Improving the Operation of Pharmaceutical Services

Increasing financial pressures and changing perspectives of healthcare delivery have driven many hospitals to reengineer the processes by which medicines are supplied. This research endeavor aims to improve both the efficiency of drug distribution and the accessibility of pharmacists. In order to achieve the optimal use of medication in a healthcare facility, it is important to consider the appropriate prescription of medications, the identification and resolution of medication use problems, and the provision drug information source for patients and healthcare providers. The primary driving forces behind this study are the reduction of both costs and risks associated with pharmaceutical services.

Many hospitals utilize a purely centralized pharmaceutical operation system, in which the responsibilities associated with drug product preparations and unit dose medication distribution stem from a central pharmacy location. Other centers may utilize a purely decentralized operation system, which utilize strategically located satellite pharmacies to provide complete pharmacy services to targeted patient care areas. Yet another option is the combination of both systems (centralized/decentralized). Here, satellite pharmacies allow for enhanced pharmacist interaction with patients, physicians, nurses, etc, while a central pharmacy serves to provide unit dose cassette fills and for sterile product preparation functions. Integrated technology (IT) and information systems (IS) can also allow for improved pharmaceutical services. Automation of the hospital's process of ordering, dispensing, and administrating medications can result in reduced order turnaround time (initiation of order to delivery of medication), reduced in pharmacokinetic failures, and reduced 'tight' failures (resulting in improved rate of doses of medications that are delivered in time to be administered).

Testing of a reengineered drug distribution process is difficult, as any reduction in the level of service provision can be dangerous. That is, patients are put at risk if drugs are not available when needed or if errors are made in the drug supply. Hence, discrete-event simulation can be used to safely analyze the drug distribution system design by allowing the researchers to investigate the various service alternatives without the expense and disruption of assessing each in practice.