Background Technician led ward top-up services are the backbone of the pharmacy supply chain in many hospitals. In light of increasing demands and reduced resources, this service was reviewed from an efficiency perspective. The length of the top-up list was identified as potentially impacting on time spent delivering the service.

Purpose The primary aim of the project was to reduce the time spent by pharmacy technicians on top-up procedures by 15 min/ward/week.

Secondary considerations were to ensure that:

1. Ward stock levels (patient care and ward staff time) were not adversely impacted.

2. Additional dispensary time (technician and pharmacist) was not consumed on orders for stock items between top-ups.

Material and methods Following a 4 week pilot project on two medical wards, the study was conducted over an 8 week period in 10 wards.

During the study period:

1. Completed top-up lists for the previous 2 months were reviewed.

   1. Items dispensed weekly were flagged as high turnover and subsequently checked every week during the top-up.

   2. Items dispensed less frequently were flagged as low turnover and subsequently checked on alternate weeks only.

   3. In the first week, half the wards received a ‘short’ top-up and the other half received a ‘full’ top-up; the next week this was reversed.

2. Data were collected and analysed.

   1. Time spent on the ward marking the top-up list.

   2. Time spent dispensing the marked items.

   3. Number of stock items ordered between top-ups.

At least 4 weeks of short top-up data and 4 weeks of full top-up data were collected for each ward included in the study.

Results Results showed that tailoring top-up lists more closely toactual usage:

• Reduced overall top-up time by 22.5 min/ward/week, a total of 3.75 h/week; and

• Had no significant impact on the number of items dispensed between top-ups (an additional 3 items/ward/week were dispensed).

Conclusion Minor changes in procedure, although taking some time to prepare, can result in significant time savings without reducing quality of service. This time can be used to enhance services. Closer scrutiny of top-up lists and between top-up ordering is warranted in the future.

References and/or Acknowledgements The authors would like to thank all the staff of the pharmacy department of Our Lady of Lourdes Hospital, Drogheda.

No conflict of interest.