kdhcd pharmacy automation

1

Kaweah Delta Health Care DistrictDrug Distribution Automation

Jerry Fahrni, PharmD

2

Kaweah Delta Health Care District

Centrally located in the San Joaquin Valley, California

581 beds

Offers a variety of services

Inpatient

Outpatient

New tower opened April 2009

3

Five Licensed Pharmacies

Outpatient

Employee Pharmacy

Home Infusion Pharmacy

Inpatient

Main Campus

South Campus (Sub-acute, SNF)

West Campus (Rehab, Mental Health)

4

Pharmacy Remodel

Phase I complete February 2008

Designed around automation

Phase II complete December 2008

Designed around clean room and dispensing

Phase III complete June 2009

Designed around creating more work space

“Design the pharmacy around the technology”

5

Phase IAutomation

Phase IIClean Room

Phase IIIMore Workspace

6

7

8

9

10

Pharmacy Remodel – Phase I

Part of Kaweah Delta’s Medication Error Reduction Plan (MERP)

All Medications will have a readable bar code prior to dispensing

Patient Safety

Create an error free Pyxis fill

Increase Pyxis fill efficiency

Automate wholesaler ordering

Control Inventory - $$$

11

Phase I-Automation/Technology

AutoPack

Implemented February 2008

AutoLabel

Implemented February 2008

AutoCarousel / AutoPharm

Implemented March 2008

12

Pharmacy Remodel - Phase IAutoPackFebruary 2008

14

500 canister model

Currently using just over 120 canisters

“Back-fill” vs. “Primary-fill” model

Minimize “A” locations

AutoPack

15

Pharmacy Remodel - Phase IAutoLabelFebruary 2008

17

Circle labels Mostly for liquids unit-

dosed to smaller size

AutoLabelFlag labels

Mostly vials and ampules

Insulin for BCMA

Pharmacy Remodel - Phase IAutoCarouselMarch 2008

21

23

AutoCarousel

Items in carousel MUST be barcoded

Full integration with Pyxis

Replenishment

OMNL

PARx

Extending AutoPharm’s Reach

Storage outside the carousel

Chemotherapy

Large, bulky items with high turnover

Increasing storage within the carousel

Refrigerated storage

“Other” locations

Remote ordering

Storage Outside the Carousel

Consistency

Large items with high turnover

Take advantage of:

Barcoding

Inventory tracking

Remote Ordering

Tweaks and such …

30

Package insert holders

Smaller storage bins

Pyxis PARx technology

Barcode scanners – newer is better

Label changes

Package insert holder

31

Maximizing Storage Space

Herman Miller (A-size subcontainer) fit perfectly in the gaps

Pyxis CUBIE / PARx TechnologyImplemented with Pyxis 3500 in April 2008

Barcode scanners

Code Corp CR3 vs. 3500 – no contest … really

The 3500 is

Faster

Easier to use

More forgiving

Slightly tougher

35

36

37

Better control of inventory on the wall and counter area

Barcode solution for off campus locations

Decreased fill time for main campus

Not so happy at satellite location

“Interrupts” workflow

Takes too long

AutoPharm Pilot

38

Questions?

jfahrni@kdhcd.org