Justification of an operating-room satellite pharmacy

The pharmacy department's documentation of medication handling and control in a 24-suite operating room (OR) complex to justify implementation of an OR pharmacy satellite is described. At a 937-bed hospital, medication inventory, charge capture, and procedures for handling controlled substances were assessed to justify an OR pharmacy both financially and in terms of patient safety. Actual medication charges to patients using the OR billing system were compared with theoretical pharmacy charges based on medication administration records; results indicated that an OR pharmacy would increase gross revenue by $671,606 annually. New collectible revenue from increased charge capture was projected to be $71,926, considering payer mix, reimbursement rates, and current payment methods. The cost of medication inventory in the OR complex was $75,576; a $55,000 inventory reduction and $50,000 annual decrease in drug wastage was projected. First-year personnel costs associated with an OR pharmacy were estimated at $79,872 and equipment and renovation costs at $5,000. New collectible revenue to the institution, after expenses, was projected at $79,959 from the first year of operation and $277,569 after five years. Controlled-substance documentation was incomplete; 19% of fentanyl and 31% of sufentanil removed from inventory were not recorded as administered, returned, or wasted. The results indicated that, at this institution, approximately three OR complex full-time equivalents could be relieved from medication-related activities. Based on the potential for improved patient safety and new revenue generation, implementation of an OR satellite pharmacy was recommended to the hospital administration.