Hospital pharmacy automation important for hospital of the future
'Increasing medication safety for patients was our biggest goal. When you administer 10,000 drugs to patients every day, you want it to be as safe and error-free as possible. There is a lot involved in that. How do you get the organization to go along with this new way of working? How do you ensure clear agreements between the supplier and the hospital?'
Digitization has dramatically changed the way we communicate, work and live in recent decades. Healthcare has not escaped this development either. Digital technologies have the potential to make healthcare more efficient, accessible and personalized. From teleconsultations to wearables that monitor our health, digital healthcare innovations have become an integral part of today's healthcare. What exactly are the benefits of this digitization and what challenges does it bring? In this article, we discuss a real-life example: how could the world's first fully automated hospital pharmacy be realized?
Coen Zeeman, Young Executive at Boer & Croon, interviews Chris Pellicaan and Inge Schenk on this topic. Chris has been affiliated with the Amphia hospital in Breda for 15 years and in recent years has worked on setting up a digital and automated pharmacy. Together with Inge Schenk, healthcare manager at Boer & Croon and project leader on behalf of Swisslog Healthcare (the supplier of the automated logistics), he talks about the creation of the world's first hospital pharmacy that packages and delivers fully automated patient-specific medication to the departments.
What exactly has changed? What did the process of drug distribution look like and in what ways was it digitized?
Inge: 'In the past, the hospital pharmacist would look for the right medication on a shelf. The medication was then checked and distributed manually. It was a labor-intensive and routine process.'
With the TherePick, this happens automatically. This machine finds the correct medication per patient and bundles it into a ring (similar to a keychain) with individually wrapped medication units. Nurses now only need to scan to verify that they are giving the right medication to the right patient. In addition, emergency deliveries are now sent by tube mail, which is unique and efficient. Return of medication is also now easier. Previously, many medications were thrown away because it was not clear whether they could still be used after opening a package. Now all medication is individually packaged and barcoded, making it easier to re-dispense. This reduces waste, lowers costs and is good for the environment.'
Implementing such a big change involves a lot. What was the biggest challenge?
Inge: 'Indeed, it is not simply a matter of installing a machine. Such a machine has an impact on the way of working of hundreds of employees: the processes in the hospital have to be adapted to that. How can we act together as partners? The challenge lay largely in preparing the organization for this new way of working and creating support. That requires good change management from the hospital.'
Chris: 'When you consider that a failure in such a machine has a major impact on medication administration, you understand that proper implementation is essential. A short interruption of a few minutes is no big deal, but if it lasts for several hours or longer, it becomes problematic. This is a scenario that can keep a hospital pharmacist awake. That's why before we started at all, creating a backup plan was critical. Administration of medication must always be guaranteed and patient safety must not be compromised.'
Inge: 'That's why redundant parts are built into the machine. Many parts have a dual design. If a part fails for any reason, the most crucial tasks can continue on the other part. In addition, we ensure that spare parts are always available and we have a picket service.'
The implementation has a lot of impact on the organization and the way staff do their jobs. How did the Amphia hospital handle it?
Inge: "Of course this has a big impact. The people who previously collected and checked medication will now have time for other work. Here it is necessary to get everyone "on board" at an early stage and keep them informed about what is coming at them and to what extent it differs from the current working method. It is also important to communicate well about the new situation. To keep everyone on board, it is also important to keep emphasizing the biggest reason we are doing this: to increase patient safety and be able to provide good care.
Chris: 'It is enormously difficult to get staff for hospital pharmacies. A big advantage is that you can use the existing workforce in a good and efficient way now that some of the work is being automated. If we can get hospital pharmacists to do things that are more substantively satisfying than collecting and checking drugs, I think that's only a benefit. These people can now spend much more time with the patient. In addition, people really started working differently: logisticians suddenly became operators of a machine. With the help of the right training, we were able to take this step successfully as well.'
When the hospital decided to partner with Swisslog Healthcare, you entered into a multi-year project together. What does this collaboration look like?
Chris: 'As far as Amphia was concerned, it was 'learning by doing'. A continuous improvement cycle. That's what I find so cool about this innovative hospital. Many things were unclear in the beginning, because we were starting on something unique.'
It was therefore great that with Inge we had a project leader from Swisslog Healthcare who brought clarity and knew how to make good agreements. She took the lead in the way we communicated, for example in the steering committee, and organized how and when we consulted. As a result, we knew exactly where we stood as a hospital.
Chris: 'Inge made sure that this project started running and was pulled from A to B. She was a very strong project manager. In that respect, she was a very strong project leader who was very helpful to us. We were really able to make significant steps with her.'
You are making the case for digitization in healthcare. Why do you think this is so important?
Inge: 'For me, the most important thing is that we can continue to provide the care that everyone deserves. That is a huge operational challenge even if we had an unlimited budget. With the rising demand for care, we need to use our staff smartly. Through the use of technology, we can provide as many 'hands on the bed' and time for the patient as possible, while at the same time keeping the quality of care high.'
Chris: 'In addition, digitization in healthcare is of enormous importance for exchanging patient data. Good ICT is necessary for this. I think we can still take many innovative steps in that area. I personally hope to contribute to that, because I get excited about innovations. That is also the reason why I work at Amphia Hospital with a lot of passion.'
What should healthcare organizations do to accelerate digital innovation?
Inge: 'To achieve this acceleration, the right people are especially needed in combination with sufficient budget. First, people with the right skills are essential. It's about people who, on the one hand, understand digital innovation, but on the other hand also understand that healthcare is people-oriented and that digitization brings about a radical change in healthcare delivery. It also involves people who can properly perform good project and change management.
Second, you need people who dare to make informed bold decisions. To innovate, you also need to take risks. But not too many, after all it is about medication safety! That is where I admire Chris, he knew perfectly how to find the balance between initiating change (by using new technology) and good control during the process. You also need such people in the strategic and financial corner of your organization.
Third, you need people who have the time and desire to change. If continuous improvement is in the DNA of your colleagues and you have an achievable long-term or program plan, you've already come a long way. Leveraging these 3 types of people in the right way is, I believe, the key to sustainable digital innovation in healthcare, and perhaps the solution to the healthcare shortage. '