Efficiency of different systems for medication distribution in an academic children's hospital in The Netherlands.
BACKGROUND
In the Sophia Children's Hospital, both a ward stock system and a decentralized, patient-orientated, ready-to-use drug distribution system (a 'satellite pharmacy system') exist. Hospital management considered expanding the concept of the satellite pharmacies. Little was known, however, about the efficiency of this drug distribution system, whereas there is increasing pressure to demonstrate the cost-effectiveness of pharmacy services.


OBJECTIVE
To analyze the efficiency of satellite pharmacies compared with other medication distribution systems.


METHODS
All medication orders and prepared doses were counted. The workload of the two current distribution systems was calculated using the direct time study method. Furthermore, the consequences of altering the distribution system were calculated by formulating nine variants in which certain activities surrounding the medication distribution were moved between nurses and pharmacy technicians. Moreover, we varied the degree of computerization of the medication order registration.


RESULTS
The required working hours are the largest in the variants in which nurses do the preparation of the drugs. Moving the distribution of some drug categories, such as ready-to-use drugs, prepared oral drugs, and prepared inhalation drugs, from pharmacy technicians to nurses appeared not to produce noticeable benefits compared with the current distribution system. Expanding the concept of the satellite pharmacies involves a small rise in total working hours compared with the current situation, but does not raise personnel costs. The largest cost savings can be achieved by introducing an on-line computerized physician order-entry system.


CONCLUSIONS
The concept of satellite pharmacies offers an efficient distribution system for the Sophia Children's Hospital.
Poley
Marten J
MJ
Institute for Medical Technology Assessment, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. poley@bmg.eur.nl
Bouwmans
Clazien A M
CA
Hanff
Lidwien M
LM
Roos
Peter J
PJ
van Ineveld
B Martin
BM
D003365:Costs and Cost Analysis; D017598:Efficiency, Organizational; D006776:Hospitals, Pediatric; D008510:Medication Systems, Hospital / Q000191:economics / Q000458:organization & administration*; D009426:Netherlands; D010607:Pharmacy Service, Hospital / Q000191:economics / Q000458:organization & administration*; D013997:Time Factors