The work described here was presented at the Pharmacy Together 2019 conference.
Routine data collection showed that discharge medication To Take Out (TTO) is completed on average within 65 minutes of arriving in pharmacy. TTOs then wait on average for one hour for a porter to collect and deliver them back to the wards. Medication that is required more urgently will often be collected by ward staff; however, this takes front line staff away from patient facing roles.
We trialled the use of a mobile dispensary, consisting of a computer workstation with integrated lockable cupboard and a bluetooth printer, for one month to see if the TTO processing time could be improved, whilst maintaining the same level of patient safety.
The mobile dispensary was allocated to the medicines management pharmacy technician (MMT) responsible for four Elderly Care wards. It was stocked with medications that would commonly be required for TTOs, and with medication that could be required at short notice such as restricted antibiotics and intravenous iron. The MMT was contactable via bleep and would aim to dispense as many items on the ward as possible.
Data collected included whether the medication was for a TTO, an inpatient item, or an item that needed relabelling, how many items dispensed per patient, and the time taken for the whole dispensing process to be completed.
The mobile dispensary resulted in medication being available on wards ten times quicker
During the project period the Elderly Care wards required 25 TTOs, which took 229 minutes to dispense. Of these, 17 TTOs bypassed the main dispensary completely, and were completed at the mobile dispensary. They took an average of 14 minutes from being screened by the pharmacist, to being ready on the ward for a patient to take away. Combined, these 17 TTOs took a total of four hours to process (at an average of 14 minutes per TTO), compared to an estimated 42 hours (an average of 150 minutes per TTO) if they had gone to main pharmacy and delivered back to the ward with a porter.
There were 126 items dispensed for inpatients on the wards. The total time spent on these was 2.8 hours, an average of 1.4 minutes per item. Using pre-project data, we estimated that those same items could have taken over 25 hours (an average of 12 minutes per item) to be dispensed by main pharmacy and back to the ward if they were collected by a porter.
The results show that the mobile dispensary resulted in medication being available on the wards ten times quicker compared to being dispensed in the main pharmacy department. Other potential benefits include a computer solely for the use of the pharmacy team, less front line staff time taken away from patient duties to pick up medication, increased patient satisfaction as medication was available more quickly, and beds becoming available earlier on the day of discharge.
Due to these results the Trust has invested in two mobile dispensaries so that the pharmacy department can continue to provide this service permanently.
Tania Beadling, Wendy Longman & Joanne Rhodes, Surrey & Sussex Healthcare NHS Trust.
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Competing interest statement:
The author declares: support from Toshiba (loaned equipment) for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.