Pharmacy Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, c/Doctor Esquerdo, 46, 28007, Madrid, Spain.
Faculty of Pharmacy, Universidad Complutense de Madrid, c/Plaza Ramón y Cajal s/n. Ciudad Universitaria, 28040, Madrid, Spain.
J Eval Clin Pract. 2019 Feb;25(1):28-35. doi: 10.1111/jep.13014. Epub 2018 Aug 22.
RATIONALE, AIMS AND OBJECTIVES: Implementation of robotic systems in outpatient hospital pharmacies is uncommon. Other than cost, 1 of the barriers to widespread adoption is the lack of definitive evidence that this technology actually reduces dispensing errors and improves inventory management.
To identify the frequency of medication dispensing errors before and after the implementation of a robotic original pack dispensing system in an outpatient hospital pharmacy and to analyse the impact of this system on the quality of stock management and staff satisfaction.
A prospective before-and-after medication error study was performed using a disguised observation technique. Several indicators of stock management and staff satisfaction were monitored. Drugs were dispensed manually by technicians using a barcode-controlled system (preimplementation phase) or the dispensing robot ROWA Vmax (ARX) (postimplementation phase). As not all drugs could be handled by the robot, residual manual dispensing was also used.
The dispensing error rate was reduced from 1.31% of prescriptions (43/3284) to 0.63% (19/3004) (relative risk reduction [RRR], 51.7%; 95% CI, 17.3% to 71.8%). The error rate decreased up to 0.12% (3/2496) (RRR, 90.8%; 95% CI, 70.4% to 97.1%) if errors during residual manual dispensing were excluded. The stock-out ratio was reduced from 0.85% to 0.17% (RRR, 80.5%; 95% CI, 49.5% to 92.5%). Daily staff time (median) in stock management was reduced by 59.3% (from 1 hour 36 minutes to 39 minutes). High level of staff satisfaction with this technology was achieved, although it was slightly higher in the group of pharmacists compared to technicians (8.63 ± 0.7 vs 7.78 ± 0.7, P = .046).
The implementation of a robotic original pack dispensing system substantially decreased the rate of dispensing errors and optimized stock management. Minimizing the number of drugs out of the dispensing robot is critical when attempting to maximize the benefits of its implementation.
背景、目的和目标：在门诊医院药房实施机器人系统并不常见。除了成本之外，广泛采用的障碍之一是缺乏明确的证据表明这项技术实际上可以减少配药错误并改善库存管理。
确定在门诊医院药房实施机器人原始包装配发系统前后药物配发错误的频率，并分析该系统对库存管理质量和员工满意度的影响。
使用伪装观察技术进行了前瞻性的药物配发错误研究。监测了几个库存管理和员工满意度指标。技术人员使用条形码控制的系统（实施前阶段）或 ROWA Vmax 配发机器人（ARX）（实施后阶段）手动配发药物。由于并非所有药物都可以由机器人处理，因此仍进行残留的手动配发。
配发错误率从 3284 张处方中的 1.31%（43/3284）降至 3004 张处方中的 0.63%（19/3004）（相对风险降低[RRR]，51.7%；95%CI，17.3%至 71.8%）。如果排除残留手动配发过程中的错误，错误率可降低至 0.12%（3/2496）（RRR，90.8%；95%CI，70.4%至 97.1%）。缺货率从 0.85%降至 0.17%（RRR，80.5%；95%CI，49.5%至 92.5%）。员工的库存管理日常工作时间（中位数）减少了 59.3%（从 1 小时 36 分钟减少到 39 分钟）。尽管药剂师组的员工对这项技术的满意度略高于技术人员（8.63±0.7 与 7.78±0.7，P=0.046），但这项技术还是获得了很高的员工满意度。
实施机器人原始包装配发系统可显著降低配发错误率并优化库存管理。当试图最大化实施机器人的效益时，将配药机器人配药范围最小化至关重要。
