Category: Professional Posters
Purpose: Historically, the 24 automated dispensing cabinets (ADCs) at our 186-bed rural community hospital in upstate New York have been reviewed monthly using the Min / Max Method which allowed for the determination of a minimum and maximum number of units to be stocked at any given time. However, the ADC inventory was not regularly reviewed for how long items remained stocked but unused other than to replace them with fresh stock when they expired. Over the past year, the value of our ADC inventory had increased greater than $15,000.
Methods: This project was spearheaded by the hospital’s pharmacy buyer. The department was divided into teams each under the direction of a specified Team Leader who could be pharmacist or a technician. Each team was then assigned a set of ADCs. In Phase One of the project, which ran from July to September 2018, the teams reviewed what was currently stocked in each of their assigned ADCs. Medications that were determined to be essential to that specific hospital unit (i.e., code medications, dextrose syringes, etc.) were marked as such in the ADC software so that they could not be unloaded. This Master Standard Medications list was then presented to and approved by the hospital’s Pharmacy and Therapeutics and Medical Executive committees. The remainder of 2018 was used for Phase Two during which the teams visited each ADC and unloaded all non-essential medications that did not have a currently active patient order. After this initial cleanout, the ongoing project began as Phase Three in which daily reports are generated by the ADC software indicating which medications have been loaded for greater than 30 days without being dispensed. This report prints automatically in the pharmacy each day at 13:00, and technicians then take it with them as they round to each ADC and remove the specified medications.
Results: The hospital’s full inventory including ADCs is completed each January. In 2018, the value of the inventory sitting in the hospital’s 24 ADCs was $164,610.34. This was up from $149,018.34 the previous year. After the completion of Phase One and Phase Two of the project, the ADC inventory in January 2019 had been decreased to $133,068.05. This is a savings of $31,542.29. Monthly spot checks by the department’s buyer have determined that this savings has been maintained throughout the first half of 2019.
Phase Three of the project will remain ongoing indefinitely in order to maintain the current inventory levels and attempt to further decrease them over time if possible. While it has not been specifically studied as a part of this project, anecdotal reports from pharmacy technicians indicate that the project has also decreased their overall workload as they now need to maintain fewer medications in the ADCs and are seeing fewer medications need to be removed and replaced due to expiration dating.
Conclusion: The majority of the medication doses at our hospital are dispensed via our ADCs. During the period in which we were not carefully monitoring their inventory, the volume and value of the medications they contained steadily climbed to a peak of nearly $165,000 at which time we implemented this project. By limiting the ADC inventory to only medications that were determined to be essential for the specific unit’s function, patient safety, or were in active use, we decreased the overall ADC inventory value by over $30,000, and this success has been maintained for greater than six months.