Purpose: To determine the impact of implementing 2 technologies in succession, the Carousel system and XR2 robot, in a hospital central pharmacy. The study examined the technologies' impact on workload shifted from fully human-involved, labor-intensive filling from shelves to Carousel and/or XR2, prevention of filling errors, and efficiency.
Methods: Implementation occurred in 3 phases from August 2021 through October 2022. In phase I, medications were manually filled from the shelves for immediate doses and automated dispensing cabinet stock. RobotRx was used for unit-dose (UD) carts. In phase II, the Carousel system was introduced, while RobotRx was used for UD carts. In phase III, the XR2 robot was added and RobotRx was decommissioned. Epic data and time studies were utilized and analyzed with ANOVA.
Results: Over the 3 phases of implementation, workload shifted away from filling from the shelves, with 2,479, 1,044, and 864 orders filled from the shelves for phase I through phase III, respectively. The Carousel workload was 1,234 orders (phase II) and 348 orders (phase III). Nearly 71% of the workload was shifted to the XR2. The overall filling error (prevented) rate did not significantly change from phase I to phase II, remaining at 0.5%. In comparison, the error rate significantly decreased to 0.41% in phase III. Use of the Carousel system resulted in a significant reduction in filling errors compared to manual filling from the shelves. Use of the XR2 robot resulted in a filling error rate of 0%. The savings in time when using both Carousel and XR2 led to a decrease in full-time equivalents of 0.77 for pharmacists and 1.76 for pharmacy technicians.
Conclusion: Carousel and/or XR2 significantly shifted workload from manual filling to automated technologies, decreased filling errors, and improved efficiency, reducing pharmacist and technician workload. Time saved could allow staff to spend more time on patient-centric tasks.
Keywords: automated dispensing; automation; efficiency; medication errors; pharmacy robot; work capacity evaluation.
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