Measuring the impact of automated dispensing cabinet initiatives at a tertiary care hospital

Allegheny General Hospital utilizes the Pyxis® Medstation ES system. Pyxis® automated dispensing cabinets (ADCs) are deployed throughout the patient care areas and dispense the majority (>75%) of medication doses. Since the deployment of Pyxis®, there have been changes in nursing unit floors, changes in patient acuity, and a need to reflect these changes with the medications in each machine. From a pharmacy department perspective, there is a need to decrease medication/labor waste and efficiently utilize resources to provide optimal patient care. Our plan is to accomplish these goals by increasing the vend: refill ratios, decreasing stockout percentages, and potentially remove medications in ADCs not used within 90 days. An automated dispensing device frees pharmacists from labor-intensive distributive functions, improves patient care for nursing and pharmacists, enhances pharmacist clinical service opportunities, improves accountability and medication storage. Finally, barcode technology is utilized to ensure medication/antibiotic refills are appropriately completed. DoseEdge is a technology assisted workflow system used to prepare sterile compounds for point of use. The system interfaces with an electronic health record (Epic) to determine a patient’s specific order and regimen. Pharmacy technicians prepare doses as they fall into their appropriate batch times, Appendix B, and pharmacists verify each subsequent dose. DoseEdge’s reporting capabilities was leveraged to determine the number of prepared doses by patient unit. This objective output helped determine the average number of doses dispensed in a given day to justify par levels for a Pyxis® machine. Appendix B describes the antibiotic added, its average daily dose in each unit, and par levels in each machine. Conclusion/Public Health Significance Optimization of various processes is a time intensive process requiring appropriate resources to deliver timely medications. There are multiple approaches to ensure regulatory, operational, and clinical compliance for automated dispensing systems. To provide the safest and best medication delivery, optimization initiatives must be developed and performed on an annual basis