Stewardship Program at a Tertiary Academic Medical Center. J Pharm Technol. 30:6. https://doi.org/10.1177/8755122514551560
McCarthy BC, Ferker M (2016) Implementation and optimization of automated dispensing cabinet technology. Am J Heal Pharm. 73:19. https://doi.org/10.2146/ajhp150531
Esmaili N, Norman BA, Rajgopal J (2018) Shelf-space optimization models in decentralized automated dispensing cabinets. Oper Res Heal Care. 19. https://doi.org/10.1016/j.orhc.2018.03.005
Bui Q (2015) Watch Robots Transform A California Hospital. NPR. https://www.npr.org/sections/money/2015/05/27/407737439/watch-robots-transform-a-california-hospital.
Lathrop K, Lund J, Ludwig B, Rough S (2014) Design, implementation, and evaluation of a thrice-daily cartfill process. Am J Heal Pharm. 71:13. https://doi.org/10.2146/ajhp130411
Pedersen CA, Schneider PJ, Scheckelhoff DJ (2015) Dispensing and administration ASHP national survey of pharmacy practice in hospital settings: Dispensing and administration - 2014. Am J Heal Pharm. 72:13. https://doi.org/10.2146/ajhp150032
Gray JP, Ludwig B, Temple J, Melby M, Rough S (2013) Comparison of a hybrid medication distribution system to simulated decentralized distribution models. Am J Heal Pharm. 70:15. https://doi.org/10.2146/ajhp120512
Poley MJ, Bouwmans CAM, Hanff LM, Roos PJ, van Ineveld BM (2004) Efficiency of different systems for medication distribution in an academic children’s hospital in The Netherlands. Pharm World Sci. 26:2. http://www.ncbi.nlm.nih.gov/pubmed/15085942.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
There is no financial support or personal connections that create a conflict of interest with our work.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This article is part of the Topical Collection on Implementation Science & Operations Management
Rights and permissions
About this article
Cite this article
Svirsko, A.C., Norman, B.A., Hostetler, S. et al. Optimizing the Medication Distribution Process for Inpatient Units. J Med Syst 46, 32 (2022). https://doi.org/10.1007/s10916-022-01822-2
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s10916-022-01822-2