Medication Distribution Models


State of Pharmacy Automation 2019 - Vol. 16 No. 8 - Page #48

Point-of-care distribution has proven its value in terms of ensuring reliable medication access while also allowing pharmacy to assert sufficient control and fine tune product inventory. While some larger teaching facilities prefer a hybrid model, this distribution approach is not expected to expand over the next few years. It is widely recognized that successful point-of-care distribution relies on effective par levels, yet also key is pharmacy’s commitment to assigning appropriate FTEs to conduct ADC system maintenance and also review patient transfers on an ongoing basis.

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Definitions

Centralized: 80% or more of inpatient beds receive medications from the central pharmacy, and/or robot/carousel is the main dispensing platform to unit dose carts

Decentralized, supported by satellite pharmacy: 80% or more of inpatient beds receive medications from satellite pharmacies and/or ADCs restocked from satellite pharmacies

Point-of-care model: 80% or more of inpatient beds receive medications from ADCs on the patient unit, which are restocked from central pharmacy

Hybrid: a combination of dispensing methods, meeting none of the conditions above


While point-of-care distribution, with most medications distributed via ADCs on the unit, experienced a small dip this year and hybrid facilities saw a small increase, the overall projections for distribution methods remains quite consistent. Point-of-care distribution is the preferred approach for most facilities, with hybrid distribution most commonly utilized by large teaching facilities with strong IT support.

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It is rare for pharmacy to rely on a single device to handle all medication distribution functions. Rather, most facilities utilize ADCs, which are then supplemented by a variety of other approaches including pneumatic tubes, COWs, couriers, medication carts, and in-room cabinets.

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Over the next 5 years, the majority of facilities with fewer than 400 beds will operate under a point-of-care distribution model with a strong emphasis on ADC usage. It is notable that the largest facilities are projecting more varied approaches to their medication distribution models. There is increased interest in centralized distribution in the 400+ bed cohort. Just over one quarter of 400+ bed facilities are planning to utilize centralized distribution in the next few years; last year, just 10% were planning to take this approach.

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