In the summer of 2011, The University of North Carolina (UNC) Hospitals began a project designed to remodel and upgrade our existing central inpatient pharmacy (CIP) with the goals of improving existing layout inefficiencies, automating inventory management, and installing a USP <797> open-air cleanroom. Until that point, the CIP layout and inventory model for medication storage and distribution had remained unchanged for nearly 30 years as evidenced by the alphabetical storage of medication SKUs on traditional stock shelves, among other antiquated practices. This created an inefficient layout largely due to the abundance of shelves, which made it difficult to maximize our limited space and resulted in staff meandering from shelf to shelf picking medications. There were additional inefficiencies in the loosely structured process of inventory management that was devoid of inventory tracking software. Ultimately, the burden of so much foot travel in this traditional system became overly labor intensive and proved to negatively impact employee satisfaction.
At UNC Hospitals—an 803-bed academic medical center—the department of pharmacy includes a staff of more than 300 FTEs and an annual expense budget of approximately $100 million. Given the medication volume processed through our CIP and the number of staff interacting with medication inventory, having a comprehensive software package that could integrate directly with our storage mechanism, and dramatically reduce the number of movements necessary to fulfill an order, became a high priority.
Streamlining with Automation
Fortunately, prior to embarking on the main CIP remodel, UNC Hospitals had already streamlined and automated inventory management at another facility within the medical center. In August 2009, the AutoPharm Enterprise software platform and an AutoCarousel from Talyst were implemented at the North Carolina Cancer Hospital—a 50-bed facility for medical oncology practices and bone marrow transplant that includes 72 infusion stations for adults and children. After reviewing the impact of that technology on medication distribution, we found that the addition of a carousel and inventory management software enabled the pharmacy to improve workflow efficiency by providing maximum medication storage in a secure, organized, accessible, and central location. Furthermore, due to the success of this model, UNC Hospitals decided to manage the inventory and operational aspects of its robust investigational drug service trials through this pharmacy.
Automating Drug Storage
Taking our positive experience with AutoPharm and AutoCarousel into the design process for the remodel of the 6,000 square foot CIP, UNC Hospitals felt carousel and inventory management software technology could provide the same benefits on a much larger scale. Once the remodel was completed in March 2012, staff, medications, and pharmacy operations were relocated to the new CIP space.
Incorporating carousel and pharmacy software technology optimized not only our inventory tracking and quantity on hand, but also streamlined our pharmacy operations and maximized our pharmacy footprint. The technologies provide real-time inventory with PAR levels that are adjusted based on actual automated dispensing and usage by our patient population. By adopting the AutoPharm Enterprise software system along with two AutoCarousels, our pharmacy department has begun to realize the benefits of integrated medication storage, inventory, ordering, and bar coding within its CIP operational armamentarium. We have eliminated dated operational and human resource-dependent practices, replacing them with a more precise ordering process, the ability to manage satellite pharmacy inventories via remote inventory workstations (i.e. sterile products, operating rooms, pediatrics, etc), along with preparing for bar code medication administration.
Employee Satisfaction and Patient Safety
Since deploying this technology, we have noticed a marked increase in employee satisfaction related to the medication storage and distribution process. Choosing to implement carousel and pharmacy software in our hospitals has helped greatly increase our workflow efficiency and ultimately, our patients’ safety.
Robert Granko, PharmD, MBA, is the associate director of pharmacy at The University of North Carolina Hospitals. He earned a BS in pharmacy from Long Island University, School of Pharmacy, a PharmD from the University of North Carolina at Chapel Hill, and an MBA from Pfeiffer University, School of Graduate Studies.