RESUMO
The use of the automated dispensing cabinet (ADC) for drug distribution in hospitals has become increasingly common and has numerous benefits. This retrospective study assessed the effectiveness of an ADC that uses integrated information technology in the drug distribution process in a surgical unit as part of a smart medical process improvement project at Taichung Veterans General Hospital in 2019. The outcomes include medicine delivery time, working time of healthcare professionals, transportation manpower, dispensing errors, and satisfaction of nursing staff with the medication distribution process. After ADC implementation, the average waiting time of standing orders decreased significantly for both on and off duty periods (40.0 ± 27.6 to 3.0 ± 3.9 min, P < 0.001; 45.2 ± 25.8 to 2.9 ± 2.9 min, P < 0.001; respectively). Similar results were observed with immediate or temporary medication orders (54.4 ± 31.5 to 2.0 ± 3.0 min, P < 0.001; 64.0 ± 47.5 to 1.5 ± 1.8 min, P < 0.001; respectively). The average time spent by operation room and post-operation room (OR/POR) nurses on communicating with ward nurses for medication delivery to OR/POR was shortened by 46.9 ± 4.4 h per month, and the average time pharmacists spent on dispensing immediate or temporary medication orders was shortened by 5.6 ± 0.2 h per month. The satisfaction of nursing staff with the OR/POR drug delivery process was significantly improved after ADC implementation (3.2 ± 0.8 vs 4.2 ± 0.7, P < 0.001). Our results showed that ADC implementation in surgical units simplified drug delivery processes, shortened drug delivery time, improved drug delivery timeliness for surgical patients, decreased dispensing errors, and increased nursing staff satisfaction. In conclusion, the implementation of ADC was beneficial for surgical units. To the best of our knowledge, there have been no studies on a similar ADC system.
RESUMO
Shortening waiting times is the most obvious and effective method of increasing service quality. As the workforce is limited, it is necessary to reform current systems of medical care and improve the efficiency of medical care. After process reengineering was proposed in 1990s, however, this concept has not yet been commonly applied to medical centers. The subject of this study was an outpatient pharmacy in a medical center. This study applied the methods of a time study to measure field observations and as an analytic tool in process reengineering. The results show that the pharmacists were hindered in filling prescriptions for the following reasons: the preparation of certain prescription units, the menial sorting of medicines and also storage issues related to medicines. Improving the process will decrease time wasted by 10.41% and enhance service by 8.95%. The reengineering process resulted not only in a reduction in outpatients' waiting time but also enhanced the quality and competitiveness of the Hospital's medical treatment.