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By Mark Neuenschwander, Neuenschwander Company & HospitalRx Report

Web: www.pharmacyautomation.com Email: HospitalRx@aol.com

I've been thinking once again about my all-time favorite comment related to dispensing automation. It came over the phone, quite unwittingly, from a sincere director of pharmacy. I'm not kidding, here's what he said. "Before we automated we had chaos. Now we have automated chaos."

Automation vendors thrive on hospitals that want to get rid of some of the chaos in their medication distribution process. While incorporating automation is by no means a requirement for an orderly distribution process, it can be an effective tool for helping a hospital manage medications in a more orderly manner. However, automation can also bring new opportunities for chaos. This is especially true if the people who are expected to use and manage the automated system are not properly trained. Hunting for someone who knows how to help the untrained temp nurse get into the Pyxis box is not all that different than the chaos resulting from a nurse looking for the person with the keys to the traditional lock box.

The wisest implementers of automation have learned that training is not only necessary to ensure order, it is also necessary if they wish to capitalize on the benefits of the new system in their facilities. This is all the more true as automated dispensing systems mature-as functions and features are added. Most of us have feature-rich Microsoft Word on our computers. A select few drill down into the manuals and figure it all out. Most of us rely on the intuitivity of the system. Thus we capitalize on but a small portion of Word's myriad of benefits.

Pyxis President Steve Thomas recently told me, "All the automation vendors claim their software is easy because it is intuitive. It is only intuitive to people 12 and under, the rest of us need training. The more feature rich the software the less intuitive it is and the more training it requires if those features are to be exploited." Steve summarized, "Feature-rich intuitive software is an oxymoron."

More is Better - When it comes to training

Call it a trait of the times. Technology products are becoming more, not less feature/function rich. Just like PC's, microwaves, climate control thermostats, home entertainment systems, fax machines and cellular phones, automated dispensing systems are arriving with many more functions and features than most of their owners know how to use. Take computers or cellulars for example. In all honesty, time spent in mastering some of their functions is not worth the time saved or value received from using them. Other functions, however, really are worth the effort. But let's face it, operating these devices is not nearly as intuitive as we were led to believe when we read the ads or made the purchase. Most of us are quickly overwhelmed with the manuals (even the ones for "Dummies"). And few of us are looking for something else to do. So we end up never fully capitalizing on the technology's benefits. The same is true when it comes to automated dispensing technologies. For this reason, we suggest that a well thought through, structures, thorough and ongoing training program is essential for getting one's money's worth out of their dispensing automation.

We believe that both automation vendors and customers have good reason to place an ever higher value on training. Industry leader Pyxis, noted for its high commitment to training, recently came to a similar conclusion. Steve Thomas, Pyxis' president, told us that he believes one of the great shortcomings of automation vendors is the lack of investment in and commitment to training people. He was quick to add, "with the introduction of web-based training we are demonstrating that we have made the investment and commitment to provide world class training."

It appears to us that most players in the industry are picking up the training tempo. We commend them and wish to contribute to the momentum. We want to do our part to create still greater demand from the customers and greater supply from the vendors related to quality training.

Our advice: When shopping for automation and negotiating with the vendors give attention not only to the dependability of their products and reliability of their service, but also to the quality of their training programs. It is the only way you will realize the value of your purchase.

Training: Who needs it?

Who needs to be trained? More people than you think. But there are essentially two categories to consider: system managers and device operators. System Managers: Each vendor has its own term for this position: System Administrator, System Operator or System Manager. They key word is system. Who is going to be responsible for the automated drug dispensing system's over all operations at your hospital? Anticipate the need to have a minimum of three or four people trained by your automation vendor at this level. Expect that a couple will end up focusing on the management of the system, while one or two will be called upon to do the lion's share of the initial training of operators. Systems managers will need to include Pharmacy, Nursing and perhaps IS personnel. Someone has to be trained in how system servers interact with their clients (cabinets) as well as to the other information hosts in the hospital's information infrastructure. Someone has to know how to configure/reconfigure the system as needed. How to upload and download information related to formulary, inventory, patient data, drug usage, etc. How to manage passwords for all operators, and of course, how to trouble shoot.

Northside Hospital (Atlanta) required all their pharmacists to take six hours of training from a Pyxis Applications Specialist. Eight of these were designated as "super users" ensuring that there would be one, maybe two in house on every shift to trouble shoot any difficulties operators might experience.

Device Operators: These include pharmacy technicians responsible for stocking the machines as well as nurses who will be dispensing drugs from them. The training requirements for each person at this level are much less demanding than for system administrators. However, an incredible number of people at this level will need training. For example, Northside (455 beds) had to provide training for some 1,400 nurses-a significant portion of which were part time employees. Training of part time employees is more demanding than training full time employees. Part timers have fewer repetitions to reinforce learning and longer time between shifts for forgetting what they've learned. training temporary help is even more challenging.

Clearly, training to use Pharmacy Automation equipment is key to its successful implementation. Videos, manuals, tutorials, instructors and the Internet are all being used to make training effective, and help products perform. For more questions on training and pharmacy automation, please email Mark at HospitalRx@aol.com or visit his website www.pharmacyautomation.com

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