Relocation or Renovation of the Inpatient Pharmacy: Guide to a Seamless Transition

Choosing a pharmacy consultant to lead the way

The new USP-797 requirements have created the need for many pharmacies to contract with pharmacy consultants to ensure compliance. There are several factors to consider when obtaining the services of a pharmacy consultant.

First and foremost, it is imperative that your chosen consultant/company has extensive experience in pharmacy design, a successful track record, and an excellent reputation. Secondly, he or she should assist you throughout the process and be available for troubleshooting after the project is complete.

The consultant you choose should be able to recommend several casework manufacturers who are equipped to meet your needs. When selecting a casework manufacturer, make certain that they provide a modular, free standing design that provides flexibility and versatility for future modifications as required.

To provide proper recommendations, consultants must be aware of your automation requirements so adequate space is provided for support functions. With this in mind, the decision should be made whether to renovate your existing pharmacy or move into a completely new location.

Relocation or Renovation

The decision to renovate your current pharmacy or move into a new space takes time and attention to detail. Take the following items into consideration during your decision process:

Renovating current pharmacy space may present several logistical problems. For example, if extra square footage is needed, it must be determined if the current pharmacy can be expanded to accommodate the extra space. Also, you will need to determine if there is a space that the pharmacy can use temporarily while construction is taking place.

Because of the logistical complexities that arise with renovation, building a new facility is thought to be the simpler of the two situations. In both cases, having adequate space is the most important element and your consultant should assist in defining the square footage needed and identify the prospective area.

To do this, the consultant must take your individual pharmacy processes into account when allocating the area. For instance, a USP-797 compliant sterile compounding area requires nearly three times the space required by traditional IV rooms. Most pharmacy automation systems, whether in the form of a robot or a decentralized automated dispensing machine, occupy 15 to 20 percent of the total pharmacy space. Space is also needed for additional printers, servers, cabinets, and packaging.

Tips for planning a seamless transition

Here are some points to consider before you draft a new pharmacy layout. Proper planning will help you ensure a smooth transition to a new pharmacy facility.

To determine adequate square footage, consider the following areas of service:

• Number and size of work stations, printers, and fax machines
• Pneumatic tube system if applicable
• Automation requirements to include space for main equipment and packaging and storing medications
• Pick/fill station
• Refrigerators and freezers
• Purchasing/inventory and order breakdown area
• Nurse pick up and consultation
• Outpatient/employee needs
• Administrative and clinical pharmacists offices
• Secretary and/or receptionist area
• Waiting area for nurses/visitors
• Training/education offices/area
• Controlled substance vault
• Non-sterile compounding and packaging area
• Sterile compounding area to include sterile prep, chemo prep, anteroom, IV storage, stat IV, and distribution areas
• Bulk storage
• Code cart return, fill and storage area
• Anesthesia trays
• Emergency and disaster preparedness medication storage area
• Bulk storage shelving (mobile, carousel)
• Lounge/break area and lockers
• Restrooms if applicable

After the physical space has been determined, prepare and follow a moving/renovation checklist such as:

Pre-move (planning) stage

• Get organized. Make a detailed plan for your move and make sure deadlines are met. You need to plan the work and then work the plan.
• Outline the pharmacy workflow. Make every effort to reduce unnecessary staff movement by placing the pneumatic tube station, fax machine, phones, order entry station, and IV check station in the same area. 
• Contact your state board of pharmacy for inspection and approval of your new space.
• Use an inventory worksheet to organize all the equipment you are moving. This should include a time-line, existing and new location column.
• Identify the equipment that must be placed on emergency power outlets.
• Determine the number of digital and analogue phone lines needed (telephones require digital lines while faxes and modems require analogue lines. This is of the utmost importance as many vendors use modems to dial in and troubleshoot your equipment).
• Identify the number of network drops necessary for PCs, printers, automation equipment, and servers.
• Make every effort to keep the same phone and fax numbers.
• Determine the maximum height of your new shelving. If untold, the vendor may place shelves all the way up to the ceiling.
• Identify the casework and cabinets that require lock and key (personnel file cabinet, etc). This information is not routinely provided to your casework company.
• Schedule IV hood certification for the day of move as most state boards of pharmacy require IV hoods to be certified immediately after relocation.
• Make a comprehensive list of items you will keep in the sterile compounding area as approved by USP-797.
• Check for running hot water.
• Consider placing large and visible temporary signs on shelves until your staff is accustomed to the new space.
• Consider a blackout on vacation/leave requests for two weeks prior and two weeks after the move.
• Consider ordering additional inventory and stocking the shelves a few days prior to the move.
• Test all the pharmacy equipment in the new pharmacy. This should include a test of your PCs and their connectivity to network, label printers, fax machines, pneumatic tube station, emergency power outlets, and any other equipment necessary for daily operations. This will eliminate last minute surprises.

On moving day(s)

Moving will be stressful. However, you may reduce the level of stress with prior preparation and an accurate and thorough evaluation of the new space. Make a comprehensive list of the equipment, supplies and services you simply cannot do without and make certain these are relocated and operational prior to your pharmacy’s “busy” hours on the first day of move.

You will be presented with what seems like a lifetime supply of keys. Purchase an organizer in which to keep your keys and labeled each one. Also, be sure to educate your staff on the new locations of fire pull stations and fire exit routes.

In your new ‘home’

It will be most challenging for your long-term employees to adjust to their new surroundings. These staff members who were able to perform their daily tasks blindfolded in their old space are now struggling with simple tasks such as drug picking and stocking. Stay firm and focused with these and other staff. Remind yourself and your staff that an adjustment period is to be expected for the first few weeks after the move, but that the rewards and benefits of your new space will be well worth it.

Authors:

J. Douglas Amick

Amick Medical Systems

amickmedical@mindspring.com

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