Automation in pharmacy: two institutions' experiences with novel distribution systems.

A computerized medication system, implemented at Rochester (MN) Methodist Hospital in 1987, has been adopted by the hospitals at the Mayo Medical Center, Rochester, MN. A key component of the medication system, which uses individualized patient medication envelopes, is the delivery of doses of medications to nursing units just before their administration time. The system has been shown to provide greater nursing support, increase patient safety by reducing medication errors, and decrease both full-time equivalent costs and operating costs. The immediate impact of the system has been to shift dose scheduling from a nursing to a pharmacy responsibility. At Duke University, an automated pharmacy system (APS) has been in operation since October 1993 and is used to dispense the majority of unit dose drugs. The APS provides up-to-the-minute information about the drugs that patients are receiving, which is used to fill each patient's unit dose drawer. It has not dispensed an incorrect drug since its installation and has allowed centralization of the unit dose cart system. Other benefits include decreased billing labor and increased drug usage reporting.