An evaluation of two automated dispensing machines in UK hospital pharmacy

Abstract

Objective To assess the impact of two different automated dispensing machines (‘robots’) on safety, efficiency and staff satisfaction, in a UK hospital setting. Setting An NHS teaching hospital trust with two main sites each comprising 450 beds. A Swisslog Pack Picker automated dispensing machine was installed in the dispensary at site 1 in December 2003, and a Rowa Speedcase at site 2 in October 2005. Method A before‐and‐after study design was used on each site, with site 2 acting as a control for site 1. Staff recorded data on dispensing errors identified at the final‐check stage; an observer recorded the time taken to label, pick and assemble dispensed items; we recorded turnaround times for the different types of prescription and assessed storage space efficiency. We also used questionnaires to explore staff views. Key findings The robot resulted in a significant decrease in dispensing errors on each site (from 2.7 to 1.0% of dispensed items on site 1, and from 1.2 to 0.6% on site 2). Reductions occurred in errors involving wrong content; there was no clear effect on labelling errors. There were reductions in the time required to pick items for dispensing; there was no impact on labelling or assembly times. There was no conclusive effect on turnaround times. Increases in storage capacity occurred on each site; staff on site 2 were more satisfied following introduction of the robot; there was no difference on site 1. Conclusion Installation of a dispensary robot has modest benefits in terms of reduced dispensing errors, reduced picking times, increased staff satisfaction and increased storage capacity; there was no conclusive impact on turnaround times. These findings seem to be independent of the type of robot installed.

Incidence, type and causes of dispensing errors: a review of the literature

“…[46] This supports previous research by Fitzpatrick and colleagues [42] which reported that automation reduced the incidence of prevented dispensing incidents by 16%. However, not all medication is suitable for dispensing from an automated dispensing system and it is unclear whether items dispensed manually in the post-automation period were included in the study.…”

“…[3,[33][34][35]43,46,72] Five papers investigated the impact of automation on the types of dispensing errors. [42,[44][45][46][47] Three papers analysed prevented dispensing incidents [42,45,46] and two papers examined unprevented dispensing incidents. [44,47] Adedoye [45] reported that the most common prevented dispensing incidents associated with an automated dispensing system were labelling errors (76%, n = 81) and drug/content errors (18%, n = 20).…”

“…Guernsey and colleagues [50] objectively measured the impact of dispensary workload on unprevented dispensing incidents in a US hospital outpatient pharmacy. They concluded that a linear relationship existed between the number of prescriptions dispensed and potentially serious W r o n g p a t i e n t n a m e W r o n g q u a n t i t y o n l a b e l O t h e r Figure 6 Most common types of prevented dispensing incidents reported by UK hospital pharmacies with manual [3,[33][34][35]43,46,72] and automated [45,46,72] dispensing systems. Where ( ) Spencer [3] (n = 1500); ( ) Adedoye [45] (n = 108); ( ) Franklin [46] site 1: pre-automation (n = 245); ( ) Franklin [46] site 2: pre-automation (n = 217); ( ) Franklin [46] site 2: post-automation (n = 51); ( ) Bower [33] (n = 98); ( ) Wu [35] (n = 352); ( ) Beso [43] (n = 130); ( ) Banning [34] (n = 180); ( ) James [72] (n = 291); ( ) Franklin [46] site 1: post-automation (n = 93).…”

Return on Investment after Implementation of a Centralized Automated Storage System in a Hospital Pharmacy

“…The real payback period has been increased by approximately two years (six years of use, instead of four years as expected). The difference between the real ROI and the initial projected ROI for Pharmacy-based ADS improve workflow efficiency with a greater storage capacity [5,11,12]. In UK hospital pharmacies, Franklin et al [11] showed that the implementation of ADS represents a 23% increase in storage capacity in the first site and a 123% increase in the second site, compared to traditional storage [7].…”

The Experience of Using an Automated Dispensing System to Improve Medication Safety and Management at King Abdul Aziz University Hospital

“…[6] This increase serves to indicate the benefits of an ADS including improved safety and efficiency through reduced dispensing times, improved storage capacity and stock control, more appropriate allocation of staff to tasks with minimal time wastage and reduced dispensing errors. [7] Frequent drug stock-outs and expiry attributable to poor quantification and coordination practices [8] can also be managed using the ADS.…”