JMIR Publications

ABSTRACT

Background:

We describe the introduction, use and evaluation of an automation and integration pharmacy development program in a private facility in Saudi Arabia. The project was specifically undertaken to increase throughput, reduce medication dispensing error rates, improve patient satisfaction, and to free up pharmacists’ time for increased face-to-face consultations with patients.

Objective:

We forecasted growth of our outpatient service at 25% per annum over 5-year and 10-year horizons and set out to prepare our outpatient pharmacy service to meet this demand. Initial project goals were set as a 50% reduction in the average patient wait-time, a 15% increase in patient satisfaction regarding pharmacy wait-time and pharmacy services, a 25% increase in pharmacist productivity and zero dispensing errors. This was expected to be achieved within ten months of go-live. Realignment of pharmacist activity towards counselling and medication review with patients was a secondary goal, along with the rapid development of a reputation in the served community for patient-centred care.

Methods:

Pre-implementation data for patient wait-time for dispensing of prescribed medications as a specific measure of patient satisfaction was gathered as part of wider ongoing data collection in this area. Pharmacist activity and productivity in terms of patient interaction time were gathered. Reported and discovered dispensing errors per 1,000 prescriptions were also aggregated. All pre-implementation data was gathered over an eleven- month period.

Results:

From go-live, data was gathered on the above metrics in one-month increments. At the 10-month point there had been a 53% reduction in the average wait-time, a 20% increase in patient satisfaction regarding pharmacy wait-time, with a 22% increase in overall patient satisfaction regarding pharmacy services, and a 33% increase in pharmacist productivity. There was a zero-rate dispensing error rate reported.

Conclusions:

The robotic pharmacy solution studied was highly effective, but robust upstream supply chain is vital to ensure stock levels, particularly when automated filling is planned. The automation solution must also be seamlessly and completely integrated into the facility’s software systems for appointments, medication records and prescription in order to garner its full benefits. Patient overall satisfaction with pharmacy services is strongly influenced by wait-time and follow up studies are required to identify how to use this positive effect and how to make optimal use of ‘freed-up’ pharmacist time. The extra time spent with patients by pharmacists, and the opportunity for complete overview of the patient’s medication history, that full integration gives, may allow for the tackling of challenging issues such as medication nonadherence. Reduced wait-times may also allow for smaller prescription fill volumes, and more frequent outpatient department visits, allowing increased contact time with pharmacists for patients.