Implementing a stand-alone packaged pharmacy computer system in a 580-bed hospital.

The problems experienced by a hospital pharmacy department in implementing a stand-alone packaged computer system are discussed, and recommendations for avoiding and managing these problems are presented. In 1984, a stand-alone packaged computer system was implemented in a 580-bed, tertiary-care institution that provides services from a central pharmacy and five satellite pharmacies. The department developed a request for proposal and contracted with a vender for a system that would support unit dose drug distribution and i.v. admixture services. During the implementation process, the following problems were experienced: The hardware was insufficient for the department's workload, the software design was limited, and personnel were frustrated with learning to use the system. These problems were intensified by the heavy workload and the large number of users. In the 18 months since implementation, the department has purchased more hardware, improved the software applications, and resolved many of the problems associated with employee frustration. Pharmacy departments at other large institutions might avoid some of these problems by training personnel adequately before implementation and by researching and estimating hardware and software needs in advance. In this large hospital, the efficiency of a stand-alone packaged pharmacy computer system has improved 18 months after implementation.

Users' perspectives of hospital pharmacy computer systems.

A survey was conducted to determine if user characteristics affected respondents' expectations of computer systems and to identify the most and least desirable features hospital pharmacists want in computer systems. A questionnaire was mailed to 200 hospital pharmacists selected randomly. The survey was designed to gather demographic data, general systems information, and information on system features in 10 major categories. A total of 111 surveys were returned. Of the respondents, 55% had some type of computer system. The leading type of system used by the respondents was a mainframe-shared system. The majority of respondents (87.4%) indicated that they had a "moderate" amount of experience with computer systems. The most commonly preferred hardware was the minicomputer. It appeared that user characteristics did not influence the pharmacists' expectations of computer systems. In ranking the categories, the hospital pharmacists indicated that the i.v. admixture area, inpatient drug distribution, and clinical functions were the most important for computer applications.

Work-sampling evaluation of an upgraded outpatient pharmacy computer system.

The effect of an upgraded outpatient pharmacy computer system on routine dispensing activities was studied. A computer system that previously generated patient bills, prescription labels, and management reports was upgraded to provide patient profiles, allergy and drug-drug interaction monitoring, auxiliary-label notification, and prescription prices. Four months after the upgraded system was implemented, dispensing activities were analyzed using a work-sampling technique. The percent of time spent in prescription processing, inventory maintenance, problem solving, or miscellaneous activities was determined. These data were compared with data obtained in a study of the old system. A total of 5897 observations of the upgraded system was compared with 5632 observations in the previous study. There were significantly different changes among the four activity groups for the total staff and for pharmacists, technicians, and the data-entry operator. Under the modified system, pharmacists spent more time in prescription coding and less time on patient counseling. The data-entry operator had less computer-entry time. It could not be stated conclusively that overall efficiency was improved by the new system.

Hospital pharmacy computer systems--1982.

Results of a survey of hospital pharmacy computer systems vendors are reported. A questionnaire was mailed to 317 possible vendors of hospital pharmacy computer systems in August 1982. Of the 89 companies responding, 30 stated that they marketed a hospital pharmacy system. The results are tabulated in this paper according to general system information, system hardware, system software, and system features. The most common classification of the responding companies was the health-system corporation; second most common was pharmacy computer system companies. Twenty companies have marketed their systems for two years or longer. Sixteen companies now claim to have contracts with more than 20 health-care institutions. The survey results are offered as a guide for comparing the similarities and differences among various vendors of hospital pharmacy computer systems.

Audit mechanism for hospital drug distribution.

The development and application of a pharmacy department audit of its unit dose drug distribution system is described. Criteria used in the program were based on broad drug distribution criteria developed by the Minnesota Society of Hospital Pharmacists' PSRO Liaison Committee, with subcriteria developed by the staff of the hospital pharmacy department. Month-long audits are based on one of three criteria. A committee consisting of two staff pharmacists, one administrative pharmacist and one technician audits a predetermined number of randomly selected medication orders, medication profiles, filled medication orders or medication drawers. Deficiency patterns are identified, and appropriate corrective action is taken. Audits require approximately eight hours of pharmacist time and three hours of technician time per month per criterion. Audit of the drug distribution system makes pharmacy staff more aware of the quality of service it provides.