Every pharmacist knows how dispensing works. Prescription comes in, do the checks, pick the stock, label the items, bag everything and hand it out. Rinse and repeat.
As simple as this all sounds, it is a fine balancing act. On one hand we want to be as efficient as possible, yet on the other hand we can’t afford to cut any corners for fear of making a mistake. We take great care in setting out our procedures to minimise any risk. Our SOPs will insist we do one prescription at a time, one basket per patient, and we scatter manual checks throughout the process. Hence the reason we often see baskets strewn across the dispensary everywhere and pharmacists rushing around to check everything in their path.
New technologies have of course sought to help improve efficiency and mitigate risk. For example, Titan PMR has reorganised the process and redistributed workload. The system has digitised the workflow, removed the need for paper and introduced pharmacy to the world of barcode scanning to ensure safety. Furthermore, by ensuring prescriptions are checked up front along with the support of machine learning, Titan has helped reduce the time pharmacists spend in the dispensing process without compromising clinical safety.
One By One Dispensing
As much as we try to streamline the process and reorganise the workflow, there are steps which simply can’t be removed. For example, one still has to pick stock from the shelf, put it in a basket and bring it back to the bench for labelling. At busy times, this task of picking one basket at a time can become slow and inefficient. It might be good for your daily step count, but not great if you are trying to get some serious volumes out the door.
This is one area where picking robots have excelled. As well as helping put stock away and manage stock inventory, they make the job of picking really simple. Instead of staff walking over to the shelves to get stock for every basket, the PMR sends a message to the machine and the stock is retrieved and drops nicely out of a shute.
However, robots aren’t for everyone and don’t solve all the problems, even for busy pharmacies. Each machine has a speed limit on how many items it can pick per minute, and once that’s reached, you are waiting for the machine to get through the workload. More picking arms may help, but that too will eventually reach a limit.
One of the problems in pharmacy is that volume is not a constant. Workload often arrives in fits and starts. Sometimes it feels like a bus of elderly patients has unloaded outside the door. At other times, a 100 bed care home needs to be dispensed and delivered that day. It’s during these times that even a multi-arm robot would struggle to help.
I experienced this challenge myself. A long time ago, I used to do a lot of care homes and it was painful to watch staff walk up and down aisles to get one patient’s drugs at time. Whilst looking at ways to improve the efficiency, I looked at robots but the maths didn’t stack up. In the end, my team and I came up with a new process for dispensing. It was really quite simple but extremely effective. We called it Batch Dispensing. When it was in full flow, one person could pick and dispense a 20 bed care with 150 items home in about 30 minutes, without any robot in sight. Taking inspiration from this experience, we created a new process in Titan called Batch Flow.
Under this concept prescriptions arrive and get checked in the usual way, but unlike the standard process where you produce a picking sheet for each patient, Batch Flow allows you to group all the patients together and gather all their stock in one go and into one tote. Items in the tote are then scanned one at a time and barcode validation scanning ensures the right label goes on the right pack. The screen alerts staff which basket to place the items. Once the tote is empty and the baskets are full, the Titan packaging process ensures every item goes in the right bag. In this way, large numbers of prescriptions are processed as one mass order giving rise to super fast efficiencies.
Innovation comes in many forms. It doesn’t always have to be big shiny expensive machines. We don’t need to send our workload off site in the hope that a central warehouse can do it more efficiently. The Titan Batch Flow process, which can help safely and efficiently dispense large volumes, demonstrates that innovation can be achieved through simply reimagining the process we already have, and thinking outside the box, or should I say, outside the tote.