looking for similar sites
Kim (botsford@hhsc.ca)
We're a Canadian, 1000+ bed academic teaching centre, with patient
populations ranging from neonates to pediatrics to full service adult
acute and rehab services. We currently have full unit dose
implementation (distributed via med cart q24h) supported by PacMed
packagers, with AcuDose on each clinical unit for wardstock and
narcotic distribution. We are considering robot and med carousel
installation in the near future. Is there anyone in the group using
the robot for this range of patient populations, particularly with
fully unit-dosed liquids for pediatrics? I would appreciate hearing
from you, and hearing the challenges that you've encountered.
Determining robot capacity and the most efficient workflow has proven
challenging.
many thanks
Kim
Kim Botsford
Automation Systems Manager
Hamilton Health Sciences
237 Barton St E
Hamilton ON
Canada
905-521-2100 ext 74514
Tomlinson.Patricia
Our Hospital is a 600+ academic teaching center, with patient
populations including Neonates, Peds, and Adult acute and outpatient
services. WE also have full unit dose 24 hr supply carts, picked by
Robot (supported by a contract McKesson packager). We have PYXIS
cabinets in each nursing area for PRN's, medications used only in
Special areas, fluids and narcotics. We have 2 MedCarousels, one for
PYXIS refill and the second for 1st doses. Our peds and neonates do not
have a 24 hr supply cart. All of these meds are placed in Pyxis. We
did not plan well for MedCarousel capacity and have placed many large
items as remote stock on shelves in the Robot/Carousel area. The unit
dose liquids require a great deal of space in the MedCarousel so we were
forced to make adjustments. I'm happy to help if you have specific
questions.
Patricia Tomlinson
Clinical Pharmacy Manager
Medical Center of Central Georgia
Macon, GA USA
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10/20/09, 11:09:55
Seth Cohen
Per yesterday's Capacity Analysis report (attached), UMMC is currently at 720 beds. You can see the breakdown here from neonates to pediatrics to full service acute, if you're curious. Unit doses are distributed partially through Robot cart fill (24 hour fill) and first dose, with many medications stocked in Omnicell; Omnicell dispenses include stat medications, lockables, PRNs, etc. Approximately 4000 doses/day are dispensed from Robot, with another 8-11K doses from Omnicell. Unit doses of liquid medications can come from either the Robot or Omnicell depending on whether they are usually stocked in Omnicell, and some are prepared as patient-specific doses that are batched simultaneous with cart fill (another 24 hour batch). This is both for adults and peds. C-II medications are not prepared patient-specific at UMMC; nurses (mostly in Peds) draw a unit dose from the Omnicell and redose it based on the medication order.
We experimented with having volumes from the Robot higher than 4000 doses/day, but the speed of the Robot and our staffing situation meant that if we wanted to perform cart fill operations from 0600-1400 and still have the Robot dispensing some first doses, we shouldn't regularly exceed 5000 doses/day. My understanding is that if we split cart fill into two or more cart fills, total dispensing and restock will go down by a fair percentage. Moving cart fill to after peak order changes have happened (~1800 hours) would also reduce restock & returns. The Robot dispenses as many as 700 doses/hour from the conveyor belt, as many as 600 doses/hour from the Envelope Delivery System, and has variable restock speeds depending on whether the Return Rack is filled with randomized returns or is less random (from offline storage).
Our long-term patient care hospital nearby (University Specialty Hospital, or USH) has no robot - it is 180 beds, with Omnicell cabinets on each unit and carousel in the pharmacy for cabinet restock and cart fill. I haven't worked there, but their cart fill is a very different beast.
Let me know if you have questions.
Thanks,
Seth
--
Seth A. Cohen, Pharm. D
University of Maryland Medical System
Phone 410-328-1006
Page 410-328-BEEP, #1521
email: sco...@umm.edu
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