Automation improves med distribution

The BoxPicker helped cut pharmacy errors by half at Cohen Children’s Medical Center.

Image courtesy of Swisslog Healthcare

Cohen Children’s Medical Center, located in Queens, N.Y., is a 202-bed hospital serving a patient population of 1.8 million. The children’s hospital, which is a member of the Northwell Health System, cares for kids living in the Brooklyn and Queens boroughs and the Nassau and Suffolk county areas from prematurity to adolescence.

In such a fast-paced environment, staff at the hospital strive to keep work as close to the point of care as possible, including medication distribution. Cohen Children’s Medical Center stored pharmacy inventory in multiple locations throughout the facility, including several satellite pharmacies and inventory rooms situated in various department areas.

This setup meant that pharmacy staff was required to routinely walk throughout the hospital to these locations to carry out inventory and stocking tasks, causing logistical challenges and inefficient and time-consuming workflows. Within these satellite locations, medication was stored and managed on static shelving.

Not only was the method time-consuming, but it was also highly susceptible to human errors, including inaccuracy in labeling bins, misidentification of medication during manual pulls and returns, and incorrect medication picks. Inventory counts were done by hand each day, and these handwritten counts were used to place medication orders with wholesalers.

The high-touch process required constant management and presented opportunities for miscounts, which in turn led to instances of over- and under-ordering from wholesalers. This highly manual workflow also led to medication stockouts, increasing the risk of delayed patient care. Pharmacy leadership sought to minimize inventory shrinkage, gain visibility into medication stocking and reduce the volume of expired medications.

When reviewing their operations, hospital administrators recognized the need for a medication storage and retrieval system capable of streamlining medication administration workflow to improve efficiency and patient safety. As plans emerged for the hospital to construct a new facility, a priority was placed on consolidating pharmacy operations.

The BoxPicker Automated Pharmacy Storage System from Swisslog Healthcare was chosen to be the cornerstone of Cohen Children’s new inventory workflow. Administration was highly interested in the flexible and scalable nature of the solution, the opportunity to improve patient safety through secure scan-in/scan-out access and overall time-saving potential. A five-module, three-operator station, 10-foot dual temperature BoxPicker was selected to replace the previous manual process. Inventory was moved from satellite locations to be securely located and managed for pharmacy workflows.

At the time of implementation, Swisslog Healthcare’s project management team worked closely with the pharmacy staff to ensure a smooth transition to using the new technology in their space. The trainers used a hands-on approach to train “super-users” on the machines on-site and followed with a train-the-trainer model so that the whole staff felt confident in the change.

BoxPicker has allowed Cohen Children’s Medical Center to streamline medication ordering. Following the implementation of BoxPicker, Cohen’s pharmacy department realized a greater than 50% reduction in picking errors and a greater than 30% increase in time saved.

Also, fewer personnel are now needed to complete the process. Whereas three pharmacy technicians were previously dedicated to inventory control and ordering, today a single reorder list is generated by BoxPicker based on periodic automatic replenishment levels and medication usage, enabling pharmacy staff to quickly and accurately place orders before moving on to more engaging duties. The first inventory review following implementation of the BoxPicker identified a 30% decrease in total value of inventory on hand.

“Before implementing a central pharmacy model with BoxPicker, the medication storage, inventory and ordering processes were chaotic and inefficient,” says Wazeem Mohammed, RPh, MHA, coordinator, inventory management and finance, Cohen Children’s Medical Center. “Technicians had to conduct manual checks of bins, trays and counts —­ all very labor-intensive. The BoxPicker makes it all faster, and those techs can now do more rewarding work.”