Optimizing Pharmacy Talent and Technology at Owensboro Health
Podcast Episode 15
Persistent labor shortages are forcing health system pharmacy leaders to rethink their operational and clinical choices. Learn how innovative leaders at Owensboro Health are sidestepping labor issues, up-leveling clinical programs, and optimizing medication management processes with advanced robotics and software operated by dedicated on-site resident experts.
Jason Collins, PharmD, Director of Inpatient Pharmacy
Q: How is Owensboro Regional Hospital’s pharmacy services organized to support patient care?
Jason Collins: We have a unique approach. The hospital was built in 2013 with nursing alcoves located outside of patient rooms. The alcoves include a computer and locked medication drawers. We wanted nurses to have the vast majority of patient medications right at their fingertips so they’re not walking up and down hallways searching for medications and supplies.
During day shift, pharmacy technicians hand deliver patient-specific medications to each medication drawer. At night, we use the tube system.
Also, the main hospital provides the medications used in the health system’s 30 clinics and Healthplex locations throughout the 19-county service area. The clinics place their orders with us, and we prep and ship them to the locations.
Q: To support your patient server model, how is pharmacy operations organized?
Jason Collins: For many years, we’ve used a 24-hour cart fill model supported by the ROBOT-Rx central pharmacy robot and two carousels. The robot was used for cart fill, Carousel One was for first doses, and Carousel Two was for cabinet filling.
As the ROBOT-Rx was nearing end of life, we evaluated different options. We wanted technology that would help us continue to grow while also providing a safe environment for our patients and reduce stress on pharmacy staff.
We decided to continue with our cart fill dispensing model and move forward with the XR2 robot.
Q: What improvements have you experienced with the new technology?
Jason Collins: The XR2 robot has been great for our medication distribution model. We’re automating more doses and have cut manual picks by more than half.
First, XR2 has more than twice the capacity of our old robot, and manages a lot more different form factors, like syringes, vials, cards, oral tables, even sleeves of tablets. That’s a real safety advantage because those doses are now bar-code scanned rather than picked manually. This also saves time on technician picks during both the day and night shifts, and saves time on pharmacist medication checking.
Second, the XR2 is completing up to 95% of cart fill. That’s less manual picks. This is freeing up technicians to perform other duties, such as making IVs, dealing with code carts, delivering meds to the floor, or answering phone calls.
Third, the XR2 robot is doing about 50% of our picks for XT automated dispensing cabinets. The automated processes have resulted in a big improvement in workflow for dayshift technicians. The robot dispenses items for cabinets into clear, sealed, labeled bags. Technicians take the filled bags to the floor to restock the XT cabinets.
Q: What’s your experience with the onsite XR2 service operator?
Jason Collins: Having our XR2 service technician on site has been a major asset. Our technician came in fully trained and ready to go, which helped us get comfortable right off the bat. She’s operating the XR2 40 hours per week, reviewing reports, doing tray analysis, and working to optimize the robot and inventory.
She also helped train staff on safely operating the robot when she’s not there. That’s been so helpful to reduce stress. Other technicians don’t have to worry about trying to figure out on their own how the robot works. They can have confidence in what they’re doing, and that medications are being dispensed in a timely, safe manner for patients.
Q: How has pharmacy labor efficiency been enhanced with the new XR2 and dedicated operator?
Jason Collins: Previously, we had one technician on each of the two carousels, and one technician to unit-dose package medications and work the robot. We also used a third party to package some medications.
Now, with 95% of our cart fill is coming from XR2, we don’t need two people on the carousels eight hours per day. Because XR2 uses manufacturer bar codes, we no longer have a technician packaging eight hours per day, and we’re saving money by eliminating the third-party packager.
We’re looking to repurpose that pharmacy technician labor for higher-level tasks, such as medication reconciliation.
For pharmacists, there’s much less medication checking. It’s really opened the door for our pharmacists to do more of the things they were struggling to find time to do, such as additional reviews of patient charts, more safety reviews, and more patient counseling.
Q: How did you manage change for your pharmacy team?
Jason Collins: Obviously, it was a huge change. Not everything was perfect, because anytime you create change of this magnitude there are going to be hiccups. The key is to have a good internal team and a good vendor partner to exchange ideas related to planning, scheduling, preparing for down times, and then to identify and fix issues in a timely manner.
When we went live, we followed a phased approach. We introduce one workflow at a time, and after being successful with that over a couple of days, added additional workflows.
Omnicell had technicians in the pharmacy pretty much 24 hours per day, with the onsite operator and expert resources, helping our staff understand the process, walk them through workflows, and making sure our teams had hands-on the whole time. This really built confidence in our staff.
Also, we continue to meet monthly with the Omnicell team to talk about how to continue optimizing the technology and workflow.
The Future of Pharmacy Podcast is produced and distributed by Pharmacy Podcast Network. The views and opinions expressed in this podcast are those of the authors and do not necessarily reflect the official policy or position of any other agency, organization, employer or company. Assumptions made in the analysis are not reflective of the position of any entity other than the author(s). These views are always subject to change, revision, and rethinking at any time and may not be held in perpetuity.