Automated Dispensing Cabinet Stocking Schedule and Inventory Management Optimization.

HCA healthcare journal of medicine Pub Date : 2025-06-01 eCollection Date: 2025-01-01 DOI:10.36518/2689-0216.1822
Daniel Elkes, Victoria Timmons
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Abstract

Background: Prior practice in a 523-bed community hospital required automated dispensing cabinets (ADCs) to be replenished daily by early afternoon to ensure accurate drug ordering. Because of the tight time window, technicians frequently refilled ADCs during peak medication administration times. After a positive report from a smaller facility in the health system, the study facility implemented a quality improvement project to optimize the ADCs. This involved new processes of every-other-day ADC replenishment staggered via shift-specific workflows, and a dedicated technician was assigned to optimize ADC inventories.

Methods: Monthly reports of ADC refilling and dispensing transactions were compiled from inpatient, nonprocedural units. Data on stock-out transactions, when a nurse attempts to remove a medication from an empty ADC pocket, were obtained from facility reports from the same machines. Based on hospital policy for standard medication administration times, peak times were identified. For these time windows, an overlap ratio was calculated by dividing the relative frequencies of refill and dispense transactions. The average overlap ratios were calculated for the pre- and post-implementation periods. Stock-out transactions were tracked monthly, and a 95% confidence interval was constructed for all months before implementation.

Results: Post-implementation, monthly stock-out counts significantly decreased by 38% within 6 months. While there was no change in medication dispensing patterns, there was a major shift in refilling activity patterns. Overlap during morning peak times decreased, but overlap increased during the evening peak times due to the rearrangement of technician shift times and workflows.

Conclusion: After implementation of the new process and ADC inventory optimization, refill habits significantly changed, leading to reduced technician-nurse overlap during the morning medication pass, likely due to the spread out replenishment schedule. Dispensing habits did not change during the study period, and while there was a significant decrease in stock-outs post-implementation, there was insufficient data to assess effects of the new refilling processes.

自动点胶柜库存计划及库存管理优化。
背景:在一家拥有523个床位的社区医院,以往的实践要求每天下午早些时候自动配药柜(adc)必须补充,以确保准确的药物订购。由于时间窗口紧张,技术人员经常在给药高峰期间补充adc。在卫生系统中一个较小机构的积极报告后,该研究机构实施了质量改进项目,以优化adc。这涉及每隔一天通过轮班特定工作流程交错补充ADC的新流程,并指派专门的技术人员优化ADC库存。方法:从住院、非程序性单位编制每月ADC补充和调剂交易报告。当护士试图从空的ADC口袋中取出药物时,关于缺货交易的数据是从同一台机器的设施报告中获得的。根据医院的标准给药时间政策,确定高峰时间。对于这些时间窗口,通过除以重新填充和分配事务的相对频率来计算重叠比率。计算了执行前后期间的平均重叠比率。每月跟踪缺货交易,并为实施前的所有月构建95%置信区间。结果:实施后6个月内,月缺货数量显著下降38%。虽然药物分配模式没有变化,但再填充活动模式发生了重大变化。由于技术人员轮班时间和工作流程的重新安排,早高峰时段的重叠减少,但晚高峰时段的重叠增加。结论:在实施新流程和ADC库存优化后,补药习惯发生了显著变化,可能是由于补药时间表分散,导致上午给药时技师和护士的重叠减少。在研究期间,配药习惯没有改变,虽然实施后缺货的情况显著减少,但没有足够的数据来评估新的补充过程的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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