Robotic Dispensing Improves Patient Safety, Inventory Management, and Staff Satisfaction in an Outpatient Hospital Pharmacy

J Eval Clin Pract. 2019 Feb;25(1):28-35. doi: 10.1111/jep.13014. Epub 2018 Aug 22.

Abstract

Rationale, aims and objectives: Implementation of robotic systems in outpatient hospital pharmacies is uncommon. Other than cost, 1 of the barriers to widespread adoption is the lack of definitive evidence that this technology actually reduces dispensing errors and improves inventory management.

Objective: To identify the frequency of medication dispensing errors before and after the implementation of a robotic original pack dispensing system in an outpatient hospital pharmacy and to analyse the impact of this system on the quality of stock management and staff satisfaction.

Methods: A prospective before-and-after medication error study was performed using a disguised observation technique. Several indicators of stock management and staff satisfaction were monitored. Drugs were dispensed manually by technicians using a barcode-controlled system (preimplementation phase) or the dispensing robot ROWA Vmax (ARX) (postimplementation phase). As not all drugs could be handled by the robot, residual manual dispensing was also used.

Results: The dispensing error rate was reduced from 1.31% of prescriptions (43/3284) to 0.63% (19/3004) (relative risk reduction [RRR], 51.7%; 95% CI, 17.3% to 71.8%). The error rate decreased up to 0.12% (3/2496) (RRR, 90.8%; 95% CI, 70.4% to 97.1%) if errors during residual manual dispensing were excluded. The stock-out ratio was reduced from 0.85% to 0.17% (RRR, 80.5%; 95% CI, 49.5% to 92.5%). Daily staff time (median) in stock management was reduced by 59.3% (from 1 hour 36 minutes to 39 minutes). High level of staff satisfaction with this technology was achieved, although it was slightly higher in the group of pharmacists compared to technicians (8.63 ± 0.7 vs 7.78 ± 0.7, P = .046).

Conclusion: The implementation of a robotic original pack dispensing system substantially decreased the rate of dispensing errors and optimized stock management. Minimizing the number of drugs out of the dispensing robot is critical when attempting to maximize the benefits of its implementation.

Keywords: hospital pharmacy; information technology; medication error; patient safety; robotic dispensing system.

MeSH terms

  • Attitude of Health Personnel
  • Drug Prescriptions / standards
  • Drug Prescriptions / statistics & numerical data
  • Humans
  • Information Technology
  • Medication Errors* / prevention & control
  • Medication Errors* / statistics & numerical data
  • Outpatients
  • Patient Safety / standards
  • Pharmacy Service, Hospital* / methods
  • Pharmacy Service, Hospital* / organization & administration
  • Pharmacy Service, Hospital* / standards
  • Robotics / methods*
  • Safety Management / methods
  • Safety Management / organization & administration
  • Spain