An 18-month trial in the trust which opened England’s first hospital dedicated to emergency care, Northumbria Specialist Emergency Care Hospital, has found that significant cost-savings and efficiencies can be made by installing a revolutionary medication automation cabinet system provided by Omnicell Ltd, a leading provider of medication adherence packaging and automated healthcare solutions. In the wake of the Lord Carter review, which highlights the urgent need for efficiencies and standardised savings across the NHS, the impressive results from the trial show nurse time savings of £7000 per department (0.25 WTE band 5 nurse-time) which has been released back to patient care; patient safety benefits with a 0% critical missed dosed rate and a 6% financial reduction in medicine spend per patient.
The unique partnership between Northumbria Healthcare NHS Foundation Trust and Omnicell Ltd saw the trial of the automated storage and ordering systems in two of its general hospitals in the North East prior to the opening of the new Northumbria hospital, the first purpose-built hospital in the country to have emergency medicine consultants on site 24/7 and specialist consultants in a broad range of conditions also working seven days a week. Following the overwhelming feedback to the system and demand from nursing staff, a total of 24 Omnicell medication automation cabinets are now in use across emergency care, theatres and admission units at Northumbria Specialist Emergency Care Hospital. As part of the initial trial and subsequent roll-out period, Omnicell has worked alongside and closely with both the pharmacy team and clinical staff members to provide training and support. Such is the success of the project that another seven cabinets are now in use across the Trust with a new system recently installed on the Oncology Day Unit at North Tyneside General Hospital.
Quantitative and qualitative evaluation from the extensive trial found:
- The average drug spend post automation dropped on average by 6% per patient and equated to an annual drug efficiency saving of £7500 per year or £30,000 across the four departments
- Stock-out fell from 22% in January 2014 to 6% in February 2014 reducing nursing led ordering, increasing stock efficiency and availability of medicines for patients
- Pharmacy believe that Omnicell has improved patient care and medicines management by utilising patient safety features such as Dispensing Alerts for, for example, allergy status checking, NPSA alert compliance, antibiotic stewardship etc.
The rationale behind the collaboration with Omnicell was the need for the Pharmacy team to address a number of issues as a result of pharmacy supplies stored in cupboards supported by manual paper recording for controlled drugs by the nursing team. These issues included:
- Significant time ‘wasted’ by nursing, medical and pharmacy staff looking for medicine cupboard keys
- Over-reliance on human accuracy for manual ‘top-up’ ordering, storing, rotating and organising medicines in the right location
- Inaccurate ad hoc ordering leading to risk of stock outs, omitted doses and treatment delays OR over-stocking
- Inadequate audit trail of medicines use following supply by Pharmacy department
Omnicell’s inventory management and dispensing systems allow organisations to manage and control the usage of medicines and supplies throughout the hospital or care setting. The solutions include secure closed cabinets and open scanning systems which track inventory in real time and cost product usage to patients and procedures. Unique features of the system include fingerprint access, an electron CD register enabling a keyless and paperless CD system and a FULL audit trail of who took what, when and for which patient. Each system is integrated with the Trust pharmacy stock system to automatically reorder medicines and a unique guiding light system which guides and directs the user to the medicines they require reducing picking errors.
Steven Campbell, Pharmacy Technical Services Manager at Northumbria Healthcare NHS Foundation Trust comments: “The development of the new site and the design of its infrastructure required a huge amount of planning, with some significant challenges in terms of the supply of medicines across such a wide geographical area. We were very fortunate to meet the team at Omnicell and be introduced to the unique product offering at the very early stage of the planning process. The response to the system by all staff has been fantastic with the benefits exceeding all our expectations.”
Paul O’Hanlon, Managing Director for Omnicell, UK & Ireland comments: “It’s been a privilege to work alongside the Pharmacy Department at Northumbria Healthcare NHS Foundation Trust right from the outset, giving us a unique opportunity to measure the success of the system in real time and adapt the installation to the specific needs of both the clinical and pharmacy teams. We’re delighted with the feedback and look forward to a continued partnership with the Northumbria Specialist Emergency Care Hospital team to see further efficiency, safety and time savings in the near future.”
Lauraine Gibson, Matron ED and Discharge Lounge, Northumbria Healthcare NHS Foundation Trust, adds: “As with any change, there was some trepidation from staff before the installation but I can honestly say that the Automated Medication Cabinet System was one of the easiest pieces of technology we have had to implement! There are numerous benefits to staff in using the system not least the fingerprint-controlled access, which increases accuracy, maximising accountability and reducing errors. However, without a doubt the greatest benefit has been seen in nurse time savings, with staff no longer wasting time searching for keys or medicines. These time savings which have been re-directed into frontline patient care are both invaluable and rewarding for nurse and patient alike.”