IV Automa*on Experience at Duke University Hospital. Udobi C. Campbell, PharmD, MBA Associate Chief Pharmacy Officer Duke University Hospital

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1 IV Automa*on Experience at Duke University Hospital Udobi C. Campbell, PharmD, MBA Associate Chief Pharmacy Officer Duke University Hospital

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4 Duke Children s Hospital and Health Center Duke Children s Hospital & Health Center is dedicated to the advancement of pediatric healthcare by providing compassionate care to children of all ages, from newborns to young adults, in a family-friendly environment.

5 Duke University Hospital Endowed in 1925 by James B. Duke to meet the health care needs of the Carolinas Provide care across the life con*nuum including highly specialized, complex care, such as: Stem cell/bone marrow transplant Pediatric cardiac intensive care Comprehensive Cancer Center Level 1 Trauma Center Solid Organ Transplant TJC Disease specific accredita*on for VAD and stroke

6 Duke University Hospital Part of the Duke University Heath System which includes 3 acute care hospitals as well as services such as primary care, home care and hospice, diagnos*c services, and health & wellness Provides an environment for research and educa*on ac*vi*es as a service to our pa*ents, their loved ones and each other Over 7,000 employees inclusive of 950+ residents, 29 hospitalists and over 2,000 volunteers In partnership with 1,400 physicians that we consider part of the workforce

7 Duke University Hospital 25 care delivery sites Over 45,000 discharges/957 beds Over 37,000 surgical procedures 1.2 million outpa*ent visits 67,000 ED visits 400 solid organ transplants

8 Duke Pharmacy Mission To work collabora*vely with other healthcare professionals to provide op*mal pharmaceu*cal care to all pa*ents, to advance pharmaceu*cal knowledge through educa*onal and scholarly ac*vi*es, and to promote posi*ve pa*ent outcomes.

9 Duke Pharmacy Sta*s*cs Opera*ng Expense of $199 million $28 million personnel $158 million pharmaceu*cals Total of 350 FTEs, including 148 pharmacists & 162 pharmacy technicians

10 Duke Pharmacy Inpa*ent Sterile Prepara*on Opera*ons Cleanroom established in 2007 Provides 24/7 services Approximately 1800 doses prepared daily Physical separa*on of adult and pediatric prepara*on areas Available technologies Compounders Workflow / BCMP sobware IV robo*cs automa*on Dose tracking sobware Page 10

11 IV Robo*cs Experience at Duke Pharmacy Why did we consider it? Enhanced accuracy of compounded sterile prepara*ons (CSPs) BCMP/Gravimetric Support transi*on from high volume and expensive select premixed products $1.6 million annual spend Pharmaceu*cal u*liza*on management program What did we do? Installed 2 i.v. robots Named Elvis & Ivana Non pa*ent- specific prepara*ons ~70,000 prepara*ons to- date Non- hazardous

12 IV Robo*cs Experience at Duke Pharmacy $50,000 $45,000 $40,000 $35,000 $30,000 $25,000 $20,000 $15,000 $10,000 $5,000 $- Contributed to $167K Drug Savings with TransiDon from Premixed Products $180,000 $160,000 $140,000 $120,000 $100,000 $80,000 $60,000 $40,000 $20,000 $- Vanco 1 g Pip- Tazo 4.5g Pip- Tazo 3.375g Pip- Tazo 2.25g Savings Total Savings

13 IV Robo*cs Experience at Duke Pharmacy Hospital award earned for financial benefits released through transition from premixed products and implementation of IV robotics.

14 Key Considera*ons & Tac*cs with IV Robo*cs Implementa*on Governance structure Who has oversight of the process? Quality assurance Drug addi*ons Specific gravity collec*on Product performance Staff training Repor*ng capability

15 Key Considera*ons & Tac*cs with IV Robo*cs Implementa*on Facility assessment Where should it be located? Cleanroom vs non- cleanroom Travel path from loading dock Ceiling height Door space Data ports Power outlets Work space Device accessibility for rou*ne maintenance

16 Key Considera*ons & Tac*cs with IV Robo*cs Implementa*on Staffing plan How will staff be trained? Training plan Training valida*on Shib assignments Troubleshoo*ng and support service communica*on

17 Key Considera*ons & Tac*cs with IV Robo*cs Implementa*on Change management Resistance at *mes is unavoidable Requires leadership Use staff feedback to improve performance Provide frequent updates Partnership with vendors to remove obstacles and improve product

18 Next Steps for IV Robo*cs at Duke Interface development Support pa*ent- specific dose prepara*ons Primer for further deployment of robo*cs technology Pharmacy

19 Thank You