Outsourcing the preparation of parenteral nutrient solutions

A hospital pharmacy's experience with using an outsourcing center to prepare parenteral nutrient solutions (PNs) is described. In 1994 the pharmacy at a 340-bed level 1 trauma center selected an outsourcing center located 20 miles away to provide PN-compounding services; the center is licensed as a manufacturer and has an extensive quality control program. The necessary telephone and computer links were established. When a PN order is received, the pharmacist simply dials into the outsourcing computer system and enters the order. At 1400, a pharmacist dials into the system to verify all PN orders entered for that day. After 1500, personnel at the outsourcing center print labels and compound the solutions, which are delivered by courier within a few hours. The net savings during the first year of outsourcing PNs were estimated at about $59,000. The savings were attributable to the elimination of a technician full-time equivalent (FTE), a reduction in pharmacist labor, and favorable contract provisions; money was saved even though the service's PN-preparation fees outweighed the savings from reductions in labor. The hospital's onsite inventory of PN supplies decreased by $5800, and storage space was freed for other uses. Very few problems were associated with the service provided. Outsourcing the preparation of parenteral nutrient solutions reduced personnel, inventory, and expenditures in a hospital pharmacy.