Design, implementation, and evaluation of a thrice-daily cartfill process

Area of Science:

• Pharmacy Practice
• Health Systems Engineering
• Medication Management

Background:

• Optimizing medication delivery is crucial for efficient hospital operations.
• Traditional once-daily cartfill models may not align with dynamic patient care needs.
• Academic medical centers face challenges in expanding clinical services within budget constraints.

Purpose of the Study:

• To report efficiencies gained from redesigning the central pharmacy cartfill process.
• To evaluate the impact of transitioning from a once-daily to a thrice-daily medication cartfill model.
• To assess the feasibility of expanding clinical pharmacy services in a budget-neutral manner.

Main Methods:

• A pre-post analysis was conducted at a large academic medical center.
• The study involved a transition from a once-daily to a thrice-daily medication cartfill schedule.
• Data on medication preparation, delivery lead times, and waste were collected and analyzed.

Main Results:

• A 32.7% decrease in the mean daily number of extemporaneously prepared oral doses.
• A 55-65% reduction in lead times for three of four peak delivery periods.
• A 44.1% decrease in first doses dispensed and a 42.9% decrease in returned medications.

Conclusions:

• The thrice-daily cartfill process improved efficiency and reduced medication waste.
• Implementation led to a 2.1% increase in overall cartfill doses dispensed.
• Redeployment of two technician full-time equivalents enabled the expansion of pharmacy services.