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

2. each with own dispensary
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. Delays getting orders from ward pharmacy team to dispensary
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. Orders dispensed by robot Ward trained pharmacy team
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)

7. To test an alternative model of ordering named patient medicines
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

8. “Traditional” Workflow (PTS)

9. Time of Porters vs. Dispensing

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

11. Comparison of Approaches

12. Robot in-line labelling Wireless black-spots
“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)

13. Pharmacy Staff Satisfaction

14. Pilot demonstrated proof of concept for remote ordering
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

15. Awaiting EPMA Recently rolled out across all three cancer wards
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