Chinese Medical University Hospital Improves Pharmacy Outcomes with ADCs

Established in 1980, China Medical University Hospital (CMUH) was the first hospital in Taiwan to integrate Chinese and Western medicine. As an important medical center in central Taiwan, China Medical University Hospital now has 2,222 beds, combining both the latest developments in technology and society to create an intelligent interconnected ecosystem that is constantly learning and adapting to staff and patient’s needs. On average, the hospital has more than 190,000 outpatients, 14,000 patients admitted to emergencies, and 7,600 hospitalized patients (5,100 patients receiving surgeries) every month.

The fast-paced hospital outpatient pharmacy is a complex hub of patient care. At CMUH, the manual and disjointed medication distribution model got in the way of workflow efficiency and safety. After the pharmacist dispenses the medication, the patient still needs to bring the medications to the Outpatient Injection Room for injection. Because that transport relied on manual process, the last segment of medication administration was often an undocumented and unsecured journey.

Technology was necessary to overcome the risks that result from the medication delivery process. Committed to overhaul the medication distribution model, the first step for the hospital was to adopt automated dispensing cabinets (ADCs) and usage strategies in outpatient areas. After a rigorous vetting, the hospital finally chose our Medication Management Cabinet that provides the widest range of optional hardware available, powered by Intelligent Closed-loop Medication Management System, a fully integrated software platform.

NuboMed’s services team works closely with the hospital to ensure medication locations and security levels are optimized for its processes. Designed to reduce the risk of medication errors and provide secure storage, the cabinet ensures proper safeguards are in place for each item that is dispensed. Items held within the compartments are hidden to increase security and protect the contents from light. A variety of optional configurations give CMUH the most flexibility and security for storing single-dose and bulk items. Furthermore, the system’s single item control accommodates a wide range of medication sizes that require higher safety and security than open compartments.

Prior to the upgrade to Medication Management Cabinet, communication and medication transfer between hospital staff and patient often gave rise to delays and human errors in medication distribution workflows. Now all medications are stored in a controlled, locked and credentialed environment. The streamlined operations avoid the possession of medication by patients themselves thereby significantly decreasing errors and eliminating manual errors from the delivery process. The software module provides visibility so that the outpatient pharmacy can remotely view and control inventory.

“In the 2-year pre-period (2015-2016) and 2-year post-periods (2017-2018), we observed 222,696 and 210,528 injection medication doses respectively. All medication error types were reduced in the post intervention study period. The medication error was decreasing from 13 orders to 0 order after implementing ADCs in the outpatient injection room. Almost nurses agreed that they were able to administer medication more efficiently and spent less time waiting for medication from the pharmacy than they did before the ADC system was introduced. The overall satisfaction rate for the nurses was 90 % and for the pharmacists was 100%.” (Cheng, Y., Yu, W., Kuo, C. and Hsieh, Y., 2019. IMPLEMENTATION AND EVALUATION OF AN AUTOMATED DISPENSING SYSTEM IN OUTPATIENTINJECTION ROOM. Fip,.)