By Annette M. Boyle
CHERRY POINT, NC—Prior to a renovation late last year, patients at Naval Health Clinic Cherry Point’s pharmacy left negative feedback twice as often as positive. Installation of a robotic pharmacy system reversed those numbers, however. Today, two-thirds of comments are upbeat.
The change in tone has good cause. The new robotic system enabled the pharmacy to reduce wait times by 50%, addressing one of the chief causes of pre-renovation complaints. The upgraded equipment and new processes also decreased fill times for refills by one full day, said Lt. Anthony Wyble, PharmD, Medical Service Corp, and Naval Health Clinic Cherry Point Pharmacy department head.
The pharmacy is in the clinic on Marine Corps Air Station Cherry Point, NC, and serves 33,000 active-duty members and DoD beneficiaries.
In addition to increased efficiency, the high-tech robots have led to more opportunities for high-touch connections. “We’re seeing increased interaction between staff and patients, resulting in not only a better experience for our patients, but a more-rewarding work environment for our staff,” Wyble told U.S. Medicine.
The new technology has dramatically streamlined the process of dispensing medications, he said. Each of the two robots can hold up to 200 different types of medication, which they autofill when a prescription is activated at the drop-off window. The machines handle the filling, labeling and capping process. A pharmacist then verifies that the correct medication, dose and quantity is going to the right person.
Cherry Point was selected as one of three pilot sites for a major Navy pharmacy improvement project first announced in late 2012. The project will bring the latest automated technology to Navy outpatient pharmacies, with the goal of reducing wait times to less than 30 minutes for at least 90% of prescriptions, as well as increasing safety and efficiency.
The initial goal was for 40% to 50% of prescriptions to be processed and filled by the equipment installed as part of the Navy program. At Cherry Point, however, the robots handle nearly all of them.
Despite the automation, the pharmacy has not seen a change in prescription filling accuracy. “Patient safety and accuracy have always been our top priority, and we are pleased to say it remains excellent,” Wyble noted.
The increased productivity also has led to other positive changes, according to Wyble, who pointed out, “Since our new system requires less staff for the actual medication dispensing process, they are able to focus more attention on each and every one of our patients.” The machinery did not cause any layoffs, instead enabling pharmacists and technicians to spend more time on patient counseling and customer service-related activities.
As part of the reconfiguration of the pharmacy space, staff members freed up from the counting and filling tasks are now positioned close to the service windows. From their new locations, they can easily hear and immediately respond to a patient’s questions.
With more time available for education and counseling, “if patients need more in-depth information, we have the ability to take that patient right in, instead of them having to wait,” Wyble added.
The renovation also created a new narcotic filling and refill processing area. Additional shelving provided needed storage for the pharmacy to expand inventory, which has further increased efficiency.
Many expect complex machinery to be loud, but Cherry Point has found the robots to be remarkably quiet “co-workers.” After installation, the “staff immediately noticed a drastic reduction in the noise level, which supports better communication across our staff and with patients,” Wyble noted.
New technology can take some time to incorporate into pharmacy workflows and often even longer to master well enough that the new system takes less time than the one it replaces. The Cherry Point pharmacy staff quickly acclimated to the new processes, however, as they were already familiar with the automation software, he said.
A renovation project on this scale with new equipment installation often takes 18 months or more and costs a pretty penny. The Cherry Hill project was all about efficiency from the start, however.
“Our pharmacy staff, with the support from command leadership and multiple departments, was able to accomplish the entire renovation with only three months of planning and four days to complete teardown and installation,” Wyble said.
During the intensive four-day construction phase, the team disassembled the old system, moved and installed new shelving, reconfigured the space, had the new technology installed, established connectivity to the new system and tested the equipment.
The cost came in well within budget, too. “Being good stewards of taxpayer dollars is always important—something we achieved with this renovation, which came in at about $400,000,” he emphasized.
Since the revamped pharmacy reopened to patients last fall, there have been no changes with the equipment or software. The pharmacy team continues to seek ways to “improve the quality and safety of our care, while increasing patient satisfaction,” said Wyble. Consequently, Cherry Point has also become a pilot site for the Navy Pharmacy Patient Experience initiative which is designed to improve the overall patient experience.
More than a dozen military treatment facility pharmacies have implemented a pilot customer service system that gives patients greater control over how they spend their time while waiting for prescriptions to be filled.
Venous thromboembolism, which includes deep venous thrombosis and pulmonary embolism, is the most common preventable cause of hospital death, according to the VA.