KL20 from Kirby Lester

June 2013 - Vol.10 No. 6 - Page #30
Category: Automated Capsule and Tablet Counters

It can be a valuable and profitable resource for a facility to expand their pharmacy services to include an employee pharmacy. At Cabell Huntington Hospital, we expanded the employee pharmacy to include all union employees in an effort to help control the increasing costs of health care. As a result, the pharmacy earned 340B-eligibility and our self-insured hospital actually decreased overall health care expenditures. 

Cabell Huntington is a 300-bed teaching facility affiliated with Marshall University in West Virginia. We operate an employee prescription pharmacy onsite to serve our employees. In early 2012, we began filling prescriptions for the health system’s 1,600 union employees, which expanded our daily dispensing numbers to an average of 300 prescriptions with an outreach total of 3,000 employees. We antici-pate another escalation in prescription volume in the future when we expand our services to include discharged patients.

Workload and Budget Challenges 
With this growth, our facility was faced with two challenges: the immediate and long-term escalation of our prescription volume, and the ever-present potential for dispensing errors. Prior to 2012, all dispensing was completed by hand-counting medication and our technicians were filling prescriptions without the benefit of verification software or bar code scanning. Furthermore, most prescriptions were 90-day fills, both time-consuming and challenging for maintaining count accuracy, with the additional need to hand-count all narcotics twice. Overall, this manual process increased the risk for potential errors.

While a system upgrade was clearly necessary, we simultaneously needed to maintain our FTE levels and payroll, manage the escalating workload, and improve efficiency. In late 2011, we investigated pharmacy automation options that would suit our facility and our budget. We required a small, inexpensive solution that could help automate the dispensing process. 



A Dispensing Technology That Addresses Our Needs
In the fourth quarter of 2012, we decided to implement the Kirby Lester KL20, a combination product that includes scan-verification software with a tablet counting device, thus addressing our need for an affordable dispensing technology to help manage a rising prescription volume while lowering the risk of dispensing errors.

The tabletop-size fits easily in our limited pharmacy space, and it interfaces with our Rx30 pharmacy management software, so orders flow directly from the Rx30 to the KL20 after order entry. Incorporating the system into our workflow was simple, and Kirby Lester representatives trained our technicians. We fill as many orders as possible with the device, including all countable medications as well as boxed items. Each technician signs into the device with a fingerprint scan and then pulls up the patient’s order on the touch screen. They scan and verify the UPC bar code on the stock bottle or unit-of-use medication to confirm the medication and dosage is correct. The system then counts out the medication and alerts the user in the event of a drug mismatch or an undercount or overcount. Every transaction is recorded in the KL20 database so we can access information on any prescription.

Our staff uses this system for additional functions, such as assisting with our bi-annual inventories and rapidly counting 500- or 1,000-pill bottles of bulk medications. When scanning items, the device’s NDC check feature helps to manage inventory by alerting the user when the bar code does not match and we need to change the prescription to the NDC on hand. This is particularly beneficial with government sponsored prescription programs given the reporting required for Medicaid and Medicare rebate programs.

Tangible and Intangible Benefits
Since installing the KL20, we have had a significant reduction in the time required to fill orders, especially for 90-day prescriptions. Our count accuracy is never questioned, and the pharmacy staff appreciates that the device confirms every order, lowering the risk of errors. This technology has helped improve dispensing safety, shorten fill times, and manage an escalating workload without an increase in staff levels. We will be expanding our services in the future to include prescription fulfillment for discharged patients and we are considering the purchase of additional devices to handle the increased workload. 


Jeffrey Fenerty, RPh, is the assistant director of pharmacy at Cabell Huntington Hospital, where he has managed pharmacy operations for the past five years. He previously spent 14 years with Walmart in retail pharmacy management, including three years as district manager of Southern West Virginia. Jeffrey earned his degree from the Philadelphia College of Pharmacy.

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