1. Automation: Practice & Pitfalls Presented by: Geoff Phipps Principal Pharmacist – Operations & David Ledger Principal Pharmacist – Technical Services Dudley Group of Hospitals – NHS Trust

2. Automation: Practice & Pitfalls  Split into small groups (2 or 3) & take a few minutes to think of any types of automation you have seen or had experience of.  Report back to this group the ideas you have come up with.  Consider the benefits & disadvantages of the examples you have come up with.  We will then give you our experiences of the robotic dispenser recently installed @ RHH

3. Robotic Dispenser

6. Benefits of Robotic Dispensing  Saves time  Saves space  Aids Stock Control & Stock Rotation  Supports OPD & 1 stop dispensing  Improves security  Should reduce errors  Allows advantageous skill mix review

7. Business Case Considerations  Need a Business Case that might include:  Original Pack Dispensing  NHS Plan / ‘Spoonful of sugar’  ‘Human’ Dispensing Errors  Reduction in Patient delay  Space saving  Reduces waste & Improves Stock Control  Improvement of ‘Skill Mix’  Don’t forget Interface – 2 ends

8. How big will you need it? What will you put in it? Where are you going to put it? What is your workload activity?

9. What will you put in it? Bulk Stock Ward & Outpatient items Only ‘boxed’ items Only ‘small’ items Only ‘Bar coded’ items Only ‘lightweight’ items

10. Where are you going to put it?  What will it be used for?  Delivery time? Chutes, Belts, or Air tube?  What space available?  Number of robotic arms?  Height of the ceiling?  Fire regulations?  Ease of maintenance?  Noise of Robot & delivery belts?

11. Where are you going to put it? (contd)  Also consider any weight restrictions on the building – involve Estates Dept at an early stage  You need an adjacent work area

12. Commissioning – What we did  Having decided on position we installed:  Direct dial telephone line  Network connection  Electrical Power points  Resited Fire Detectors / Extinguishers  Moved lights  Decided on ‘chute’ locations & moved PC’s  Involved Estates Dept & IT  Built ‘Drug File’ for the Robot

13. Commissioning – What we did (contd)  Initially loaded items in the robot & used for storage – allowed familiarity  After JAC interface loaded used the robot for picking  Delivery / assembly took 1 week  Testing & training took 1 week

14. The Drug File For JAC – Input EAN code for each drug / packsize going in to the robot EAN code input by scanning or keyboard EAN code against the FIRST supplier in list Exported file to EXCEL & using combination of WORDPAD & EXCEL formatted to the suppliers protocol Loaded file into robot Took 10 days to complete

15. The Drug File – (continued) New or missed drugs are added into the ‘Interface’ computer direct or ‘off-site’ using ‘PC DUO’ Must keep up with changes to suppliers Must add additional EAN codes into ‘Interface’ computer Be aware that some items have no bar code Be aware that some formats of bar code don’t ‘read’

16. The Drug File – (continued) Could input ALL data & codes into ‘Interface’ computer manually! Would take MUCH longer Beware of long drug names Trade names may be an easier way of ID ing certain lines

17. What worked well  Caused minimal disruption, but do need ‘Superusers’  Staff accepted the change well  Automated picking worked well, just prior to Xmas  Company support – Very Good  Enabled ‘space saving’ exercise  Perceived time saving by Storekeeper  Job satisfaction

18. Problems - Initial Addictive – to input items No Official Manual Bar codes missing – Contract changes Some products input twice! Should have used alternate EAN Should have had a dedicated phone line Only accepted 13, 7 & 8 digit bar codes There are also 14, 12, hyphened codes – some products have none Cabinet temperature – put PCs & PSU outside

19. WOT! NO BAR CODE?

20. What can you do with products with no readable bar code?  Don’t put the item in the robot!  Use a code from another product e.g. Can of Coke, Magazine.  Make up your own code  13 digit EAN codes have 1 st 7 digits – Company prefix of which 1 st digit is Country origin  The next 5 digits are the item reference  13 th digit is a check digit

21. How do you make your own Bar Code number? A 13 digit EAN code has an internal check. It prevents a misread, but also means its difficult to invent your own. Consider the EAN code: 501234567654A501234567654A 0 + 2 + 4 + 6 + 6 + 4 = 22. 22 x 3 = 66 5 + 1 + 3 + 5 + 7 + 5 = 26. 66 + 26 = 92 92 + A = 100 Therefore A = 8

22. But how can I generate bar code numbers?  Set up an Excel spreadsheet  Decide on a sequence that wont be repeated e.g. 999999912345X  Load the formula into Excel & enter your numbers  Don’t enter the 13 th digit, let the formula do it for you.

24. Problems - Maintenance Reboot ‘Visual’ & ‘Robotic’ PC 3 x a week Reboot ‘Interface’ PC 1 x week Packs must not be torn Don’t load items after sticky labels removed Beware loading when error message displayed Occasional wrong item picked Odd pack on floor! Only picks 1 pack @ a time – beware multiple dispensing products e.g. Fortisip Keep daily diary for problems