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 • 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
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
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
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
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)
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
Phase 3:Further Automation of Pharmacy Supply Process
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
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
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)
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
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
Phase 1 – initial results • Reduced errors • Reduced dispensary workload • Reduced ward top-up workload • Full evaluation to follow
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
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
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
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
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
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)
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
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,
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
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
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
Questions Shoshana Bloom Manchester Royal Infirmary Oxford Road Manchester M13 9WL 0161 276 4665 Shoshana.bloom@cmmc.nhs.uk
