Research results regarding pharmacy automation in a university hospital: Highlighting safety, efficiency and rationality

Hospitals are renewing their pharmaceutical services with the expectation that automation will improve patient safety, make medicine supply services more efficient, and promote occupational safety. Their expectations are valid, as a Finnish pharmaceutical study verified in September 2019 confirms. It is a pioneering study, as few international studies on the same scale have been conducted on compounding systems.

Hospitals renew their pharmaceutical services by replacing manual processes with new ones, utilising automated equipment with integrated information systems. In Finland and globally, hospitals are developing their pharmaceutical services toward an uninterrupted medical service process.

“The barcode recognition of patients and medication, and recording the administration of medication next to the patient enable us to update the patient and medication information in the information systems in real time. We still have a fair way to go before we have an uninterrupted medical service process, says Riikka Metsämuuronen, pharmacist and Doctor of Science (Pharmacy).

However, according to Metsämuuronen, many hospitals have taken important steps toward an uninterrupted medical service process. In her research, she studied the impact the automated dispensing cabinet (ADC) and compounding robot had in Kuopio University Hospital.

ADC makes staff more efficient by up to 30 minutes

Metsämuuronen’s dissertation shows that, based on the nurses’ experiences and improved pharmaceutical services, the commissioning of the automated dispensing cabinets (ADCs) in Kuopio University Hospital was a successful reform.

“The key findings were that the nurses are happy with the ADCs and that they were so easy to use. They felt that they have quick and easy access to the medicines.

The observation study showed that every day, the nurses spent up to 30 minutes less on preparing medicines than before the commissioning of the ADCs. In addition, the use of the ADCs had a significant impact on the anaesthesia nurses, decreasing their need to fetch medicines from outside the operating theatre in the middle of surgery.

”The ADCs freed up time to monitor the patient’s condition, thus improving patient safety. We can also expect the risk of infections to decrease, as any movements to and from the operating theatre will increase the risk of impurities entering the operating theatre.”

Research also showed that few adverse events related to ADCs were reported and those that were did not cause any harm to patients.

“More than two-thirds of the respondents felt that the ADCs improve patient safety. Responses to open questions indicated that factors that improve patient safety the most include the barcode identification and light direction of the ADC.

Compounding system for antibiotics reduced work-related symptoms

Using a compounding system for intravenous antibiotics reduced work-related symptoms among ward pharmacists and nurses in Kuopio University Hospital. Preparing the antibiotic syringes manually may cause wrist pain due to the circular motion of the hand as well as respiratory and skin symptoms due to the dry powder antibiotic wafting through the air.

Half of the respondents with a history of skin and respiratory symptoms felt that they had experienced fewer symptoms since the commissioning of the antibiotics robot, while no one reported increased symptoms. The result is based on a questionnaire conducted before and after the commissioning of the antibiotics robot.

“I think the next step should be to study the cost effect to see whether there have been fewer absences due to illness since the commissioning of the antibiotics robot. I believe that we will see a decrease, generating savings for the hospital, but more research is required to show that.”

Compounding system for antibiotics made hospital work more efficient

It is likely that savings will also be generated as work on the wards becomes more efficient. Staff members felt that using the antibiotics robot decreased the time used to prepare antibiotics. This time could then be used for patient care.

“Savings in working time were not calculated in this study but, in my opinion, staff members on wards feel less rushed, which improves motivation and coping at work. That alone can generate considerable savings for the hospital.”

The use of the antibiotics robot is also expected to improve the microbiological purity and dose accuracy of antibiotic medicines. The observation study showed that when antibiotic doses were prepared manually on the wards, there was some room for improvement in asepticity. The same observation was made in previous studies conducted in Finnish hospitals.

“Our aim is to improve patient safety by concentrating the preparation of antibiotic doses in the hospital pharmacy to be done by a compounding system.”

Renewing processes requires change management

Metsämuuronen follows the progress of automation in hospitals with interest. As mentioned earlier, she is interested in conducting further research from the aspect of generating cost savings.

“More research is needed to provide research-based data on benefits and savings.”

Hospitals are facing a big change, which has also made Metsämuuronen think about resistance to change among staff members. She points out that all employees should be involved in change management. Discussions and genuinely listening to the professionals will lead to the best outcome. They have good experiences of this in Kuopio.

According to Metsämuuronen, patients see automatisation in hospitals as a positive thing.

“I believe that automation will continue to improve patients’ confidence in medical care. In addition to improving patient safety, automation gives staff more time for patient care; this is something that patients do appreciate.