Optimizing Hospital Pharmacy Workflow for Cost Reduction and Improved Patient Care

Introduction: Streamlining Pharmacy Operations for Efficiency and Patient Safety

CM Hospital is committed to providing high-quality patient care while managing costs effectively. A key area of focus is the hospital pharmacy, responsible for dispensing medications to patients accurately and promptly. The pharmacy handles a wide range of medications, including intravenous fluids and pills, purchased in bulk and dispensed in unit doses according to doctor's orders.

The pharmacy's primary objective is to ensure the 'right drug, right amount, right patient, right time' principle is strictly followed. However, errors in the medication dispensing process can lead to adverse patient outcomes, ranging from minor side effects to severe allergic reactions and, in extreme cases, even fatality. National studies reveal a concerning range of error rates in hospital pharmacies, from a negligible 0.01% to a significant 15%.

Current Pharmacy Process at CM Hospital:

CM Hospital's pharmacy follows a seven-step process:

1. Order Reception: Receiving doctor's medication orders via written prescriptions, phone calls, or the hospital's internet system (average time: 0.2 minutes per prescription). This step can be performed by a medical technician or a registered pharmacist.

2. Order Verification and Validation: A registered pharmacist verifies the order for legibility and contacts the prescribing doctor for clarification if needed (average time: 1.9 minutes, considering a weighted average based on the complexity of prescriptions).

3. Duplicate Prescription and Allergy Check: A registered pharmacist uses the pharmacy's computer system to check for duplicate prescriptions and review the patient's allergy and medication history (average time: 1.4 minutes).

4. Drug Availability Confirmation: A registered pharmacist verifies that the requested medication is in stock, not expired, and available in the required form and quantity (average time: 1 minute).

5. Prescription Preparation: A registered pharmacist prepares the prescription, including labeling the medication containers accurately (average time: 4.5 minutes).

6. Prescription Storage and Delivery: A registered pharmacist stores the prepared prescription in the designated area for pickup and delivery to the patient (average time: 1 minute).

7. Record Keeping and Billing: Pharmacy staff prepare charges, add notes if necessary, and close the patient's pharmacy record in the computer system (average time: 2 minutes). This step can be performed by a registered pharmacist or other authorized personnel.

Challenges and Opportunities for Improvement:

Currently, registered pharmacists at CM Hospital are responsible for steps 2 through 7 of the medication dispensing process. Two medical technicians are also on duty to assist with tasks such as receiving prescriptions, answering phone calls, managing supplies, stocking shelves, delivering prescriptions, and interacting with nurses and doctors.

Consultation Objective:

Your team has been invited as consultants to analyze CM Hospital's pharmacy workflow and recommend improvements. The goal is to streamline the process, reduce costs, and enhance patient safety.

Initial Observations:

Initial investigations reveal a peak period between 8 am and 9 am on Mondays, with an average of 32 prescriptions received and five pharmacists on duty. This information provides a starting point for analyzing pharmacist workload and potential bottlenecks in the process.