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DD-007 Is the Unit Dose Process a tool for patient safety and for implementing ‘Lean Thinking’ in the drug supply chain?
  1. A Costantini,
  2. C Di Candilo,
  3. C Cinalli,
  4. S Pizzica
  1. AUSL Pescara, Pharmacy, Pescara, Italy


Background A Unit Dose Drug Dispensing Process (UDDDP) by an automated system (2 PillPick and 1 BoxPicker systems, Swisslog) is being implemented in our hospital for the daily distribution of patient-specific, “ready-to-use” treatments to wards.

In 2013, UDDDP was serving about 250 beds with a shift from a Ward Stock Distribution System to a “Just in Time” dispensing process that allows a high level of clinical risk monitoring.

Purpose To assess the impact of UDDDP on hospital drug expenditure

To assess the Return on Investment for the acquired technologies

To evaluate the UDDDP’s contribution to risk management.

Materials and Methods Drug expenditure was compared before and after UDDDP implementation for the 250 beds served.

A Return on Investment (ROI) model was used to calculate the break-even point according to the number of beds served.

Statistics provided by the Computerised Physician Order Entry (CPOE) were examined for change of prescription because of a potential drug interaction.

Results Expenditure on drugs was reduced by 30%, calculated on 250 beds served by UDDDP in a 7-month timeframe (analysis before and after implementation).

The cash flow analysis calculated considering savings in drugs expenditure and the costs of investment in technologies (PillPick and BoxPicker systems, CPOE, IT hardware), full-risk maintenance fees, consumables and payroll for the staff involved in Unit Dose production resulted in a ROI break-even point equal to 498 beds.

1,579 physician prescriptions with a potential risk of drug interaction were modified in 6 months (12.3% of the total number) thanks to pharmacist monitoring and CPOE support.

Conclusions UDDDP reduces the hospital’s drug expenditure, thanks to the implementation of “Lean Thinking” (a management strategy based on improvement and reorganisation of the processes) on the hospital drug supply chain, and improves the safety, because the whole process is monitored from prescription to the drug administration.

Considering the costs of UDDDP implementation, in order to reach the ROI break-even point the UDDDP should be extended to a further 248 beds.

No conflict of interest.

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