COMPARISON OF THE EFFECTIVENESS OF AUTOMATED VERSUS MANUAL DISPENSING SYSTEMS AT SIRIRAJ HOSPITAL

Abstract

Automated dispensing machine (ADM) was implemented in 1 of 4 inpatient pharmacy units at Siriraj Hospital to dispense medicines to inpatient ward. The first ward was automated dispensed in February 2012 and the second ward in November 2012. This research evaluated the recent situation of ADM implementation to further plan for all inpatients. The purpose of this study was to compare medication errors and workload, between automated and manual dispensing systems. Unit cost per prescription and the estimated net cost of investment over a 10-year period, when ADM has been thoroughly implemented throughout the hospital were also calculated. In this study we compared 3 models of ADM system. ADM model 1 was the current implemented system, which added the prescription verifying process into the manual dispensing procedures with a pharmacist in charge of checking and monitoring the returned drugs back in ADM. The dispensing procedure of ADM model 2 skipped the last checking process by pharmacist with pharmacy technician in charge of checking ADM drug and filling returned drug back to ADM. ADM model 3 had similar dispensing process to ADM model 2 but dispensed drug by ADM was not allowed to return. The study found that ADM model 1 needed 81 pharmacists while model 2 and 3 needed 70. ADM model 1 needed 114 pharmacy technicians while model 2 and 3 needed 116 and 113 respectively. Unit cost of ADM model 1 was 64.07 baht/prescription with 60.83 and 60.34 baht for model 2 and 3 respectively. Cost of investment over 10-years was 687,128,835 baht for model 1 with 641,784,802 and 636,170,946 baht for model 2 and 3 respectively. When we covered more prescriptions by ADM with less work process, the number of pharmacy technicians, unit costs, and cost of investment could decrease. The sensitivity analysis showed that when 75% of prescriptions were dispensed by ADM model 3, we needed 70 pharmacists and 71 pharmacy technicians with unit cost of 53.95 and 567,819,915 baht for cost of investment over 10 years. When compared with manual system, 47 pharmacists and 133 pharmacy technicians were required with unit cost of 55.59, and cost of investment over 10 years at 569,436,486 baht. The study present that ADM system could decrease pharmacy technicians but increased pharmacists was due to adding the verifying process, which was not performed under the manual system. This would improve the quality of patient care. The study estimated about 906 medication errors per year in preparation, dispensing, and administration could be prevented from the ADM. In conclusion, ADM system could increase the efficiency of drug distribution system and improve quality of patient’s care while the improved efficient working system should be implemented.