Presentation on theme: "Guy’s and St. Thomas NHS Foundation Trust"— Presentation transcript:
1 Guy’s and St. Thomas NHS Foundation Trust Installing Medicine Smart Store CabinetsBy Bill PulmanDeputy Pharmacy System Administrator(Ward Automation)
2 Topics What is a cabinet The Vision From tender to go-live Interfacing PreparationCabinet installationRestock processThe teamWhere are we now (inc QR)Problems encounteredSavings
3 What is a Medicine Smart Store Cabinet? A fully automated cabinet that provides end users with instant information and access to stock medication twenty four hours a day, seven days a week.Orders are automated and delivered by pharmacy staff to cater for the individual ward requirements and needs. Stock is checked weekly to monitor levels and usage.
4 The VisionUsers spend less time preparing and dispensing medicines enabling more time at the patients bedside.Efficient timely and safe system that protects and aids users. Safety features like bar code readers for high risk items like PotassiumBetter control of inventory stock Reports available to identify key information.A cleaner environment to hold stock and prepare medicationsAvailability of financial reportingImprove preparing discharge medicine on ward.Reduce cost of unused, waste and overstocked medicine.Ability to Quality Review areas and assess performance.A flexible, robust system that will deliver.Decrease the need for Ad Hoc deliveries.
5 From Tender to Go-Live Tendered 2008 Staff needs were identified and recruited for projectGlobal stock List reviewDevelop interfaceProject plan devised with weekly follow-up meetingsPhysical location of cabinets agreedMeet with ward staff. Discuss early implementersFinalise ward go live order and co-ordinate work needed on wards
6 Interfacing JAC wasn’t dm+d compliant No Mechanism for HL7 Interface into Pharmacy SystemProduct Development path already defined until 2011 (as of 2008)Only solution was to replicate PDA Ward Top Up system - BWPROFThe Interface eventually drove the Omnicell Catalogue Design
7 Interfacing JAC BWPROF - PDA Top-Up Process Not widely used by JAC user community.Involved:Copy, Paste and Synchronise Ward profileCount Medicines on Top-UpReturn to PharmacyProcess Transfer of File to PCRun BWPROF to book out medicines.Sample extract files (written in Hexadecimal) from Royal Liverpool HospitalUS Omnicell Developer reversed engineered output files to develop the interface.Key components of the interface drove the development of the Catalogue
10 InterfacingKey Interface Fields, Including Name and JAC Indexed Field:Location lnkdwbWard / Cost Centre lnkacbDrug name lnkdidDrugpack lnkdpzProfile SectionNo.Max Qty NumberQty NumberMajor Change on JAC is to create a section called Cabinet, and relocate all medicines into that section
11 InterfacingAny unmatched data fields can result in a processing error - Most noticeable errors occurred during contract changesA large number of data mismatches arising from changes on JAC’s ward profile not reflected on the Omnicell cabinet.Booked out on JACAction: Control / Remove generalaccess to JAC to manage changesShared Drive
12 Pre-Go-Live Checks & Processes CatalogueInterface between Omnicell and present Pharmacy systemOmnicell server (and back-up server)Training program (no defined American training book)SOP creationEquipment support
13 Cabinet InstallationConfirm works dept completed any prep work required (tests & certificates)Configure cabinet for quantity, size, locationLiase with ward staffAgree re-stocking schedule with Pharmacy & WardTrain ward staff (min 80% before go-live)Deploy cabinets to ward area & transfer stockCarry out 100% stock checkRemove over-stockHandover system to ward staffTrainers present to assist during shift change and problems encountered
14 Restocking Process Cabinet talks to server through interface (24/7) Restock file created by cabinet server and stored on trust server as a PDA output fileFiles processed using BWPROF (up to 12 wards daily)JAC picking list createdStock is selected and packed (at Guy’s a Robot processes within 12 minsStock delivered to the wardStock put away by ATO/Pharm Tech
15 Our Team Picking and putting away automated orders. Cycle counting and expiry checking cabinet inventory.Training all end users.Report writing and reviewingStock list analysingBuying in stockIntegrating within long standing MDT’sSystem Administration
16 Where we are now30 wards successfully installed with Medicine Smart Store at Guy’s and St. Thomas NHS Foundation trustOngoing training of pharmacy users and all end usersAdding more safety features, Validating more “High Risk” medications such as HeparinReports and schedulingSetting up a specialist European training centre on siteUndertaking Quality reviewProviding tours and information to overseas visitors and NHS trusts across the UK
17 GS1 13 BarcodesTrust used Datix reported incidents to propose list of medicines to be validated using GS1 13 barcodesPotassium IV’s Initially Configured(Now trialled for 6 months)Plan to include Heparins& InsulinsScope to move to 2D data matrixNo “validated” catalogue to use (such as dm+d) so used a number of Pharmacy Safety Team to triple check configuration of barcodes on Omnicell system
18 Encountered ProblemsChange of work practice (biggest in over 25 years)Nursing staff reverting to old practicesInterface / processing problemsPack / drug changes (frequent)Training issues (understanding of ‘how to use it’)Equipment failureJammed drawers
22 Quality Review System Admin tasks Training including re-fresher training and super user trainingMeeting Clinical LeadsLooking at key performance indicatorsWard SavingsMeet clinical leads and ward pharmacist to explain data analysis and stock saving recommendationsCurrently assessing data usage across 30 clinical areas to optimise PAR levels, deliveries and possible financial savings.
23 Inventory SavingsWe currently hold stock £127,000 worth of stock across 30 wards. Our target from the outset would be to reduce this figure by 20% or £25,400 We have achieved the figure of £16,027 from 12 areas so far. So anticipate achieving that figure in the coming few weeks of Quality Review.
25 The Future??????Complete phases to Guy’s ward, Evelina Children’s hospital and TheatresFurther savings across the stock listsReview metrics of quality and improvementUse 2D bar coding technology to track expiry dates and batch numbers.Learn from other established sites that use this type of technology around the world.Automate reports to include safety stock, other high risk medications.
27 The VisionUsers spend less time preparing and dispensing medicines enabling more time at the patients bedside.Efficient timely and safe system that protects and aids users. Safety features like bar code readers for high risk items like PotassiumBetter control of inventory stock Reports available to identify key information.A cleaner environment to hold stock and prepare medicationsAvailability of financial reportingImprove preparing discharge medicine on ward.Reduce cost of unused, waste and overstocked medicine.Ability to Quality Review areas and assess performance.A flexible, robust system that will deliver.Decrease the need for Ad Hoc deliveries.
28 Contact DetailsDaniel Mandeman Chief Pharmacy Technician Automation System Administrator.William Pulman Senior Pharmacy Technician Deputy System Administrator