By Joel D. West, Pharm.D., pharmacy manager, Spectrum Health – Zeeland Community Hospital
The opportunity to implement a new inventory management system within my hospital pharmacy was met with a certain level of excitement mixed with nervousness. I thought, “Will this technology actually do what it says it can? How well will it fit within current workflows? How well will it integrate with existing technologies? Will the expense be justified?” I knew that in any event, a sound implementation strategy was required. Talking with fellow users helped gain perspective, but with all the differences between my hospital pharmacy and fellow users, this only took me so far.
Looking back, I wish there was more literature available around the real benefits of the system, what went well during implementation and the lessons learned. So here it is: My brief experience with implementing an inventory management system.
To set the stage, I currently work at a 57-bed community hospital in West Michigan that is part of a 12 hospital system. We implemented an inventory management system along with upgrading its current automated dispensing cabinets. The main benefits to adding this technology were related to patient safety and inventory management efficiencies.
Pharmacy supply chain is a complex set of processes, especially when variation is added into the equation. With all of this variation, we believed we could significantly decrease on-hand inventory with this standardization, but could we expect a 70 percent reduction like the vendor had previously seen? While a 70 percent reduction has not fully panned out, we have seen significant improvements.
Our inventory management system provided new opportunities to assign minimum and maximum inventory levels ultimately standardizing reorder points. This gives all staff the same ordering expectations in order to prevent over or under ordering. Standardizing the product purchased within the system helped to ensure the same product is ordered each time, regardless of the staff who submitted the order. Ensuring the same product is ordered each time decreases the number of products added to our other technologies thereby saving time. Reporting data has also allowed us to track usage more closely and use this data for updating and improving inventory all while providing usage data to staff to help prevent hoarding behaviors. Reporting data has allowed us to track usage more closely. This data has been used for improving inventory and to help educate staff about preventing hoarding behaviors.
Barcode Medication Administration has long been a layer of safety built into the medication use cycle to decrease medication administration errors. This technology has also been used in retail settings and some inpatient pharmacies for years but was not a part of our current practice. This additional barcode scan during receipt, restocking and dispensing includes a further layer of safety by ensuring the right product is picked prior to leaving the pharmacy. Barcode driven supply chain improved safety and helped create a closed loop perpetual inventory system which decreased on-hand inventory costs.
Staff engagement is the single biggest factor in the success at our facility. We needed to share how this technology will make staff’s life easier, and how it will make our patients safer. These are key conversations to have with end-user stakeholders to not only help during the implementation stage but also with continuous improvement of the system. We are most successful when the end-user becomes the expert and works to make the system even better than when it comes “out of the box.”
Communication goes hand-in-hand with staff engagement. With any new system there are improvements that commonly come with a change in practice or additional steps. It is common for leadership to share that this new technology will solve all of the staff’s problems, only to find out that it does not and, at times, adds more work or complexity to their daily tasks. In order to show both respect for the staff members as well as the great work that they do, sharing the benefits of the system and the workflow changes early on will help to accomplish this.
Our finance team works closely with us while using this software to keep watch on the trends of inventory and related expenses. We use a cycle count methodology to ensure our perpetual inventory is accurate and get an inventory snapshot on a quarterly basis to see how we stack up to previous inventory levels. This is a great way to teach finance for a pharmacy supply chain and hold the pharmacy accountable to continuous improvement.
Contracting is a tedious, yet mission critical step in the process. This is the first step that can make or break a project from the beginning. Although pricing is often at the forefront of the contracting conversation, understanding contractual intricacies and the vendor value proposition are of equal importance. When negotiating the contract, be very specific in what is included such as server hardware, workstations and peripheral equipment. These are all good questions to ask so that four months into the project, you do not have to ask your executive team for more money for servers or other types of hardware, which were not included in the original agreement.
Before you sign the contract, think about how the hardware will work in your space. Many of these technologies use Bluetooth® communication which struggles to make it through the cinderblock walls of most basement pharmacies which may ultimately require additional hardware to make it operational. Data ports are always something that is an afterthought and can be sometimes very difficult to add later. Keep these things in mind as you work through your plan. Remember, you can never over plan.
Throughout the planning and implementation process, accurate local data is critical. This data ranges from medication usage trends all the way to interfacing identification. With this breadth of data requirements, having a local data expert who knows the pharmacy systems can be an invaluable resource to the project, not to mention decrease data collection through spreadsheet manipulation.
During the continuous improvement phase of the project, ask staff what they would improve with the system and focus on the pain points. Asking these questions creates a common ground on which the department can improve.
Through this implementation, there have been many benefits, successes and lessons learned. I trust that this glimpse into our story will help guide you as you look to implement technology within your pharmacy around inventory management.