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Dr Hans Mulder
Head of Hospital Pharmacy
Assen, The Netherlands
Wilhelmina Hospital (Wilhelmina Ziekenhuis Assen, WZA) is a 300-bed facility in the northern part of the Netherlands. The pharmacy department employs seven pharmacists and is renowned for its expertise in psychiatric medicine. For more than ten years it has been supplying medicines packed in unit doses to outside hospitals as part of an overall pharmacy service. Two years ago, Hans Mulder (director of pharmacy) decided to purchase an additional robot to safeguard the capacity of the packaging operation. The HD Medi robot (JV-330SLD (330 canisters, slide model)) along with a digital tablet inspection system (HD Medi Vizen) met his specifications and has enabled him not only to meet the current workload efficiently but has also provided the capacity to increase his business.
Dr Mulder’s pharmacy provides a full pharmacy service to a number of other institutions that do not have pharmacy services of their own. The service includes not only the provision of pre-packed unit doses of medication but also medication review, pharmacogenetic profiling and education. It is supported by a comprehensive quality handbook that helps institutions with certification processes. Automated packaging of unit doses is an integral part of the overall high-quality service. Medicines are packed in such a way that all the doses required for a given time are in a single sachet. In the past, when unit doses were provided, they were placed in cassettes for individual patients by pharmacy technicians. The introduction of robotic packing makes the process cheaper, quicker and safer – there is a ten-fold reduction in the risk of picking errors when the robot is used, explains Dr Mulder.
Dr Mulder’s customers are driven by quality and satisfaction and he is able to provide services that meet their needs.
The pharmacy at WZA now has two HD MEdi (JV-330SLD) robots, each of which can hold 330 different lines. They have been configured so that both carry the same lines and the one machine mirrors the other. At present some 275 lines are held so there is still room for expansion. One big advantage of the HD Medi machine is that the cassettes that hold the tablets are electronically labelled so that they can be placed anywhere in the robot whereas in the previous robot cassettes had to be placed in fixed positions. Another advantage of this is that a ‘cassette bank’ can be held for products that are used less frequently. Because the robot recognises the cassette rather than the position, once calibrated, cassettes can be brought into use as and when required.
Cleaning of the HD Medi robot is also straightforward. It is easy to clean all parts of the robot. Moreover, integration of the robots with the dispensary software was no problem, comments Dr Mulder.
Capacity and working processes
The robots are routinely managed by pharmacy technicians who are responsible for receiving orders and preparing the boxes of dispensed items to go out to customers. About 3200 patients are now served by the robots. Each week about 100,000 tablets are packaged in 65,000 sachets. Items such as liquids and creams are sent together with the unit doses to each ward or department.
Having two robots and the digital tablet inspection system enables the staff to complete the packaging operation more quickly than in the past. Whereas previously the work took a whole day, now it can be completed in the morning, allowing time for cleaning and restocking.
‘Reconsider your processes’
Dr Mulder recommends that when buying a new machine of this type, pharmacy managers should take the opportunity to upgrade their premises to meet GMP requirements. At WZA working processes were also reviewed and changed to conform with GMP requirements.
The introduction of HD Medi robots in November 2010 has had a significant impact already in enabling the pharmacy to handle the unit dose packaging operation more quickly and at lower cost than previously. Moreover, the additional capacity and greater flexibility of the new system will allow Dr Mulder to take on new business – and he plans to provide unit doses packaged by the robots for inpatients in his own hospital in 2011.