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North West Hospital Automation Programme Shoshana Bloom Programme Manager Outline of presentation Background to the programme Benefits of collaboration Achievements to date Experience and lessons learned Implementing automation successfully North West Pharmacy Automation Programme

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North West Hospital Automation Programme

Shoshana Bloom

Programme Manager


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Outline of presentation

  • Background to the programme

  • Benefits of collaboration

  • Achievements to date

  • Experience and lessons learned

  • Implementing automation successfully


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North West Pharmacy Automation Programme

  • Established November 2005

  • Initiated by the GM SHA (now NHS NW)

  • ‘Invest to Save’ initiative

  • Providing capital funding for automation

  • Strategic and collaborative approach to automation across GM


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Objectives of the Programme

  • Oversee a joint procurement process in conjunction with NHS GM Collaborative Procurement Hub

  • Ensure maximum benefits achieved from automation (clinical, financial and safety)

  • Ensure robustness of business case

  • Ensure appropriate distribution of funds

  • Collaborative approach to resolving issues

  • Gaining expertise and sharing knowledge

  • Facilitate joint large-scale evaluation


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Programme Governance

  • Programme Manager and Programme Board

  • Directors of Pharmacy input and collaboration

  • Procurement and IT expertise

  • Ensure the programme meet its objectives

  • Formal business case approval

  • Allocation of funding


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Phase 1:

  • Salford Royal, Manchester Royal, Tameside Hospitals

    • Tender process November 2005 – March 2006

    • Dematic (formally Siemens L & A) selected for Phase 1 supplier

    • Contract award May 2006

    • Installation commenced August 2006


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Phase 2:

  • Stepping Hill Stockport

  • Trafford General

  • Christies

  • RAE Wigan

  • Bolton Royal

  • Pennine Acute Trust (3 sites)

    • Contracts signed May 2007

    • Installation commenced August 2007 (ongoing)


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Phase 4:

  • Cheshire and Merseyside

    • North Cheshire (Warrington)

    • Mid Cheshire (Leighton)

    • Southport and Ormskirk Hospitals

  • Cumbria and Lancashire

    • Lancashire Teaching Hospitals (Preston and Chorley)

    • E. Lanc (Blackburn)

    • Blackpool Victoria


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Phase 3:Further Automation of Pharmacy Supply Process


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Phase 3:

  • Ward cabinets

  • Barcode drug administration

  • Bar-coded supply chain traceability

  • Wireless medicines ordering at patient bedside

  • Handhelds for ward stock ordering

  • Improved IT systems


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Proof of concept trials

  • Cardinal Health (MRI, Trafford and Salford)

  • Avantec (Stepping Hill, MRI, C of Chester)

  • Medlocker (Bolton Royal, MRI)

  • Evaluation and joint procurement planned


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Benefits of collaboration

  • Avoided duplication of effort

  • Refinement of the procurement process

  • Ensure lessons learned from previous Phases

  • Product knowledge

  • Specification development

  • Marketplace awareness

  • Supplier relationships

  • Installation pitfalls (turnkey)


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What we have been able to achieve

  • Reduced costs – multi site discounts

    • Phase 1: 6%

    • Phase 2: 15%

    • Phase 4: up to 25%

  • Purchase of the most advanced systems in the UK

  • Interface development: pushing forward developments to support increased functionality

  • Early evaluation shows benefits to errors and workload


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Pushing the boundaries…

  • Interface development in conjunction with Ascribe

  • Automated loading with automated goods receipt

  • Labelling implementation (patient and generic labels)

  • Further improvements to functionality planned


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Phase 1 – initial results

  • Reduced errors

  • Reduced dispensary workload

  • Reduced ward top-up workload

  • Full evaluation to follow


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What we hope to achieve

Large scale joint evaluation

  • Reduced errors

  • Improved prescription turnaround times

  • Improved workflow

  • Reduced stockholding

  • Reduced stock ‘shrinkage’

  • Reduced expired drugs

  • More appropriate use of pharmacy staff

  • More pharmacy input on wards


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Preparing for automation

  • Ensuring effective integration of automation within the department

    • Department layout

    • Service redesign

    • Workforce redesign

    • Supply chain modernisation

  • Project leads networking group

    • Advise and support

    • Issue solving


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Ensuring optimal robot design

  • Ensure placement supports efficient workflows

  • Robot to support multiple workflows, ensure design considers all processes within the department

  • Minimise conveyers where possible

  • Ideally robot placed between stores and dispensary


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Ensuring optimal robot design

  • Carefully consider robot size

  • Both storage capacity and throughput

  • Maximise the height of the system

  • Look at existing systems for comparison


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Service redesign

  • To understand how automation can optimise and enhance existing processes

  • How processes needs to change to maximise automation benefits

  • Examine current issues

  • Process mapping – understanding how you work now and how automation will change / impact

  • How existing processes impact on each other

  • Examine workflow throughout the day


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Workforce redesign

  • To evaluate how automation will change existing staff roles

  • Understand the most appropriate use of staff

  • Task analysis: per grade and role

  • Which tasks will be redundant?

  • Identify new tasks

  • Identify most appropriate staff for tasks

  • Identify new roles, (robot trouble-shooter, superusers etc)


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Top Tips

  • Communicate!!!

  • Set up a project team as soon as possible

  • Its never too early to get Estates involved!

  • Consider interface requirements as soon as possible (esp. if there is no existing interface with your pharmacy IT system)

  • Carefully consider robot size and location

  • Visit as many automated sites as possible

  • Fully evaluate existing processes and staff roles early in the process

  • Consider evaluation early and ensure its linked to the business case


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Automation toolkit

  • Commissioned by PASA

  • Collation of the experience built up from the work of the NW Programme

  • Step by step guide to procuring and implementing an Automated Dispensing System

  • Resources such as example business case, specification, implementation and evaluation plans,


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NHS Resource Centre: Process Portal

  • Joint initiative between:

    • NHS Institute for Innovation and Improvement

    • Microsoft

    • TC Analyzer (Analyzer Lite process modelling software)

  • ‘Facebook’ style site for NHS staff

  • Advice, support, experience sharing, process map uploading facility, resource library, verification

  • Pharmacy Automation special interest group planned


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PASA Automation Website

Website:

http://www.pasa.nhs.uk

Pathway:

Home > Products and services > Pharmaceuticals > eBusiness and technology > Robotics and automated dispensing > Robotics and automated dispensing


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NHS Resource Centre: Process Portal

  • Follow link: http://www.microsoft.com/uk/nhs/default.aspx

  • Register – using NHS email address

  • http://www.microsoft.com/uk/nhs/pages/proces_modelling_community/features.aspx


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Questions

Shoshana Bloom

Manchester Royal Infirmary

Oxford Road Manchester M13 9WL

0161 276 4665

Shoshana.bloom@cmmc.nhs.uk