Transforming the pharmacyinto a strategic assetBuilding a high performanceautomated dispensing system

A 300 bed, not-for-pro�t hospitalin the mid-Atlantic region

Success snapshot

The customer:A 300-bed, not-for-pro�t hospital in the mid-Atlantic region

The challenge:Improve performance of the ADCs Address work�ow issues with pharmacy sta� Reduce the number of medication re�llsReduce the number of stock-outs

The solutions:Automation Optimization ServicesCardinalASSIST® ADM Logistics

The bene�ts:Reliable medication availabilityImproved vend to re�ll ratioBetter PAR levelsLess wasted sta� timeMore e�cient use of pharmacy sta�Pharmacy viewed as "strategic"

Reduction instock-outs:

36%

Key learnings:ADCs can be best managed by well trained sta� membersApplying inventory management best practices to ADCs improveswork�ow and savingsCardinal Health consultants accelerate success

A 300-bed hospital was concerned about the impact of stock-outs and excess re�lls on work�ow and patient care. They wanted to optimize their investment in Automated Dispensing Cabinets (ADCs), so they called on the automation experts at Cardinal Health.

?

Too many stock-outs. Too much time spent re�lling.

1 Automation optimization

2 Automation replenishment

3

A high occurrence of stock-outs and the need to re�ll medications caused frustration for a 300-bed, not-for-pro�t hospital in the mid-Atlantic region. Far too often, lack of drug availability resulted in additional work for the pharmacy and nursing sta�.

The hospital wanted to take control of the automated dispensing cabinet inventory, processes and performance. After careful study, the Cardinal Health team identi�ed two areas that would bene�t from the introduction of optimization best practices and advanced technologies.

• 300-bed, not-for-pro�t medical center

• 24,000 admissions per year

• 600 inpatient surgeries per year

Vend to re�ll ratioWhat does it mean?

What can we do?

What is the value?

Lower ratio = Re�lling medications too oftenHigher ratio = Increased inventory in the devices

Establish processes that apply correct levels whenloading new medications and adjusting medicationmin/max levels on speci�c items that are causingincreased re�lls.

Establish processes that drive decisionson correcting min/max levels.

Less time spent on re�llsE�ciencies are found by striking abalance between inventory dollarsand labor utilization.

?Stock-outsWhat does it mean?

What can we do?

What is the value?

A stock-out occurs when the ADCmedication pocket reaches zerocurrent quantity.

Medications are available in the ADC whenneeded to treat the patient.Nursing and pharmacy have fewer interruptions

?ADC inventorymanagementWhat does it mean?

What can we do?

What is the value?

Keeping your ADCs working e�ciently

Less wasted e�ort for pharmacyIncreased value on ADC investmentBetter user experience for nurses

Establish customized processes that address the introduction of newmedications to ADCs.Train sta� on how to increaseperformance of devices by taking speci�c actions to improve problem areas.Follow established policiesand procedures

The true cost of stock-outs

• Wasted time

• Wasted money

• Disrupted work �ow

• Frustrated nurses

• Endangered patients

Two challenges. Two solutions

The bene�ts of automation optimization

1. Improve monitoring and utilization of ADCs

2. Bring balance to inventory control levels and nursing utilization

3. Adjust ADC con�guration for high-alert and look-alike sound-alike meds

4. Implement change to policies and procedures to decrease stock-outs, reduce re�lls and canceled transactions

6. Create synergies through work�ow redesign between systems involved in medication distribution throughout the pharmacy

7. Set correct min/max levels when loading new medications

1. Pre-package, bar code and label medications for each ADC

2. Automatically replenish medications

3. Analyze reporting updates on ADC status regularly tomaintain e�ciency

Hospitals typically spend around $50,000 to place an Automated Dispensing Cabinet (ADC) in a nursing unit. With 54 cabinets, this hospital had made a signi�cant investment in automation that was not delivering peak performance. Our Automation Optimization Service ensures that hospitals achieve thegreatest possible ROI from their automation investments.

Automation optimization can help you:

• Give nursing controlled access to authorized doses - Minimize risk of diversion - Decrease time to initiate medication therapy

• Increase nursing con�dence in pharmacy

• Increase collaboration between pharmacy and nursing

• Increase performance and provide sustainable, measurable results through data-driven actions

• Customize processes and work�ow coordination based on each facility’sunique setup and contributing systems

Automated replenishment – CardinalASSIST® ADM LogisticsOptimize inventory levels to improve the availability and safety of medications

Automation Optimization ServicesMaximize ADC investments and increase doses dispensed

Continuous communications between pharmacy, nursing,

technicians and purchasing yields continuous process improvements.

The bottom line

<1%

Stock-out rate:surpassing industry

best practice of

36%

Reduction instock-outsin 1-year

36hours

Time savedresponding tostock-outs in

1-month

7.82 to 10.3

Increase invend-to-re�llratio in 1-year

32%

Improvement invend-to-re�llratio in 1-year

To accelerate the process, our experts integrated Cardinal Health technologies with the hospital’s automation tools. The results of the system redesign include:

By replacing trial and error solutions with industry standards and best practices and taking advantage of Cardinal Health subject matter expertise, the hospital achieved new levels of e�ciency and improved work �ow.

• The volume of medications being removed from the Automated Dispensing Cabinets (ADCs) increased

• The lines pharmacy had to re�ll decreased• Nurses and pharmacy sta� were able to work more e�ciently• They greatly reduced the amount of medication stock outs

Top-line impact, such asmeaningful growth opportunities, cost savings, reimbursement capture and federal funding

Remove operational obstacles and waste, optimize spend and apply Lean strategies

Deliver on the vision ofquality care to every patient through core measures, utilization, clinical outcomes, physician alignment, minimize length of stay and patient satisfaction

Patient outcomes and hospital compliance starts atpre-admission and continuespost-discharge

Findmeaningful

growth

Fixine�ciencies

Ful�llquality care

mission

Followthe patient

The Four F Framework

New businessReimbursement optimizationGovernment fundingCost savings

Population health managementReadmission management

Quality careClinical outcomesContinuity of carePatient safety

Operational e�ciencySupply chain optimization

Cardinal Health7000 Cardinal PlaceDublin, Ohio 43017

877-300-9180

cardinalhealth.com

© 2013 Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO, ESSENTIAL TO CARE and CARDINALASSIST are trademarks or registered trademarks of Cardinal Health. All other marks are property of their respective owners. Lit. No. 1ACP13-8725 (11/2013)

Cardinal Health works with hospitals and health systems across the country to help them:• Add value• Lower operating costs• Improve care quality• Enhance patient satisfaction

Because we believe that...

When a hospital pharmacy is leveraged to its full potential, it can become a key driver for achieving the organization's strategic agenda.