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Kaweah Delta Health Care DistrictDrug Distribution Automation
Jerry Fahrni, PharmD
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Kaweah Delta Health Care District
Centrally located in the San Joaquin Valley, California
581 beds
Offers a variety of services
Inpatient
Outpatient
New tower opened April 2009
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Five Licensed Pharmacies
Outpatient
Employee Pharmacy
Home Infusion Pharmacy
Inpatient
Main Campus
South Campus (Sub-acute, SNF)
West Campus (Rehab, Mental Health)
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Pharmacy Remodel
Phase I complete February 2008
Designed around automation
Phase II complete December 2008
Designed around clean room and dispensing
Phase III complete June 2009
Designed around creating more work space
“Design the pharmacy around the technology”
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Phase IAutomation
Phase IIClean Room
Phase IIIMore Workspace
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Pharmacy Remodel – Phase I
Part of Kaweah Delta’s Medication Error Reduction Plan (MERP)
All Medications will have a readable bar code prior to dispensing
Patient Safety
Create an error free Pyxis fill
Increase Pyxis fill efficiency
Automate wholesaler ordering
Control Inventory - $$$
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Phase I-Automation/Technology
AutoPack
Implemented February 2008
AutoLabel
Implemented February 2008
AutoCarousel / AutoPharm
Implemented March 2008
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Pharmacy Remodel - Phase IAutoPackFebruary 2008
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500 canister model
Currently using just over 120 canisters
“Back-fill” vs. “Primary-fill” model
Minimize “A” locations
AutoPack
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Pharmacy Remodel - Phase IAutoLabelFebruary 2008
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Circle labels Mostly for liquids unit-
dosed to smaller size
AutoLabelFlag labels
Mostly vials and ampules
Insulin for BCMA
Pharmacy Remodel - Phase IAutoCarouselMarch 2008
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AutoCarousel
Items in carousel MUST be barcoded
Full integration with Pyxis
Replenishment
OMNL
PARx
Extending AutoPharm’s Reach
Storage outside the carousel
Chemotherapy
Large, bulky items with high turnover
Increasing storage within the carousel
Refrigerated storage
“Other” locations
Remote ordering
Storage Outside the Carousel
Consistency
Large items with high turnover
Take advantage of:
Barcoding
Inventory tracking
Remote Ordering
Tweaks and such …
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Package insert holders
Smaller storage bins
Pyxis PARx technology
Barcode scanners – newer is better
Label changes
Package insert holder
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Maximizing Storage Space
Herman Miller (A-size subcontainer) fit perfectly in the gaps
Pyxis CUBIE / PARx TechnologyImplemented with Pyxis 3500 in April 2008
Barcode scanners
Code Corp CR3 vs. 3500 – no contest … really
The 3500 is
Faster
Easier to use
More forgiving
Slightly tougher
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Better control of inventory on the wall and counter area
Barcode solution for off campus locations
Decreased fill time for main campus
Not so happy at satellite location
“Interrupts” workflow
Takes too long
AutoPharm Pilot