Performance and Solutions

wishaw General Hospital

Wishaw General Hospital in Lanarkshire, UK

Mission: Improving pharmacy services in NHS Lanarkshire

"The dispensary feels much more controlled and organized - there wasn’t the normal 4 o’clock rush!"

"Best thing since sliced bread. Saved so much time. Excellent.“

Pharmacy Tech

Background

Wishaw General Hospital is a district general hospital with a 24-hour accident and emergency department. It has 633 in-patient beds. Their services also includes:

  • Lanarkshire’s maternity unit, the third largest in Scotland, delivering 5,500 babies each year.
  • Paediatric neonatal unit.
  • MRI Scanner.
  • Elderly care and psychiatric day hospitals.
  • Emergency care unit containing an integrated accident and emergency unit with 36-bed ward.


Initial situation

Extended prescription fulfillment times contributed to the discharge delay experienced by patients. Included in this fulfillment time is:

  • Time taken to generate the prescription after discharge decision.
  • Time taken to transfer the prescription to the dispensary.
  • Time taken within the dispensary and time taken to transport the drugs back to the patient.


Project objectives

Objective of the project was to improve dispensary turnaround time and reduce delayed discharge across the hospital. Wishaw General is rolling out the ‘Patient Own Drug’ system across the remaining wards and is commencing roll out in ‘Hairmyres’ and ‘Monklands’ hospitals. This project provided an opportunity to ensure that effective and efficient processes are in place prior to roll out.


What we found

With close collaboration with the pharmacy department, the project team identified the following key issues:

  • Delay in generating prescriptions caused uneven demand within dispensary.
  • Queuing & batching of prescriptions extended fulfillment time.
  • Communication: There was no patient tracking system to notify the wards on prescription status. This led to numerous phone calls in dispensary and disturbed the dispensary work flow.
  • Transporation: Not all porter runs completed and dispensed prescriptions were building up in the dispensary and waiting for collection.


Solutions and Results

With all the changes that were implemented by the team, the working environment in the dispensary improved and the previous daily 4 o’clock rush was diminished to a manageable level.

pharmacu graph

Substantial improvements were implemented during the project phase. Key highlights were:

  • The project team applied ‘LEAN’ concepts into the dispensary operation which enabled faster fulfillment of prescriptions & better management of dispensary resources in response to incoming demand. After 30 days of the project, the 0-1 hour dispensary cycle time improved by 30% and 95% of prescriptions were dispensed within 2 hours.
  • The entire hospital could access the new prescription tracking system and check on patients’ prescription status, which gave the dispensary more time to focus on prescription fulfilment.
  • Combining the prescription tracking system and approporiate portering services, prescriptions were delivered efficiently to the wards and patients.