Automation: Practice & Pitfalls

Presented by:

Geoff Phipps

Principal Pharmacist – Operations

&

David Ledger

Principal Pharmacist – Technical Services

Dudley Group of Hospitals – NHS Trust

Automation: Practice & Pitfalls Split into small groups (2 or 3) & take a few

minutes to think of any types of automation you have seen or had experience of.

Report back to this group the ideas you have come up with.

Consider the benefits & disadvantages of the examples you have come up with.

We will then give you our experiences of the robotic dispenser recently installed @ RHH

Robotic Dispenser

Benefits of Robotic Dispensing

Saves time Saves space Aids Stock Control & Stock Rotation Supports OPD & 1 stop dispensing Improves security Should reduce errors Allows advantageous skill mix review

Business Case Considerations

Need a Business Case that might include: Original Pack Dispensing NHS Plan / ‘Spoonful of sugar’ ‘Human’ Dispensing Errors Reduction in Patient delay Space saving Reduces waste & Improves Stock Control Improvement of ‘Skill Mix’ Don’t forget Interface – 2 ends

How big will you need it?

What will you put in it?

Where are you going to put it?

What is your workload activity?

What will you put in it?

• Bulk Stock

• Ward & Outpatient items

• Only ‘boxed’ items

• Only ‘small’ items

• Only ‘Bar coded’ items

• Only ‘lightweight’ items

Where are you going to put it?

What will it be used for? Delivery time? Chutes, Belts, or Air tube? What space available? Number of robotic arms? Height of the ceiling? Fire regulations? Ease of maintenance? Noise of Robot & delivery belts?

Where are you going to put it? (contd)

Also consider any weight restrictions on the building – involve Estates Dept at an early stage You need an adjacent work area

Commissioning – What we did

Having decided on position we installed: Direct dial telephone line Network connection Electrical Power points Resited Fire Detectors / Extinguishers Moved lights Decided on ‘chute’ locations & moved PC’s Involved Estates Dept & IT Built ‘Drug File’ for the Robot

Commissioning – What we did (contd)

Initially loaded items in the robot & used for storage – allowed familiarity After JAC interface loaded used the robot for picking Delivery / assembly took 1 week Testing & training took 1 week

The Drug File

• For JAC – Input EAN code for each drug / packsize going in to the robot

• EAN code input by scanning or keyboard

• EAN code against the FIRST supplier in list

• Exported file to EXCEL & using combination of WORDPAD & EXCEL formatted to the suppliers protocol

• Loaded file into robot

• Took 10 days to complete

The Drug File – (continued)

• New or missed drugs are added into the ‘Interface’ computer direct or ‘off-site’ using ‘PC DUO’

• Must keep up with changes to suppliers

• Must add additional EAN codes into ‘Interface’ computer

• Be aware that some items have no bar code

• Be aware that some formats of bar code don’t ‘read’

The Drug File – (continued)

• Could input ALL data & codes into ‘Interface’ computer manually!

• Would take MUCH longer

• Beware of long drug names

• Trade names may be an easier way of ID ing certain lines

What worked well

Caused minimal disruption, but do need ‘Superusers’ Staff accepted the change well Automated picking worked well, just prior to Xmas Company support – Very Good Enabled ‘space saving’ exercise Perceived time saving by Storekeeper Job satisfaction

Problems - Initial Addictive – to input items No Official Manual Bar codes missing – Contract changes Some products input twice! Should have used alternate EAN Should have had a dedicated phone line Only accepted 13, 7 & 8 digit bar codes There are also 14, 12, hyphened codes – some products have none Cabinet temperature – put PCs & PSU outside

WOT! NO BAR CODE?

What can you do with products with no readable bar code? Don’t put the item in the robot!

Use a code from another product e.g. Can of Coke, Magazine.

Make up your own code 13 digit EAN codes have 1st 7 digits – Company

prefix of which 1st digit is Country origin The next 5 digits are the item reference

13th digit is a check digit

How do you make your own Bar Code number?

A 13 digit EAN code has an internal check.

It prevents a misread, but also means its difficult to invent your own.

Consider the EAN code:

501234567654A

0 + 2 + 4 + 6 + 6 + 4 = 22. 22 x 3 = 66

5 + 1 + 3 + 5 + 7 + 5 = 26.

66 + 26 = 92

92 + A = 100 Therefore A = 8

But how can I generate bar code numbers?

Set up an Excel spreadsheet Decide on a sequence that wont be repeated e.g.

999999912345X Load the formula into Excel & enter your

numbers Don’t enter the 13th digit, let the formula do it

for you.

EAN 13 DIGIT BAR CODE CALCULATOR CALCULATES CHECK DIGIT (NO 13)CHECKDIGIT

<------------------------------------------ USE 7 X 9'S .-------------- .---------->9 9 9 9 9 9 9 1 2 3 4 5 0 108 42 1509 9 9 9 9 9 9 1 2 3 4 6 7 111 42 1539 9 9 9 9 9 9 1 2 3 4 7 4 114 42 1569 9 9 9 9 9 9 1 2 3 4 8 1 117 42 1599 9 9 9 9 9 9 1 2 3 4 9 8 120 42 1629 9 9 9 9 9 9 1 2 3 5 0 4 93 43 1369 9 9 9 9 9 9 1 2 3 5 1 1 96 43 1399 9 9 9 9 9 9 1 2 3 5 2 8 99 43 142

Problems - Maintenance

Reboot ‘Visual’ & ‘Robotic’ PC 3 x a week Reboot ‘Interface’ PC 1 x week Packs must not be torn Don’t load items after sticky labels removed Beware loading when error message displayed Occasional wrong item picked Odd pack on floor! Only picks 1 pack @ a time – beware multiple dispensing products e.g. Fortisip Keep daily diary for problems