As hospitals grow in size and complexity, outpatient pharmacy services have become more sophisticated and essential to comprehensive patient care. No longer just a transaction-based business, modern outpatient pharmacies focus on providing safe, secure, and convenient care for both patients and employees in a manner that can be integrated with inpatient services. In many cases, enabling the provision of these services requires new practice models, new technologies, and more staff. Accommodating these changes also may require restructuring and modernizing the pharmacy itself.
Updating Outpatient Facilities
Penn Presbyterian Medical Center (PPMC)—a 350-bed, academic medical center based in Philadelphia—operates three outpatient pharmacies.
Two existing outpatient pharmacies operated using antiquated casework that dated back some 25 years. The third pharmacy, part of a recent large-scale outpatient facility development initiative delivering integrated care for Penn Medicine patients and employees, offers ambulatory surgical and outpatient radiology services, and houses the Penn Musculoskeletal Center. The pharmacy is strategically located in the lobby of the outpatient facility for visibility and convenience.
In order to design the pharmacy with consistency and quality in mind, we engaged a professional casework supplier, Pharmovative. The goal in engaging a casework vendor was two-fold: to create a state-of-the-art outpatient space with a professional appearance, and facilitate the continuing growth of outpatient services.
One immediate benefit of working with a casework vendor with design services is the depth of remodeling and new-build experience they bring to the table. For the initial meeting, Pharmovative representatives and our architect toured the facilities and reviewed the entire outpatient medication management process, from intake to output. The reps queried pharmacists regarding suggestions for workflow improvements and advised on elements that easily could be overlooked, such as utilizing angled bins for easier access, and reinforcing cabinets to prolong their life cycle and prevent damage. They also suggested additional strategies to ease workflow for patient pickup, improve medication visibility, and provide for employee comfort with items such as padded stress mats in high-use areas. Furthermore, in the interest of ensuring medication safety, we realized a need for increased counter space and HIPAA-compliant areas where private patient counseling could take place.
Aesthetic and Functional Benefits
It is not unusual for hospital pharmacies to retain the same physical environment (ie, cabinetry, wall paint, lighting, workspace layout, etc) for decades. As a result, many pharmacy practitioners are unaware of the benefits of a modern environment. Now that the outpatient pharmacy has been renovated, the results are visually appealing, and the improved layout and functionality of the casework provides operational efficiencies. The wood grain cabinets and new lighting fixtures are warm and inviting compared to the previous environment, which was monochrome and sterile in nature. Drawers that contain prescription vials are now angled to allow for greater storage density and weight capacity, while making it easier to identify and access the vials. The drawers also have a soft close function that cuts down on background noise.
Furthermore, the cabinet bottoms are reinforced with toe kicks that run flush to the floor to protect the casework, and the service counters are ADA compliant, enabling disabled patients to acquire prescriptions easily. The significant increase in useable square footage (an overall expansion from 8,000 to 25,000 square feet) allowed for the addition of an employee break room, a separate manager’s office, and a private patient consultation room.
Given the success of this pharmacy renovation, PPMC plans to remodel and update the two additional outpatient pharmacies with specifications created by Pharmovative. With three outpatient pharmacies in operation, PPMC’s original return on investment forecast of 2 years remains on track.
Nishaminy Kasbekar BS, PharmD, FASHP is the director of pharmacy at the Penn Presbyterian Medical Center of the University of Pennsylvania Health System in Philadelphia. She received her BS in pharmacy and PharmD at the Philadelphia College of Pharmacy and Science. Nishaminy is currently the president of the Pennsylvania Society of Health-System Pharmacists and is serving as vice-chair of the ASHP Council on Pharmacy Practice and the UHC Practice Advancement Committee.
One example of the integrated value of strong outpatient pharmacy services is our concierge, meds-to-beds program. The pharmacy is alerted when a patient is about to be discharged and then arranges for the patient’s medications to be delivered to the bedside. Not only is this a convenience for the patient, it also enables hands-on medication education and improves medication adherence during transitions in care.