Utilization of Critical Low Data to Optimize Automated Dispensing Cabinet Inventory Levels Using Rotational Pharmacy Students

Jayda Minor, Kaitlin Parker, Andrew Harsh, Michael Wing, Pharm D Candidates 2021, Spencer Pummel Pharm.D. BCPS

• After installation of new automated dispensing cabinets (ADC) at Saint Luke’s Hospital (SLH), there was a marked increase in critically low and stocked out medication levels throughout the hospital.

• This resulted in an increased effort for pharmacy staff to maintain inventory levels, ultimately delaying medication administration.

• A similar study found that optimization of ADC’s shortly after implementation improved pharmacy technician workflow and reduced stockout percentages1.

Background

To measure the effectiveness of the automated dispensing cabinet optimization at SLH in reducing the incidence of critically low and stocked out pockets in effort to facilitate efficient medication administration.

Purpose

• Prospective, before-and-after, cohort study• Primary Endpoint: Reduction of the number of critical lows

& stock outs

Study Design

• The first delivery the day after the implementation of the PAR adjustments was significantly larger than usual because the medications for each adjustment had to be added.

• After the first day, the new PAR levels significantly decreased the amount of medications restocked during the first delivery of the day because the number of critical lows was reduced.

• The number of stock outs was decreased to a lesser extent compared to the number of critical lows.

• These reductions positively impacted pharmacy technician workflow by decreasing trips made to the floors for emergency restocking.

Discussion

• Critical low and stocked out medication pockets were reduced by 41% and 18% respectively

• There was a marked reduction in number of unscheduled restocks performed by pharmacy staff due to critical low levels

1. McCarthy BC Jr, Ferker M. Implementation and optimization of automated dispensing cabinet technology. Am J Health Syst Pharm. 2016;73(19):1531-1536.

References

Results• Physical pocket capacity• Low use, high cost items• Drug shortages• Short stability items

Limitations

Conclusion

Methods

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Before (5/1/19-5/14/19)

After (7/1/19-7/14/19)

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Number of Critical Lows Before and After Optimization of Par Levels

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Before (5/1/19-5/14/19)

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Number of Stock Outs Before and After Optimization of Par Levels

• A report was generated that identified all of the pockets that stocked out and or went below the critical low value

Generate Report

• High cost items• Low use items• Procedural

Surgical Areas

Exclude • Par = 4x max daily usage• Restock = 50% of Par• Critical low = 20% of Par• No Par levels will decrease

Create New Restock Criteria

• Review all identified pockets and adjust the Par inventory values to fit the new criteria

Implement and Adjust