Learn how medication dispensing robotics can dramatically impact medication safety, productivity, and cost containment

1. Case Study
At a Glance
Organization
Evergreen Hospital Medical Center
Evergreen Hospital Nursing, Pharmacy Benefit from ROBOT-Rx
Medical Center
Kirkland, WA Medication Dispensing Solution
Solution Spotlight Overview increasing labor shortages and
– ROBOT-Rx® Officials at Evergreen Hospital higher labor costs, Blanchard sought
Medical Center sought to prepare for to streamline processes through
– AcuDose-Rx®
bar code medication administration automation. But he also wanted to
– Packaging Solutions balance automation with the desire
and improve efficiency of medication
– MedDirect™ delivery to nurse servers. By to continue using nurse servers.
implementing the ROBOT-Rx®
Critical Issues system, the hospital increased Answers
– Reduce the risk of medication dispensing accuracy to 99.9 percent; After an extensive review of various
errors cut cart fill labor by 72 percent; and medication distribution models,
– Position for bar code medication realized nearly $2 million in annual Evergreen chose to automate existing
administration savings via 24,000 pharmacist-patient processes. "We already were
interventions. successful in terms of delivering unit-
– Support existing nurse server
model dose medications to the bedside,"
Challenges explained Blanchard. "It became a
– Reduce laborious cart fill and Located on the outskirts of Seattle, matter of streamlining pharmacy
first dose operations the 250-bed Evergreen Hospital is a operations so that our staffing is
– Improve efficiency in a tight community-based facility serving a most efficient. The ROBOT-Rx®
labor market growing population of more than system is the obvious solution." The
400,000 people. For more than 15 ROBOT-Rx system automates
Results years, nurses at Evergreen Hospital medication storage, dispensing,
– Improved medication dispensing Medical Center were accustomed to returning, restocking, and crediting.
accuracy to 99.9% retrieving unit-dose medications
from nurse server units. To fill the Evergreen began by packaging
– Conducted nearly 24,000 clinical
nurse servers with unit-dose medications in bar-coded, unit-dose
interventions annually, saving
medications, the pharmacy form using McKesson equipment.
approximately $1.9 million
performed a daily manual cart fill. "Because the packaging looks similar,
– Cut first dose fill labor by 78% Selecting and checking the 1,125 we wanted to get nurses accustomed
– Reduced cart fill labor by 72% daily doses took nearly 15 hours for to using it—to be able to distinguish
technicians and pharmacists. what a Protonix dose looks like
– Decreased crediting labor by
versus a digoxin, for instance. It was
50%
"The nurses liked the convenience of a smooth transition." After building
– Strengthened narcotics having scheduled and common PRN its bar-coded medication stock,
management medications as close as possible to Evergreen went live with ROBOT-Rx
the bedside, as opposed to walking in March 2004. "At first, we
to the medication room down the conducted a short trial with our
hall," explained Bob Blanchard, pharmacists checking every dose the
director of pharmacy. "It's good for robot dispensed," explained
nursing workflow and safer, but the Blanchard. "Now we do a daily 10
cart fill was a very labor-intensive percent random check, with approval
process for pharmacy." Faced with of the state Board of Pharmacy."

2. The hospital uses ROBOT-Rx for 2006 to May 2007 averaged nearly
24-hour cart fill, automatically 2,000 per month, for a total
dispensing to envelopes imprinted approximate value of $1.9 million.
with the patient's name and bar
code. The patient-specific envelopes Automation also has prompted
are then transported via carts to the process improvements. Cart fill duties
nurse servers. The robot also fills first moved from day to night, freeing
doses, transported either by FTEs for emergent duties. Technician
pneumatic tube or via messenger. time for first doses dropped from
9.33 to 2 hours per day; pharmacist
To further address medication safety time for first doses dropped from 5.3
and tracking in patient care areas, to 2 hours per day. Using bar-code
Evergreen installed 24 AcuDose-Rx® scanning, medication crediting now
medication dispensing cabinets. The occurs immediately after cart fill,
“Nursing workflow stayed exactly AcuDose-Rx cabinets store narcotics, rather than several days later using
floorstock, and PRN medications. manual processes. And, importantly,
the same, which is critical to our Previously, narcotics were secured in the ROBOT-Rx system and
overall success. We're just using the medication room and required AcuDose-Rx cabinets provide a real-
extensive manual documentation. time inventory control that the
robotics in the pharmacy for tasks "The narcotic counts were done hospital didn't have previously.
three times daily, at each shift
that were previously performed change," said Blanchard. "Now, with "Nursing workflow stayed exactly
manually, and using people for the AcuDose-Rx cabinets tracking the same, which is critical to our
usage, nurses do it once per week." overall success," said Blanchard.
more critical tasks." Also, because all medications in the "We're just using robotics in the
AcuDose-Rx cabinets are bar coded, pharmacy for tasks that were
dispensing, monitoring, restocking, previously performed manually, and
Bob Blanchard and charge capture are greatly using people for more critical tasks."
enhanced, Blanchard noted. Another time-saving tool is the
Director of Pharmacy MedDirect™ imaging system for
Results medication order transmission.
Evergreen Healthcare Explained Blanchard, "MedDirect
Today, the ROBOT-Rx accounts for 95
percent of all unit dose medications reduces paperwork, improves
dispensed by Evergreen's pharmacy. communications with nursing,
This has dramatically impacted enables us to prioritize orders
medication safety, productivity, and electronically, and helps us easily
cost containment. At the same time, identify potential problems early on
Evergreen Healthcare has in the medication order process."
experienced significant growth: a
29 percent increase in average daily Conclusion
census, and a 53 percent increase in "At Evergreen, productivity is a key
doses dispensed per day. organizational imperative," said
Blanchard. "We report our
According to Blanchard, the productivity on a regular basis. The
automation systems easily have robot and the cabinets have
absorbed all of the workload contributed substantially to
increase. In fact, since implementing documented improvements. If I'm
ROBOT-Rx, the pharmacy requires over budget in staffing for a
58 percent fewer technician FTEs and particular month, or with
61 percent fewer pharmacist FTEs for pharmaceutical purchases, I'm able
medication dispensing and checking to offset those by the time savings
duties. Those FTEs have been and charge capture savings
redirected to other activities. The generated by ROBOT-Rx, by
number of hours dedicated to clinical AcuDose-Rx cabinet transactions, and
pharmacy has doubled. Explained by the number of interventions
McKesson Automation Solutions Blanchard, "We now have completed by our clinical
500 Cranberry Woods Drive pharmacists assigned to conducting pharmacists. Automation enables us
Cranberry Township, PA 16066 clinical activities on every floor." to make dramatic improvements
724.741.8000 Pharmacist interventions from May across the board."
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