Hospitals turn to automation, including medication carousels, in pharmacy operations
By Cheryl Powell, 330-996-3902, chpowell@thebeaconjournal.com, Beacon Journal medical writer
Published on Monday, April 20, 2009
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Hospitals increasingly are turning to technology as a potential cure for medication errors.
Aultman Hospital in Canton, for example, is embracing automation to fill prescriptions with its new $5.7 million pharmacy.
The recently opened state-of-the-art department features a new robot stocked with unit doses of 400 of the most commonly prescribed medications.
After receiving the order electronically, the robot zips into action, picks the individually wrapped single doses and stuffs them into an envelope to be delivered to the patient.
Another 2,000 medications are stocked in a new carousel, which rotates to the location of the prescribed medication after the pharmacy technician scans the patient order.
Each dose is tagged with a bar code, which can be scanned when the order is filled and then again when the drug is administered to verify the right patient gets the right medicine.
The hospital started rolling out the bar-code system this month. It allows nurses to scan the patient's bar-coded wristband along with the medicine's bar code as an added safety check and documenting tool, said Mimi Gozdan, Aultman's clinical informatics specialist.
The information then is added to the patient's electronic medical record.
It's a much simpler and more accurate way than paper charts to track the estimated 10,000 units of medication dispensed at the hospital each day, Gozdan said.
''I can track the process from beginning to end,'' said Jim Toohey, Aultman's co-director of pharmacy. ''We want to get things to the patients as quickly as possible and as safely as we can.''
About 10 percent of hospitals nationwide have robots in their pharmacy department to fill prescriptions, according to a study by the American Society of Health-System Pharmacists.
Nearly 13 percent use automated carousel systems to manage inventory, and almost 83 percent have automated dispensing cabinets for nurses to use on patient floors, the study found.
Nationwide, an estimated 12 percent of hospitals use computerized systems for doctors to order prescriptions, according to the study. And nearly a quarter of all hospitals use bar-code systems to administer medications.
The goal is to take out the risk of human error, said Karl Gumpper, director of the section of pharmacy informatics and technology for the American Society of Health-System Pharmacists.
According to the National Academy of Sciences' Institute of Medicine, an estimated 400,000 preventable drug-related injuries occur annually in U.S. hospitals, adding at least $3.5 billion in medical costs.
About 25 percent of the errors reported to the National Medication Error Reporting Program are caused by confusion between drugs with similar names, according to the institute.
'Five rights'
Gumpper said that automation can help hospitals adhere to what's known in the medical industry as the ''five rights'' of medications: the right patient, the right drug, the right time, the right dose and the right route of administration.
''You can prevent medication error that maybe you have the wrong tablet or the wrong dose,'' Gumpper said. ''You're able to pick up that before you administer the medication.''
Marezella McCrary of Canton said she was pleasantly surprised when nurses scanned her hospital wristband before administering medications after her recent surgery at Aultman Hospital.
''I thought it was pretty neat because it's better security,'' she said. ''You can never have too many checks.''
Several other hospitals in the area are adopting technology to boost safety.
Mercy Medical Center, Aultman's cross-town rival, recently launched a $3.7 million electronic medication administration record and wireless patient and medication bar-coding system.
''It places a computer safety system between the patient and the nurse,'' said Jim Williams, vice president of patient care services and chief nursing officer. ''It eliminates all the issues related to medications that sound alike, medications that look alike, patients that may have changed rooms and are now in a different room.''
In addition, Mercy has been using a robot and repackaging system since last year.
Williams estimates about 90 percent of prescription orders now are filled by the robot.
Smart IV pumps
This month, the hospital also started using ''smart'' computerized IV pumps that have limits to avoid accidental overdoses.
Robinson Memorial Hospital in Ravenna also has had a robot in its pharmacy for several years.
Among the Akron hospitals, Akron General Medical Center has used a robot to dispense prescriptions since 1996.
The hospital also has used bar-coding technology to administer medication for about two years, Director of Pharmacy Kathleen Donley said.
''We have found it works extraordinarily well,'' she said. ''We really don't get too many 'Stop, you're doing something wrong' messages.''
Likewise, Akron Children's Hospital is preparing to start using an automated carousel system in its pharmacy this summer.
The carousel will hold 750 items and eliminate the need for pharmacy technicians to locate the proper medications among rows of shelves, said Chris Gorczycki, the hospital's pharmacy informatics coordinator.
''It will cut down on errors,'' he said.
Summa Health System's Akron City and St. Thomas hospitals use a computerized physician order system, which allows doctors to place prescriptions directly into the pharmacy's computer system.
''This has eliminated the need for paper orders, which can be misread or transcribed incorrectly from one computer system to another,'' Summa spokeswoman Julie Uehara Sur said.
Pharmacy automation can save money.
Aultman's new pharmacy, for example, also includes a high-speed repackager. The machine allows the hospital to buy medications in bulk and repackage them into doses, saving between 5 and 12 cents per dose, Toohey said.
Technology also saves time.
By using a robot to fill prescriptions, pharmacists can spend more time consulting with doctors about the best medications for patients, said Akron General's Donley.
''It helps you reallocate your staff to more important things,'' she said.
