Supply chain digitalisation equipment's raise concerns for hospital decision-makers, especially regarding the cost-efficiency ratio, usually evaluated through health technologies assessments (HTA) at ...a national level or by return on investment (ROI) calculations by the hospital finance department. Unfortunately, none of the two methods identifies organisational impacts, nor hidden gains and costs, especially those that are related to the internal reallocation of resources as shows the example of automated dispensing systems (ADS) in the central pharmacy of a French hospital with a posteriori analysis from the hospital perspective. The introduction of the ADS caused some hidden costs or gains, which do not generate any financial flow and which are therefore not valued. When they are valued, as we do in this study by including them in the ROI calculation, the results change dramatically: the profitability of the investment goes from negative to positive. Given the importance of hidden gains and costs related to organisational impacts, they should be included in evaluations.
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The focus of this study is to improve the production system of a traditional food process. Specifically, by developing the semi-automated production line to improve the production rate of the current ...of kue bahulu process flow. In this study, Arena software is used to conduct the simulation towards the production line. First, identification of bottleneck problem related to the process flow of the production line. Second, development of dispensing system using SolidWorks software to design the semi-automated batter dispenser. Based on the simulation using Arena software, there were some improvement made and showed that the production line is significantly improved since the semi-automated batter dispensing installed in the system production line
•An automatic dispensing system was developed to improve uniformity and production rate of breeder pebbles.•The production rate of this system for Li2TiO3 pebble was estimated at 50kg/year.•The ...optimization of dispensing and sintering conditions for the mass-production of Li2TiO3 pebble was conducted.•Integrity of Li2TiO3 pebble was able to be ensured during mass-production process, especially during batch process.
Lithium metatitanate (Li2TiO3) is being considered as tritium breeding material for solid-type breeding blanket, which are used in pebble-bed form. The total amount of Li2TiO3 pebbles in Helium Cooled Ceramic Reflector (HCCR) Test Blanket Module (TBM) is approximately 80kg. Furthermore, DEMO reactor requires a great deal of breeder pebbles. Therefore, the development of mass-production system for breeder pebbles is necessary. The slurry droplet wetting method was adopted in the mass-production process for Li2TiO3 pebbles, which had been developed in Korea. In this method, an automatic slurry dispensing system is one of the key apparatuses because the uniformity of pebbles and production rate are able to be improved. The system was successfully manufactured, which was consisted of a dispensing unit for instillation of Li2TiO3 slurry, a glycerin bath for hardening of droplets, and an automatic maintaining unit for constant distance between syringe needle and glycerin surface. The production rate of this system for Li2TiO3 pebble was estimated at 50kg/year. In this study, it was investigated that the effect of dispensing and sintering conditions on the mass-production of Li2TiO3 pebbles.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Patient counseling is an important tool to help both healthcare providers and patients in achieving the desired health outcomes. It is one of the significant and well-established roles for ...pharmacists in the health care system, enabling them to develop a pharmacist-patient collaborative relationship to ensure medication compliance, improved adherence to the prescribed medication regimen and prevention of adverse drug events. Delivering effective and efficient patient counseling is often hindered by numerous personal and system-related challenges. Therefore, efforts to overcome these challenges necessitate developing and incorporating various tools and methods to establish an integrated patient-centered pharmacy design. This article demonstrates the development of one such integrated model in the Johns Hopkins Aramco Healthcare ambulatory care pharmacy setting. It includes components such as electronic health records, patient portal communication systems, telehealth models (both telephonic and virtual), physical redesign of the pharmacy layout, enhanced pharmacy website, and utilizing robotic dispensing systems to deliver more efficient and interactive patient counseling. The goal of implementing the innovative patient-centered pharmacy design and integration of the telehealth model was to mitigate many of the barriers faced by the pharmacist in the traditional system during patient counseling. This new integrated model provides an example for other healthcare organizations to improve patient counseling effectiveness and provide excellent patient-centered care.
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ObjectivesPharmacy automation is increasing in hospitals. The aim of this systematic review was to identify and evaluate the literature on automated unit dose dispensing systems (UDDS) producing ...individually packaged and labelled drugs for inpatients.MethodsThe search was conducted on eight electronic databases, including Scopus, Medline Ovid, and Cinahl, and limited to peer reviewed articles with English abstracts published 2000–2020. Studies were included in the review if drug dispensing was performed by an automated UDDS where individually packaged and labelled unit doses were subsequently assembled patient specifically for inpatients. All outcomes related to UDDS functionality were included with specific interest in medication safety, cost-efficiency and stock management. Outcomes were categorised and results synthesised qualitatively.Results664 publications were screened, one article identified manually, resulting in eight included articles. Outcomes of the studies were categorised as medication administration errors (MAEs), dispensing errors, costs and cost-effectiveness. Studies showed that automated UDDS reduced significantly MAEs of inpatients compared with traditional ward stock system (WSS), especially when UDs were dispensed patient specifically by unit dose dispensing robot. Patient specific drug dispensing with automated UDDS was very accurate. Of three different automated medication systems (AMSs), patient specific AMS (psAMS) was the most cost-effective and complex AMS (cAMS) the most expensive system across all error types due to the higher additional investments and operation costs of automated dispensing cabinets (ADCs). None of the studies investigated the impact on the medication management process such as efficiency, costs and stock management as primary outcome.ConclusionsUDDS improved patient safety. However, automation is a costly investment and the implementation process is complex and time consuming. Further controlled studies are needed on the clinical and economical outcomes of automated UDDS to produce reliable knowledge for hospital decision makers on the cost-benefit of the investment and to support decision making.
Over the past few decades, micro liquid dispensing technology has been widely used in biology, chemistry, material and environmental sciences due to its efficacy in processing multiple samples. For ...practical applications, precise and effective droplet generation is very important. Despite numerous droplet generation methods, the implementation of droplet-on-demand still faces challenges concerning system complexity, precision, cost, and robustness. In this work, a novel on-demand contacting droplet generation method incorporated with model-based feedback control with an image processing unit as a sensor was proposed. By studying droplet identification using image processing techniques, the model of droplet formation was simplified. Then model-based feedback control was implemented using volumes of dispensed samples as sensing signals by tuning related parameters adaptively to resist disturbances. The proposed method was integrated and applied to a homebuilt automated micro liquid dispensing system with droplets ranging from 20 nanoliter to 200 nanoliter. The experimental results demonstrated a high degree of accuracy and precision. Additionally, the proposed system’s practical utility was evaluated by analyzing mutations in genes associated with sensorineural hearing loss, verifying its effectiveness.
Recent advancements in 3D printing technology have integrated with Fourth Industrial Revolution technologies such as robotics and artificial intelligence, aiming to overcome the limitations of ...conventional manufacturing methods. In the field of functional foods, solvent casting, a common manufacturing technique, has been adopted to produce film-like structures with desired sizes and uniform thickness. However, the typical method of coating or injection on a conventional continuous film is difficult to produce in small amounts. To address this limitation, in the study, we developed a pneumatic pressure syringe-type dispensing system integrated with a food 3D printer utilizing fused deposition modeling (FDM) technology. A syringe type is needed to discharge crude liquid manufactured in the food field in a hygienic environment, and a 3D printing method that is easy to manufacture in small quantities or on demand was utilized. Through simulation and experiment, we wanted to confirm whether stable ejection results are generated according to the selected nozzle-based viscosity, inflow conditions, and the nozzle movement path of the food 3D printer. Based on the nozzle selected through simulation, it was confirmed that the fluid and flow velocity distribution of the viscous material were uniformly distributed and discharged under the conditions of 30,000 cps and inflow rate. By setting the parameters of the food 3D printer and preparing a coenzyme Q10 (CoQ10) sample, we achieved a stable oral dissolving film (ODF) extrusion shape through the design of viscosity and 3D printer nozzle path. The optimal viscosity range for the ODF solution was found to be 25,000 to 35,000 cps, exhibiting precise dimensions and shapes without distortion and yielding the most stable extrusion results. We defined four different nozzle path designs based on minimizing the movement of the 3D printer nozzle. Among them, a 16-step path design demonstrated a stable extrusion method, showing no tailing phenomenon under the conditions of 0.2 MPa pressure and −15.4 KPa vacuum pressure. In future research, we plan to conduct additional research to determine whether the discharge results vary depending on conditions such as viscosity of the crude liquid, nozzle path combination, and ODF thickness.
This study was conducted to compare human resource requirement among manual, automated, and modified automated dispensing systems.
Data were collected from the pharmacy department at the 2100-bed ...university hospital (Siriraj Hospital, Bangkok, Thailand). Data regarding the duration of the medication distribution process were collected by using self-reported forms for 1 month. The data on the automated dispensing machine (ADM) system were obtained from 1 piloted inpatient ward, whereas those on the manual system were the average of other wards. Data on dispensing, returned unused medication, and stock management processes under the traditional manual system and the ADM system were from actual activities, whereas the modified ADM system was modeled. The full-time equivalent (FTE) of each model was estimated for comparison.
The result showed that the manual system required 46.84 FTEs of pharmacists and 132.66 FTEs of pharmacy technicians. By adding pharmacist roles on screening and verification under the ADM system, the ADM system required 117.61 FTEs of pharmacists. Replacing counting and filling medication functions by ADM has decreased the number of pharmacy technicians to 55.38 FTEs. After the modified ADM system canceled the return unused medication process, FTEs requirement for pharmacists and pharmacy technicians decreased to 69.78 and 51.90 FTEs, respectively.
The ADM system decreased the workload of pharmacy technicians, whereas it required more time from pharmacists. However, the increased workload of pharmacists was associated with more comprehensive patient care functions, which resulted from the redesigned work process.
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An automated compounding device can be a useful tool for the rapid and accurate production of small batches for personalized medicine as well as for clinical batches. A novel electronic liquid ...dispensing system (ELDS) was investigated to produce hard capsules with individualized dose strengths. An ethanol-based solvent system containing the antihypertensive enalapril maleate was extruded through a cannula into prefilled capsules. The capsules were prefilled with a powder bed of mesoporous silica (Syloid 244 FP) or synthetic dibasic calcium phosphate anhydrous (Fujicalin). The dosing accuracy as well as content uniformity of ELDS was compared with manual preparation using a Hamilton syringe (HS). Both methods met the pharmacopeia criteria for all formulations with an acceptance value (AV) less than 15. Drug adherence to the capsule shells was also investigated. A recovery rate of 98% of enalapril maleate showed almost no drug loss, but the appropriateness of the new dispensing method.
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This paper considers the zone automated order fulfilment systems with a number of zones linked by a main conveyor. Each zone has a number of dispensers and a buffer. Each dispenser holds one type of ...item and dispenses the items for an order into a buffer before the items are merged to the main conveyor. Due to variability of the mix of item types and number of items for each type in successive orders, idle time or open space on the conveyor can occur if the buffers merge the items to the conveyor sequentially. The idle time prolongs the order fulfilment duration. This paper aims to provide a solution to reduce the idle time or open space by optimising the merging sequences among zones. A model is developed to find merging sequences with minimum order fulfilment time. However, the model is strongly NP-hard. A greedy heuristic-based solution approach is thus developed. Experiment performance shows that the presented solution can reduce the order fulfilment time approximately 5% with both empirical data and simulation data. Moreover, the sensitivity analysis is conducted to measure the effect of the solution under the variation of zone numbers and order structures. Although the idle time reduction can be achieved with any number of zones and order structures, it was most significant in certain range of zone numbers and appropriate order structures.
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