Abstract
BackgroundWe describe the introduction, use, and evaluation of an automation and integration pharmacy development program in a private facility in Saudi Arabia. The project was specifically undertaken to increase throughput, reduce medication dispensing error rates, improve patient satisfaction, and free up pharmacists’ time to allow for increased face-to-face consultations with patients.ObjectiveWe forecasted growth of our outpatient service at 25% per annum over 5- and 10-year horizons and set out to prepare our outpatient pharmacy service to meet this demand. Initial project goals were set as a 50% reduction in the average patient wait time, a 15% increase in patient satisfaction regarding pharmacy wait time and pharmacy services, a 25% increase in pharmacist productivity, and zero dispensing errors. This was expected to be achieved within 10 months of go-live. Realignment of pharmacist activity toward counseling and medication review with patients was a secondary goal, along with the rapid development of a reputation in the served community for patient-centered care.MethodsPreimplementation data for patient wait time for dispensing of prescribed medications as a specific measure of patient satisfaction was gathered as part of wider ongoing data collection in this field. Pharmacist activity and productivity in terms of patient interaction time were gathered. Reported and discovered dispensing errors per 1000 prescriptions were also aggregated. All preimplementation data was gathered over an 11-month period.ResultsFrom go-live, data were gathered on the above metrics in 1-month increments. At the 10-month point, there had been a 53% reduction in the average wait time, a 20% increase in patient satisfaction regarding pharmacy wait time, with a 22% increase in overall patient satisfaction regarding pharmacy services, and a 33% increase in pharmacist productivity. A zero dispensing error rate was reported.ConclusionsThe robotic pharmacy solution studied was highly effective, but a robust upstream supply chain is vital to ensure stock levels, particularly when automated filling is planned. The automation solution must also be seamlessly and completely integrated into the facility’s software systems for appointments, medication records, and prescription generation in order to garner its full benefits. Overall patient satisfaction with pharmacy services is strongly influenced by wait time and follow-up studies are required to identify how to use this positive effect and make optimal use of freed-up pharmacist time. The extra time spent by pharmacists with patients and the opportunity for complete overview of the patient’s medication history, which full integration provides, may allow us to address challenging issues such as medication nonadherence. Reduced wait times may also allow for smaller prescription fill volumes, and more frequent outpatient department visits, allowing patients to have increased contact time with pharmacists.
Highlights
BackgroundAn article submitted to the American Journal of Hospital Pharmacy in 1967 identified how “outpatient visits are increasing at a rapid rate and administrative adjustments will be needed to manage larger outpatient prescription volumes” [1]
Overall patient satisfaction with pharmacy services is strongly influenced by wait time and follow-up studies are required to identify how to use this positive effect and make optimal use of freed-up pharmacist time
This value increased during the implementation period to a mean of 13,587.60 (SD 3410.01; minimum 7530; maximum 16,974; median 13,809, IQR 5794), with no change observed for full-time employees (FTEs)
Summary
BackgroundAn article submitted to the American Journal of Hospital Pharmacy in 1967 identified how “outpatient visits are increasing at a rapid rate and administrative adjustments will be needed to manage larger outpatient prescription volumes” [1]. The authors laid out how, “[N]ew methods and procedures must be developed to reduce patient wait time, provide the physician and the pharmacist with information pertinent to drug therapy and increase productivity through the elimination of administrative detail which can be handled better through automation,” and how “...inpatient pharmacy functions have received a considerable amount of publicity in the literature, little work has been accomplished in this area with regard to outpatient dispensing” [1]. Outpatient visits continue to rise year-on-year, with increasingly complex patients being handled by these departments, and there remains a paucity of literature on the application of automation in outpatients to help handle this increasing workload and to deploy the outpatient pharmacy department’s human resources more effectively. The project was undertaken to increase throughput, reduce medication dispensing error rates, improve patient satisfaction, and free up pharmacists’ time to allow for increased face-to-face consultations with patients
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