Health Pharmacy
Transcript of Health Pharmacy
Review of Best Practices for Next‐Generation SengkangNext Generation Sengkang Health Pharmacy
25th FAPA Congress 11th October 2014
Angelina Tan
Head, Pharmacy Dept, Sengkang Health
Senior Principal Pharmacist, Singapore General Hospital
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ObjectivesObjectives• Sharing of processesg p
• Findings
• Adaptation of ideas
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AimAim
To innovate and explore new ways to bring pharmacy practice to a new frontier at thepharmacy practice to a new frontier at the upcoming Sengkang Health Hospitals through review of current medication use and relatedreview of current medication use and related supply chain processes both locally and internationally.
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Sengkang HospitalSengkang Hospital• Part of Singhealthg• New hospital to serve the North East
population of Singapore (~ 1 millionpopulation of Singapore ( 1 million residents)
• Total of 1400 beds• Total of 1400 beds• Completed in 2018• General hospital, community hospital and a
Outpatient block.p• Integration of care into the community
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Sengkang HospitalSengkang Hospital
Vision: Healthy Living, Fulfilling lives
Mission: Better Health Together
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Current Practices and TechnologyCurrent Practices and Technology
• Model of care: physician centricModel of care: physician centric
• Closed Loop Medication Management
‐ Electronic prescribing
‐ Unit dose or medication dispensing‐ Unit dose or medication dispensing (automated)
‐ Knowledge based medication administration (KBMA)( )
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Current Practices and TechnologyCurrent Practices and Technology
• Automated inventory management (wardAutomated inventory management (ward level and at Pharmacy stores)
d l• Home delivery services
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MethodsMethods
Sit i it• Site visits
• Focus group discussions
• Review of evidence with end users, medical planners and consultantsplanners and consultants
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Model of CareModel of Care• Patient‐centric care
• Integrated care with the community
O t ti t di ti ili ti• Outpatient medication reconciliation
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Closed Loop MedicationClosed Loop Medication Managementg• Visits to various hospitals to view their
medication management systems
• Most have electronic prescribingMost have electronic prescribing
• Packing machines (Swisslog®, Rowa®, Parata®, ®)JVM®)
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Medications dispensing andMedications dispensing and packing machinesp g
Advantages Disadvantagesg g
Reduce picking packing errors
Not all medications can be packed or dispensed
More efficientMay not
necessarily reduce manpower
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Features Limitations
Swisslog® (Inpatient) • Cut individual blister • Not all medications canSwisslog (Inpatient) Cut individual blister packaged in a pack
• Medications for one patient ringed
Not all medications can be packaged with Swisslog, limited by the orientation of thepatient ringed
• Can package any medications (blister strips and loose tablets)
orientation of the blister strip
p )• Allow returns and reuse
into Drug Nest
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Features Limitations
JVM® (Inpatient) • Package individual • Tablets have to beJVM (Inpatient) Package individual tablets into a pack
Tablets have to be presented loose therefore blister strips have to be deblistered
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Features Limitations
Rowa® (Outpatient) • Stores and inventorise • Medications that areRowa (Outpatient) Stores and inventorisecalendar packs or boxes of medications for dispensing
Medications that are available in non‐calendar packs e.g. 1000s, have to bedispensing 1000s, have to be repackaged into calendar or smaller boxes
• Unable to process loose tablets
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Features Limitations
Parata® (Outpatient) • Dispense and label • Unable to processParata (Outpatient) Dispense and label bottles of loose tablets
Unable to process medications in blister strips, will need to deblister
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Knowledge Based MedicationKnowledge Based Medication Administration
• Final stage in the close loop medication management process
• Nurse will scan patient’s ID before• Nurse will scan patient s ID before administering medication, system will also
f i f di iprompt for scanning of medication to ensure the correct medication is given to the patient
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Automated Inventory SystemsAutomated Inventory Systems (Ward Level)( )‐ Pyxis®
‐ Omnicell®
‐ MedRovers®MedRovers
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Features Limitations
Pyxis • Medications placed in • Space (especially to y pcubies or towers
• Links to fridge
p ( p ystore unit dose packages)
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Features Limitations
Omnicell • Light guided LED picks • Space (especially to g g p• Medications stored in
individual drawers or towers
p ( p ystore unit dose packages)
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Features Limitations
MedRovers • Storage of medications • Space and line itemsMedRovers • Storage of medications (IV/Orals/Bulk infusions) on wheels
• Automated
• Space and line items
• Automated
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Automated Inventory SystemsAutomated Inventory Systems (Pharmacy Store)( y )• Conveyor belt system (similar to that of
k )supermarket system)
• Automated storage and retrieval system g y
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Home Delivery SystemHome Delivery System• Reduces the need for patients to wait forReduces the need for patients to wait for
their repeat prescriptions• Looking for innovative ways to deliver• Looking for innovative ways to deliver
medications to the patients e.g. self collection via post office boxescollection via post office boxes
• Limited by locations of the boxes e.g. in non‐i di i dair conditioned areas
• Multidisciplinary home carep y• Online ordering of medications
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