Optimising Pharmaceutical Dispensing Turnaround Time to the ICU: A Quality Improvement Study
Gloria Rodrigues, Vijaya Parameshwari, Primrose Vishnu, Amitha P. MarlaAbstract
Introduction:
Efficient pharmaceutical dispensing and medication management is a critical component of patient safety. Research in hospital management consistently identifies the intensive care unit (ICU) as one of the highest risk environments for pharmaceutical dispensing. Delays in the pharmacy-to-ICU supply chain can compromise clinical outcomes for critically ill patients. By addressing systemic delays, such as transcription errors, manual data entry, and logistical bottlenecks, this study aligns with broader efforts to enhance operational efficiency and promote patient-centric care.
Aim:
This study aimed to audit the turnaround time (TAT) from ordering (indenting) to the dispensing of pharmaceutical items to ICUs using Lean Six Sigma (LSS)-based strategies toward enhanced patient outcomes. The first objective was to assess the TAT in dispensing medication and other pharmaceuticals to the ICU and, second, to identify and address potential reasons for delays.
Subjects and Methods:
A prospective, quantitative observational study was conducted at a tertiary care hospital. A sample of 70 ICU dispensing episodes was audited. LSS tools, the Donabedian model, and fishbone analysis were used to identify nonvalue-added activities.
Results:
The study found significant variations in how long it takes for a medication to actually reach the ICU floor. Only 51.4% (36/70) of samples met the 45-min standard. The average TAT was 1 h 4 min, representing a 19-min delay for 39% indents. The most significant delay was during the “packing to dispatch” stage (31 min).
Conclusion:
Systemic improvements, including electronic verification, trolley bifurcation, and optimized routing, are essential to meet NABH MOM.6 standards and ensure patient-centric care.