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Wilhelmina Hospital in The Netherlands recognises the benefits of robotics in safeguarding the capacity of the drug packaging operation, and maintaining a fast, economical supply of individualised doses to more than 3000 of its patients
Hans Mulder PharmD
Department of Clinical Pharmacy,
Wilhelmina Hospital Assen,
The Netherlands
Email: [email protected]
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.
An overall pharmacy service
For more than ten years, the pharmacy department has been supplying medicines packed in unit doses to external hospitals as part of an overall pharmacy service. The pharmacy provides a full 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.
An integral part of the service
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. Two years ago, the decision was made to purchase an additional robot to safeguard the capacity of the packaging operation.
The equipment
The HD Medi robot (JV-330SLD (330 canisters, slide model)) along with a digital tablet inspection system (HD Medi Vizen) met the required specifications and has enabled the pharmacy to not only meet the current workload efficiently but has also provided the capacity to increase its business.
The introduction of robotic packing makes the process cheaper, quicker and safer – there is a tenfold reduction in the risk of picking errors when the robot is used.
Our customers are driven by quality and satisfaction and we are able to provide services that meet their needs.
Features and advantages
The pharmacy at WZA now has two 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.
Advantages
One big advantage of the machine is that the cassettes that hold the tablets are electronically labelled so that they can be placed anywhere in the robot, whereas cassettes had to be placed in fixed positions in the previous robot. 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 robot is also straightforward. It is easy to clean all parts of the robot. Moreover, integration of the robots with the dispensary software did not lead to problems.
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. Approximately 3200 patients are now served by the robots. Each week approximately 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, it can now be completed in a morning, allowing time for cleaning and restocking.
Reconsider your practice
We recommend that, when buying a new machine of this type, pharmacy managers should take the opportunity to upgrade their premises to meet Good Manufacturing Practice (GMP) requirements. At WZA, working processes were also reviewed and changed to conform with GMP requirements.
Conclusions
The introduction of the robots in November 2010 has had a significant impact in enabling the pharmacy to handle the unit dose packaging operation more quickly and at a lower cost than previously. At the end of 2011, the pharmacy started the implementation of the unit dose packages for the hospitalised patients. The process was completed in 2012, and at this moment all inpatients are supplied with unit dose packages. In the hospital, we work with single dose packages, which saves approximately 15 minutes every medication round. Furthermore, the number of medication errors has been reduced significantly and the additional capacity and greater flexibility of the new system has allowed for new business expansion.
Key points
- The pharmacy department at Wilhelmina Hospital employs seven pharmacists and is renowned for its expertise in psychiatric medicine.
- The pharmacy supplies medicines packed in unit doses to external hospitals as part of an overall pharmacy service.
- Automated packing of unit doses is an integral part of the overall high-quality service.
- The pharmacy department now has two HD Medi robots, which have had a significant impact in enabling a more efficient, cost-effective handling of the unit dose packaging operation.
- The number of medication errors has been reduced significantly and the additional capacity and greater flaxibility of the new system has allowed for new business expansion.
