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Drug dispensing in retail pharmacies typically involves several manual tasks that often lead to inefficiencies and errors. This is the first published quality improvement study in Latin America, specifically in Brazil, investigating the operational impacts of implementing a robotic dispensing system in a retail pharmacy. Through observational techniques, we measured the time required for the following pharmacy workflows before and after implementing the robotic dispensing system: customer service, receiving stock, stocking inventory, separation, invoicing, and packaging of online orders for delivery. Time savings were observed across all workflows within the pharmacy, notably in receiving stock and online order separation, which experienced 70% and 75% reductions in total time, respectively. Furthermore, customer service, stocking, invoicing, and packaging of online orders, also saw total time reductions from 36% to 53% after implementation of the robotic dispensing system. This study demonstrates an improvement in the pharmacy's operational efficiency post-implementation of the robotic dispensing system. These findings highlight the potential for such automated systems to streamline pharmacy operations, improve staff time efficiency, and enhance service delivery. [ABSTRACT FROM AUTHOR]

Drug dispensing in retail pharmacies typically involves several manual tasks that often lead to inefficiencies and errors. This is the first published quality improvement study in Latin America, specifically in Brazil, investigating the operational impacts of implementing a robotic dispensing system in a retail pharmacy. Through observational techniques, we measured the time required for the following pharmacy workflows before and after implementing the robotic dispensing system: customer service, receiving stock, stocking inventory, separation, invoicing, and packaging of online orders for delivery. Time savings were observed across all workflows within the pharmacy, notably in receiving stock and online order separation, which experienced 70% and 75% reductions in total time, respectively. Furthermore, customer service, stocking, invoicing, and packaging of online orders, also saw total time reductions from 36% to 53% after implementation of the robotic dispensing system. This study demonstrates an improvement in the pharmacy’s operational efficiency post-implementation of the robotic dispensing system. These findings highlight the potential for such automated systems to streamline pharmacy operations, improve staff time efficiency, and enhance service delivery.

Waiting time for chemotherapy infusion is a fundamental factor to measure quality of care. It has been shown that a prolonged waiting time is related to a higher incidence of anticipatory nausea and poor patient adherence to scheduled appointments and recommended oncology treatment programs. Some chemotherapy regimens can be prepared hours ahead-of-time, due to long stability. We aimed to study the effect of an informatic-led workflow redesign intervention, facilitating workflow changes in the Oncology Pharmacy, on patient waiting time. This intervention included changes on EHR processes and the chemotherapy CPOE. Their main effect was allowing ahead-of-time preparation of selected chemotherapy regimes. We conducted a cross sectional study, comparing waiting times pre and post intervention periods. A total of 4600 programmed chemotherapy episodes were included. We found a 26.5 % decrease in the mean wait time in the post intervention period (p > 0.02). We were able to show a decrease in waiting time and a measurable impact of the intervention. This evaluation produced valuable and actionable data for Oncology units and adds a valuable, Latin American experience to the literature. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this project was to identify current emergency medicine pharmacist (EMP) practices at each site and create a plan to integrate, align, and optimize pharmacy services across the health system with established American Society of Health-System Pharmacists (ASHP) best practices for EMPs. Summary Initially, a review was performed of the literature and guidelines from professional organizations relating to EMPs. A survey was distributed across the health system to assess EMP services at each site, and survey results were used to conduct a gap analysis, comparing current practices to established ASHP best practices. The survey identified unique components of each site, including the patient population served and EMP coverage and responsibilities. To prioritize, design, and execute the gap closure plan, a systemwide EMP workgroup was created. The workgroup formulated a toolkit to provide pharmacy leaders, pharmacy informatics, and EMPs resources to facilitate alignment on the prioritized areas. Conclusion This project successfully identified gaps in EMP services and alignment with best practices across the health system. Through prioritization of essential EMP responsibilities, workflow standardization, and EHR optimization, a gap closure plan was formulated to align with ASHP best practices. [ABSTRACT FROM AUTHOR]

Missing medications can negatively contribute to the financial and operational workflows of pharmacy departments and add medication safety challenges. The missing medication request (MMR) system at the study institution converted to entirely electronic in June 2018 from a hybrid electronic system. This study evaluated 4-week periods pre- and post-conversion. The objective of this study was to evaluate the impact of conversion to an electronic MMR system on the quantity of requests received at an academic medical center. The average daily number of MMR’s decreased from the pre-conversion group to the post-conversion group (1.77 (±0.16) vs 1.48 (±0.17), p < 0.001). During post-conversion, the median triage time was 8 min [3 min–19 min], pharmacists triaged 62.4% of requests, and 29.6% of requests were declined. Conversion to an electronic MMR system represents one solution to decreasing missing medications. Future studies are needed to evaluate the financial, operational, and medication safety impact of conversion. [ABSTRACT FROM AUTHOR]

Purpose To evaluate the impact of pharmacy team huddles and near real-time performance dashboards on the punctuality of medication delivery departures from the adult inpatient pharmacy of a multihospital medical center. Methods Baseline delivery punctuality was established during a 2-week unannounced preintervention period, followed by the implementation of daily huddles focused on delivery timeliness along with visual displays of delivery performance metrics. The 5- to 15-minute huddles included pharmacy technicians, pharmacists, and managers. Printed visual displays that tracked hour-by-hour timeliness over the prior 24 hours were prominently displayed in the pharmacy. The primary outcome was the overall change in the percentage of punctual medication delivery departures (ie, deliveries leaving the pharmacy at the scheduled time) during the 2 weeks after implementation of huddles and visual displays (the postintervention period). Punctuality was assessed at both the day and shift levels using generalized estimating equations in a piecewise regression model. A multivariable model was constructed using a forward stepwise selection process to assess the potential impacts of workload drivers and staffing levels on medication delivery punctuality. Results During the pre- and postintervention periods, the punctuality of a total of 1,032 deliveries was recorded. Punctuality of deliveries across all shifts increased by 37% (95% confidence interval [CI], 18%-56% [ P < 0.001]), from 50% to 87%, immediately following implementation of the huddle intervention. When punctuality was assessed by individual shift, we observed statistically significant increases for the day (35% [95% CI, 13%-57%], P = 0.002), evening (34% [95% CI, 12%-56%], P = 0.003) and night (57% [95% CI, 35%-79%], P < 0.001) shifts. During the forward stepwise multivariable model-building process, order volume, message volume, and technician staffing levels were not significantly correlated with delivery punctuality at the day or shift level. Conclusion Daily huddles with visual displays were successful in improving the punctuality of medication delivery departures from the pharmacy, independent of workload drivers and staffing levels. [ABSTRACT FROM AUTHOR]

Objectives: To assess the impact of electronic prescription on the types and rates of medication errors in prescribing and dispensing phases, and to formulate recommendations on the use of electronic prescriptions in Egyptian outpatient practice.Methods: Medication errors and correction interventions were collected by reviewing the incident reports obtained from the outpatient pharmacy in a specialized hospital in Egypt. A data collection form was used to classify the errors. The Main outcome measures are prescribing and prescription errors, dispensing errors, error free prescriptions, pharmacy call-backs and phone calls for five months before and five months after the electronic system implementation.Results: 3512 incident reports were reviewed for errors in the hand-written and electronic phases. The use of electronic system led to a minor significant 2% reduction in prescribing errors, significant 1.2% decrease in dispensing errors, and significant 18.2% increase in the error free prescriptions (p < 0.05). Indication and omission prescribing errors were increased significantly (1.7%, p < 0.0001) in the electronic phase. The electronic system failed to significantly decrease some types of dispensing errors like wrong medicine and wrong dosage form. No difference was detected in the volume of communications between pharmacists and prescribers.Conclusion: Electronic prescribing is able to reduce prescribing and dispensing errors associated with the use of hand-written prescriptions in the Egyptian outpatient clinic, however, more advanced and trusted systems are likely needed for more efficient effect on error rates and pharmacy workflow. [ABSTRACT FROM AUTHOR]

Waiting time for chemotherapy infusion is a fundamental factor to measure quality of care. It has been shown that a prolonged waiting time is related to a higher incidence of anticipatory nausea and poor patient adherence to scheduled appointments and recommended oncology treatment programs. Some chemotherapy regimens can be prepared hours ahead-of-time, due to long stability. We aimed to study the effect of an informatic-led workflow redesign intervention, facilitating workflow changes in the Oncology Pharmacy, on patient waiting time. This intervention included changes on EHR processes and the chemotherapy CPOE. Their main effect was allowing ahead-of-time preparation of selected chemotherapy regimes. We conducted a cross sectional study, comparing waiting times pre and post intervention periods. A total of 4600 programmed chemotherapy episodes were included. We found a 26.5 % decrease in the mean wait time in the post intervention period (p > 0.02). We were able to show a decrease in waiting time and a measurable impact of the intervention. This evaluation produced valuable and actionable data for Oncology units and adds a valuable, Latin American experience to the literature.

The objective of this paper is to investigate the experience of implementing a pharmacy automation drug dispensing system in Saudi Arabia. Key informant interviews, meeting documents, and experience of the researcher were the data collection sources used in the study. A thematic analysis of the data was conducted. Study results discuss the organizational challenges prior to implementation as well as details of the implementation process. Preliminary results show improvements in the services provided by the pharmaceutical department. Lessons learned are also discussed. The work presented in this paper is preliminary and more research is needed to evaluate the overall impact of the new pharmacy automation system on services provided by the pharmaceutical department. [ABSTRACT FROM AUTHOR]

Background: Comprehensive medication reviews (CMRs) provide opportunities for pharmacists to perform clinical services to their patients. However, pharmacists are often not able to perform CMRs due to time constraints. Studies have shown that incorporating support staff into the CMR workflow may lead to increases in the completion of CMRs. Objective: The primary objective was to examine the change in the number of CMRs completed at the pharmacy after a new strategy was implemented to perform and prepare for CMRs. The secondary objective was to examine the changes in the revenue generated from CMRs. Methods: This study was a pre-post retrospective, observational study performed at an independent pharmacy. Data were collected and analyzed 10 months before and after implementation of a new strategy. The new strategy called for pharmacy interns to use a template for working up patients prior to CMRs. Wilcoxon signed-rank tests were run on IBM SPSS, Version 24.0, to determine the significance of the changes. Results that generated P values <.05 were considered statistically significant. Results: The total number of CMRs completed increased from 29 before the intervention to 158 after the intervention ( P = .009). The revenue generated from CMRs improved statistically ( P = .007). Conclusions: Implementing a strategic workflow that uses pharmacy interns and a patient workup template can significantly increase the number of CMRs completed in a community pharmacy. Appropriate delegation of such tasks may allow more time for pharmacists to deliver more CMRs. Additional benefits include increased compensation from delivering more CMRs., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2019.)