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.
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
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,.)