Pharmacy and Medication Circuit: Manages the dispensing and administration of medications, ensuring their availability and proper use within the hospital. It is included in the clinical support processes.

High level description #

Subprocesses #

Prescription #

The medication circuit begins with a prescription, where a healthcare provider orders medication for a patient. This prescription details the medication name, dosage, frequency, and duration of treatment.

Activities and estimated duration #

Prescribe Medication

Review patient information and issue a medical prescription with precise details of the required medication. Approximately  5-10 minutes per patient.

Verify Prescription

Review the issued medical prescription to ensure it complies with medical standards and hospital policies. Approximately  5-10 minutes per patient.

Approve Prescription

Authorize the verified medical prescription for dispensation, ensuring it is safe and suitable for the patient. Approximately  3-5 minutes per patient.

Dispense Medication:

Prepare and dispense the medication as prescribed, ensuring accuracy in dosage and administration instructions. Approximately  5-10 minutes per patient.

Selection, Acquisition, and Reception #

Following the prescription, the pharmacy department selects the appropriate medication, acquires it from suppliers, and receives the shipment. This stage involves verifying the accuracy and quality of the received medications against the order details. 

Activities and estimated duration #

Select Medication

Identify and select the required medications according to the details of the medical prescription. Approximately  15 minutes.

Acquire Medication

Execute the medication acquisition process, including placing orders with suppliers if necessary. Approximately between 1 hour and 3 days.

Receive Shipment

Receive and accept the delivery of the acquired medications, verifying that it matches the order and that the products are in good condition. Approximately 30 minutes.

Verify Shipment

Verify the accuracy and quality of the received medications against the order details, ensuring they are ready for storage and dispensing. Approximately 20 minutes.

Storage and Storage Management #

Activities and estimated duration #

Store Medications

Store the received medications according to their specific requirements, such as temperature control or security measures for controlled substances. Approximately between 20 minutes and 1 hour.

Manage Storage

Implement an effective storage management system to ensure medications are easily accessible while maintaining their integrity and efficacy. Approximately between 30 minutes and 2 hours.

Distribution #

Medications are then distributed to the care units or directly to patients. This process may involve various distribution methods, including cart fill systems (either via pharmacy robot or pharmacy technician) and automated dispensing cabinets (ADCs), which are strategically placed throughout the hospital to improve accessibility and control. 

Activities and estimated duration #

Cart Fill System

Use the cart fill system to distribute medications to care units or directly to patients accurately and efficiently. Approximately between 30 minutes and 2 hours.

Automated Dispensing Cabinets (ADCs)

Utilize automated dispensing cabinets (ADCs) to distribute medications securely and in a controlled manner, enhancing accessibility and control. Approximately between 20 minutes and 1 hour.

Others

Select other distribuition  method of the medication. Approximately between 30 minutes and 2 hours.

Medication received

Indicates that medications have been received and are ready to be distributed to care units or directly to patients.

Administration #

The final step in the medication circuit is the administration of the medication to the patient, performed by healthcare professionals. This step requires careful verification of the medication, dose, and patient identity to prevent errors.

Activities and estimated duration #

Verify Patient Identity

Verify the patient’s identity before administering the medication. Approximately  5 minutes.

Verify Medication

Verify that the prescribed medication matches what should be administered to the patient. Approximately 7 minutes.

Verify Dose

Verify that the prescribed medication dose is appropriate for the patient. Approximately 5 minutes.

Optimization and Safety Measures #

Throughout the medication circuit, continuous efforts are made to optimize processes and enhance patient safety. This includes implementing automation technologies like pharmacy robots and ADCs to improve efficiency and reduce the risk of medication errors.

Additionally, rigorous management practices are employed to maintain a permanent stock of essential medicines, ensure proper storage conditions, and manage stock levels effectively.

Activities and estimated duration #

Implement Automation Technologies

Implement automation technologies such as pharmacy robots and ADCs to enhance efficiency and reduce the risk of medication errors. Approximately 4-6 weeks.

Rigorous Management Practices

Implement rigorous management practices to maintain a permanent stock of essential medicines, ensure proper storage conditions, and effectively manage stock levels. Approximately 2-3 weeks.

Quality Assurance and Compliance #

The Pharmacy and Medication Circuit department also focuses on quality assurance and regulatory compliance. This involves regular audits, staff training, and adherence to best practices and guidelines to ensure the safe and effective use of medications. 

Activities and estimated duration #

Regular Audits

Conduct regular audits to ensure compliance with quality standards and regulatory requirements. Quarterly audits, each taking approximately 2 weeks.

Staff Training

Provide staff training on best practices, regulations, and quality assurance procedures. Bi-annual training sessions, each lasting 1 week.

Adherence to Best Practices

Ensure adherence to best practices and guidelines for safe and effective medication use. Regular reviews every 3 months, each review taking approximately 1 week. 

Waste Management #

Proper disposal of expired or unused medications is an essential part of the medication circuit, ensuring environmental safety and compliance with regulatory requirements. 

Activities and estimated duration #

Identify Expired or Unused Medications

Identify and collect all expired or unused medications within the hospital. Approximately 2 hours.

Separate Medications from Other Waste

Physically separate the medications from other types of waste to prevent contamination and ensure proper disposal. Approximately 1 hour.

Package Medications for Disposal

Package the separated medications in a way that meets regulatory requirements for disposal. Approximately 30 minutes.

Dispose of Medications

Properly dispose of the packaged medications in accordance with hospital policies and regulatory requirements. Approximately 1 hour.

Atributtes #

Staff #

Pharmacists: We require a team of experienced pharmacists to oversee and manage the medication dispensing and administration process, as well as to conduct verification and compliance activities.

Pharmacy Technicians: Trained personnel to assist in medication preparation and distribution, as well as to perform administrative tasks within the department.

Nursing Staff: Collaboration with nursing staff to ensure proper medication administration in care units and direct patient care.

Material #

Medications: Access to a wide range of medications and medical supplies to meet patient needs and ensure availability of prescribed medications.

Safety Equipment: Supply of appropriate personal protective equipment (PPE) for safe handling of medications and medical waste.

Office Supplies: Office materials and recording systems to maintain accurate and complete records of department activities.

Method #

Standardized Procedures: Development and implementation of standard operating procedures (SOPs) for each stage of the medication circuit, including prescription, selection, storage, distribution, and administration.

Ongoing Training: Implementation of training and professional development programs for staff in areas such as patient safety, medication management, regulatory compliance, and technology use.

Audits and Assessments: Establishment of regular internal audit processes and practice assessments to identify areas for improvement and ensure compliance with quality and safety standards

Machine #

Pharmacy Robots: Acquisition and implementation of pharmacy robots for automated and accurate medication preparation, increasing efficiency and reducing the risk of errors.

Automated Dispensing Cabinets (ADCs): Installation of ADCs at strategic locations to provide quick and secure access to medications, as well as to track and monitor inventory effectively.

Usual Loops

Downloads #

BPMN graphs #

Download the collapsed BPMN diagram.

Download the expanded BPMN diagram.

Download all the data.

Use Case #

In this use case, there are a different number of pharmacists (30,15,5) amd nursing staff (12,6,2) which directly affects some activities and transitions.The (correct) use of pharmacy robots and Cart fill systems influence the duration of activities and transitions too.

Also, there are different stock of medications depending on the hospital (Hospital 1, Hospital 2, Hospital 3) and the medications’ prices ( A:3$, B:30$, C:2$, D:2500$).

The (correct) use of pharmacy robots and Cart fill sysems influence the duration of activities and transitions. Depending on the hospital, the number of wasted medication will change (1-3%, 2-4%, 3-5%).

The recommended software is the Inverbis Healthcare platform. 

Download the use case data.

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