Momattin Hisham, Arafa Shokry, Momattin Shahad, Rahal Rayan, Waterson James
Mouwasat Medical Services, Dammam, Saudi Arabia.
King Faisal University, Al Hassa, Dammam, Saudi Arabia.
JMIR Hum Factors. 2021 Sep 1;8(3):e28381. doi: 10.2196/28381.
We describe the introduction, use, and evaluation of an automation and integration pharmacy development program in a private facility in Saudi Arabia. The project was specifically undertaken to increase throughput, reduce medication dispensing error rates, improve patient satisfaction, and free up pharmacists' time to allow for increased face-to-face consultations with patients.
We forecasted growth of our outpatient service at 25% per annum over 5- and 10-year horizons and set out to prepare our outpatient pharmacy service to meet this demand. Initial project goals were set as a 50% reduction in the average patient wait time, a 15% increase in patient satisfaction regarding pharmacy wait time and pharmacy services, a 25% increase in pharmacist productivity, and zero dispensing errors. This was expected to be achieved within 10 months of go-live. Realignment of pharmacist activity toward counseling and medication review with patients was a secondary goal, along with the rapid development of a reputation in the served community for patient-centered care.
Preimplementation data for patient wait time for dispensing of prescribed medications as a specific measure of patient satisfaction was gathered as part of wider ongoing data collection in this field. Pharmacist activity and productivity in terms of patient interaction time were gathered. Reported and discovered dispensing errors per 1000 prescriptions were also aggregated. All preimplementation data was gathered over an 11-month period.
From go-live, data were gathered on the above metrics in 1-month increments. At the 10-month point, there had been a 53% reduction in the average wait time, a 20% increase in patient satisfaction regarding pharmacy wait time, with a 22% increase in overall patient satisfaction regarding pharmacy services, and a 33% increase in pharmacist productivity. A zero dispensing error rate was reported.
The robotic pharmacy solution studied was highly effective, but a robust upstream supply chain is vital to ensure stock levels, particularly when automated filling is planned. The automation solution must also be seamlessly and completely integrated into the facility's software systems for appointments, medication records, and prescription generation in order to garner its full benefits. Overall patient satisfaction with pharmacy services is strongly influenced by wait time and follow-up studies are required to identify how to use this positive effect and make optimal use of freed-up pharmacist time. The extra time spent by pharmacists with patients and the opportunity for complete overview of the patient's medication history, which full integration provides, may allow us to address challenging issues such as medication nonadherence. Reduced wait times may also allow for smaller prescription fill volumes, and more frequent outpatient department visits, allowing patients to have increased contact time with pharmacists.
我们描述了沙特阿拉伯一家私立机构中自动化与集成药房发展项目的引入、使用及评估情况。该项目旨在提高吞吐量、降低药品调配错误率、提升患者满意度，并腾出药剂师的时间，以便增加与患者面对面咨询的机会。
我们预测了未来5年和10年门诊服务每年25%的增长率，并着手准备门诊药房服务以满足这一需求。最初的项目目标设定为将患者平均等待时间减少50%，患者对药房等待时间和药房服务的满意度提高15%，药剂师工作效率提高25%，且调配错误率为零。预计在上线后的10个月内实现这些目标。将药剂师的工作重心调整为与患者进行咨询和药物审查是次要目标，同时要在服务社区中迅速树立以患者为中心的护理声誉。
作为该领域正在进行的更广泛数据收集的一部分，收集了患者等待处方调配时间的实施前数据，以此作为患者满意度的一项具体衡量指标。收集了药剂师在患者互动时间方面的活动和工作效率数据。还汇总了每1000张处方上报和发现的调配错误情况。所有实施前数据均在11个月的时间内收集。
自上线起，每月收集上述指标的数据。在第10个月时，平均等待时间减少了53%，患者对药房等待时间的满意度提高了20%，患者对药房服务的总体满意度提高了22%，药剂师工作效率提高了33%。报告的调配错误率为零。
所研究的自动化药房解决方案非常有效，但强大的上游供应链对于确保库存水平至关重要，特别是在计划进行自动配药时。自动化解决方案还必须无缝且完全集成到机构的预约、用药记录和处方生成软件系统中，以便充分发挥其优势。患者对药房服务的总体满意度受等待时间的影响很大，需要进行后续研究以确定如何利用这一积极影响，并充分利用腾出的药剂师时间。药剂师与患者相处的额外时间以及完全集成所提供的全面了解患者用药史的机会，可能使我们能够解决诸如用药依从性等具有挑战性的问题。等待时间的减少也可能允许较小的处方配药量以及更频繁的门诊就诊，从而使患者有更多时间与药剂师接触。
