Pharmaceutical Packaging Facility

[After reading don't forget to watch UCSF's great video on the Pharmaceutical Packaging Facility. It was also featured on the tech website Engadget.]

In 2006, medication errors injured more than 1.5 million patients resulting in approximately $3.5 billion in added costs to hospitals. 98,000 medication error deaths every yearLabeling and packaging issues accounted for 33 percent of the errors and 30 percent of deaths¹. 98,000 deaths occur annually due to prescription errors with almost half attributable to dispensing and administration errors². In addition, California has effectively mandated the use of technology to help reduce medication errors³.

The national healthcare debate has also brought patient safety and efficiency issues to the forefront. Re-thinking inpatient pharmaceutical operations including consolidation, robotics, and process flow can result in a number of improvements, not only to prescription and dosing accuracy, but also to staffing safety, efficiency, and to operational costs.

For a California tertiary-care medical system, all of these issues were at the center of discussions on how to deliver and improve pharmaceutical services to their expanding health care system. 33% of errors are labeling and packaging The system currently has 2 hospital campuses and will be building a third. The cost of building three separate pharmacies was weighed against consolidation in one location. After examining various aspects of delivering these services, and operational modeling, the decision was made to consolidate the Core Pharmacy in one location and to focus on automation and robotics. At the same time, the decision was made to locate the Core Pharmacy in non-hospital construction thereby reducing construction cost and schedule.

This far-reaching and bold decision is expected to provide significant benefits to the system including:

Improved Dosing Accuracy
Automated dosing, packaging and dispensing was implemented in as many areas as possible. Specifically, the hospital utilizes robotics for bulk storage, unit dose, sterile compounding and chemotherapy compounding. This shift from manual to automated drug handling and dosing can result in improved dosing accuracy as high as 99.9%⁴.

Improved Staff Safety and Efficiency
Staff exposure to drugs, especially chemotherapy agents is becoming more scrutinized. As more drugs and compounding agents are handled robotically, the possibility of contamination and staff exposure is minimized. 99% dosing accuracy While safety is a key benefit, automation is also critical in improving overall operational efficiency of the facility. As one example - a single RIVA compounding robot can produce between 400 and 500 individual IV bags in a 24-hour period. Using this level of automation throughout the pharmacy can result in a 20% FTE reduction.

Improved Inventory Control
With bulk storage and unit doses bar-coded and stored in secured systems, miss-handling and theft issues are minimized. Tighter inventory control enables automated ordering and just-in-time restocking, reducing overall storage requirements.

Faster Occupancy
Hospital construction is a long and complicated process, especially in California. The design and construction of a phased inpatient pharmacy project can take 3 years to deliver. By shifting to a B-Occupancy the Core Pharmacy was delivered in 12 months from project inception to construction completion.

Lower Construction Cost
Factors like the age of the facility, the phasing required to maintain 24/7 operation and state code 500 I.V. bags per RIVA per day implications and impacts contributed to the construction cost being estimated at $1,500 per square foot in a hospital setting. With the shift to a B-Occupancy Office Building, the construction cost was reduced to $400 per square feet and resulted in a larger space that can accommodate pharmaceutical services for the system's long-term master plan.

See more photos of the Production Pharmacy on our portfolio page

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¹ "Medication Errors Injure 1.5 Million People and Cost Billions of Dollars Annually", National Academy of Sciences - Institute of Medicine, July 20, 2006
² "To Err is Human: Building a Safer Health System", National Academy of Sciences - Institute of Medicine, 2000
³ California Health and Safety Code Section 1339.63
⁴ "Erlanger Health System", Swisslog Case Study, 2010

Photos by Cam Vilay