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David W Bates - One of the best experts on this subject based on the ideXlab platform.
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cost benefit analysis of a Hospital Pharmacy bar code solution
JAMA Internal Medicine, 2007Co-Authors: Saverio M Maviglia, Tejal K Gandhi, William W Churchill, Erica Featherstone, David W Bates, Jane Y Yoo, Calvin Franz, Eric G PoonAbstract:Methods: We performed a cost-benefit analysis of a bar code–assisted medication-dispensing system within a large, academic, nonprofit tertiary care Hospital Pharmacy. We took the implementing Hospital’s perspective for a 5-year horizon. The primary outcome was the net financial cost and benefit after 5 years. The secondary outcome was the time until total benefits equaled total costs. Single-variable, 2-variable, and multiple-variable Monte Carlo sensitivity analyses were performed to test the stability of the outcomes. Results: In inflation- and time value–adjusted 2005 dollars, total costs during 5 years were $2.24 million ($1.31 million in 1-time costs during the initial 3.5 years and $342 000 per year in recurring costs starting in year 3). The primary benefit was a decrease in adverse drug events from dispensing errors (517 events annually), resulting in an annual savings of $2.20 million. The net benefit after 5 years was $3.49 million. The break-even point for the Hospital’s investment occurred within 1 year after becoming fully operational. A net benefit was achieved within 10 years under almost all sensitivity scenarios. In the Monte Carlo simulation, the net benefit during 5 years was $3.2 million (95% confidence interval, �$1.2 million to $12.1 million), and the break-even point for return on investment occurred after 51 months (95% confidence interval, 30 to 180 months). Conclusion: Implementation of a bar code–assisted medication-dispensing system in Hospital pharmacies can result in a positive financial return on investment for the health care organization. Arch Intern Med. 2007;167:788-794
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medication dispensing errors and potential adverse drug events before and after implementing bar code technology in the Pharmacy
Annals of Internal Medicine, 2006Co-Authors: Eric G Poon, Jennifer L Cina, William W Churchill, Jeffrey M Rothschild, Erica Featherstone, David W Bates, Nirali Patel, Carol A Keohane, Anthony D Whittemore, Tejal K GandhiAbstract:The authors measured the results of using bar code technology to identify drugs in a Hospital Pharmacy. Compared with the preimplementation period, dispensing errors and potential adverse drug even...
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how many Hospital Pharmacy medication dispensing errors go undetected
The Joint Commission Journal on Quality and Patient Safety, 2006Co-Authors: Jennifer L Cina, Tejal K Gandhi, William W Churchill, John Fanikos, Michelle Mccrea, Patricia Mitton, Jeffrey M Rothschild, Erica Featherstone, Carol Keohane, David W BatesAbstract:Article-at-a-Glance Background Hospital pharmacies dispense large numbers of medication doses for Hospitalized patients. A study was conducted at an academic tertiary care Hospital to characterize the incidence and severity of medication dispensing errors in a Hospital Pharmacy. Methods Direct observation of dispensing processes was undertaken to determine presence of errors with review by a physician panel to determine severity. Results A total of 140,755 medication doses filled by Pharmacy technicians were observed during a seven-month period, and 3.6% (5,075) contained errors. The Hospital pharmacist detected only 79% of these errors during routine verification; thus, 0.75% of doses filled would have left the Pharmacy with undetected errors. Overall, 23.5% of undetected errors were potential adverse drug events (ADEs), of which 28% were serious and 0.8% were life threatening. The most common potential ADEs were incorrect medications (36%), incorrect strength (35%), and incorrect dosage form (21%). Discussion Given the volume of medications dispensed, even a low rate of drug distribution process translates into a large number of errors with potential to harm patients. Pharmacy distribution systems require further process redesign to achieve the highest possible level of safety and reliability.
Tejal K Gandhi - One of the best experts on this subject based on the ideXlab platform.
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cost benefit analysis of a Hospital Pharmacy bar code solution
JAMA Internal Medicine, 2007Co-Authors: Saverio M Maviglia, Tejal K Gandhi, William W Churchill, Erica Featherstone, David W Bates, Jane Y Yoo, Calvin Franz, Eric G PoonAbstract:Methods: We performed a cost-benefit analysis of a bar code–assisted medication-dispensing system within a large, academic, nonprofit tertiary care Hospital Pharmacy. We took the implementing Hospital’s perspective for a 5-year horizon. The primary outcome was the net financial cost and benefit after 5 years. The secondary outcome was the time until total benefits equaled total costs. Single-variable, 2-variable, and multiple-variable Monte Carlo sensitivity analyses were performed to test the stability of the outcomes. Results: In inflation- and time value–adjusted 2005 dollars, total costs during 5 years were $2.24 million ($1.31 million in 1-time costs during the initial 3.5 years and $342 000 per year in recurring costs starting in year 3). The primary benefit was a decrease in adverse drug events from dispensing errors (517 events annually), resulting in an annual savings of $2.20 million. The net benefit after 5 years was $3.49 million. The break-even point for the Hospital’s investment occurred within 1 year after becoming fully operational. A net benefit was achieved within 10 years under almost all sensitivity scenarios. In the Monte Carlo simulation, the net benefit during 5 years was $3.2 million (95% confidence interval, �$1.2 million to $12.1 million), and the break-even point for return on investment occurred after 51 months (95% confidence interval, 30 to 180 months). Conclusion: Implementation of a bar code–assisted medication-dispensing system in Hospital pharmacies can result in a positive financial return on investment for the health care organization. Arch Intern Med. 2007;167:788-794
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medication dispensing errors and potential adverse drug events before and after implementing bar code technology in the Pharmacy
Annals of Internal Medicine, 2006Co-Authors: Eric G Poon, Jennifer L Cina, William W Churchill, Jeffrey M Rothschild, Erica Featherstone, David W Bates, Nirali Patel, Carol A Keohane, Anthony D Whittemore, Tejal K GandhiAbstract:The authors measured the results of using bar code technology to identify drugs in a Hospital Pharmacy. Compared with the preimplementation period, dispensing errors and potential adverse drug even...
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how many Hospital Pharmacy medication dispensing errors go undetected
The Joint Commission Journal on Quality and Patient Safety, 2006Co-Authors: Jennifer L Cina, Tejal K Gandhi, William W Churchill, John Fanikos, Michelle Mccrea, Patricia Mitton, Jeffrey M Rothschild, Erica Featherstone, Carol Keohane, David W BatesAbstract:Article-at-a-Glance Background Hospital pharmacies dispense large numbers of medication doses for Hospitalized patients. A study was conducted at an academic tertiary care Hospital to characterize the incidence and severity of medication dispensing errors in a Hospital Pharmacy. Methods Direct observation of dispensing processes was undertaken to determine presence of errors with review by a physician panel to determine severity. Results A total of 140,755 medication doses filled by Pharmacy technicians were observed during a seven-month period, and 3.6% (5,075) contained errors. The Hospital pharmacist detected only 79% of these errors during routine verification; thus, 0.75% of doses filled would have left the Pharmacy with undetected errors. Overall, 23.5% of undetected errors were potential adverse drug events (ADEs), of which 28% were serious and 0.8% were life threatening. The most common potential ADEs were incorrect medications (36%), incorrect strength (35%), and incorrect dosage form (21%). Discussion Given the volume of medications dispensed, even a low rate of drug distribution process translates into a large number of errors with potential to harm patients. Pharmacy distribution systems require further process redesign to achieve the highest possible level of safety and reliability.
Rebekah Moles - One of the best experts on this subject based on the ideXlab platform.
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Hospital Pharmacy workforce in brazil
Human Resources for Health, 2018Co-Authors: Thiago Reis Santos, Jonathan Penm, Andre Oliveira Baldoni, Lorena Rocha Ayres, Rebekah Moles, Cristina SanchesAbstract:This study aims to describe the distribution of the Hospital Pharmacy workforce in Brazil. Data were acquired, during 2016, through the Brazilian National Database of Healthcare Facilities (CNES). The following variables were extracted: Hospital name, registry number, telephone, e-mail, state, type of institution, subtype, management nature, ownership, presence of research/teaching activities, complexity level, number of Hospital beds, presence of pharmacists, number of pharmacists, pharmacist specialization. All statistical analyses were performed by IBM SPSS v.19. The number of Hospitals with a complete registry in the national database was 4790. The majority were general Hospitals (77.9%), managed by municipalities (66.1%), under public administration (44.0%), had no research/teaching activities (90.5%), classified as medium complexity (71.6%), and had no pharmacist in their team (50.6%). Furthermore, almost 60.0% of Hospitals did not comply with the minimum recommendations of having a pharmacist per 50 Hospital beds. The Southeast region had the highest prevalence of pharmacists, with 64.4% of Hospitals having a pharmaceutical professional. This may have occurred as this region had the highest population to Hospital ratio. Non-profit Hospitals were more likely to have pharmacists compared to those under public administration and private Hospitals. This study mapped the Hospital Pharmacy workforce in Brazil, showing a higher prevalence of Hospital pharmacists in the Southeast region, and in non-profit specialized Hospitals.
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revision of the international pharmaceutical federation s basel statements on the future of Hospital Pharmacy from basel to bangkok
American Journal of Health-system Pharmacy, 2016Co-Authors: Lee C Vermeulen, Rebekah Moles, Marianne F Ivey, James G Stevenson, Jack C Collins, Andy Gray, Abdul Latif Sheikh, Jacqueline Surugue, Robert J Moss, Yasuo TakedaAbstract:Purpose The processes used to revise the 2008 Basel Statements on the future of Hospital Pharmacy are summarized, and the revised statements are presented. Methods The process for revising the Basel Statements followed an approach similar to that used during their initial development. The Hospital Pharmacy Section (HPS) of the International Pharmaceutical Federation (FIP) revised the 2008 FIP Basel Statements in four phases, including a survey of Hospital pharmacists worldwide, an internal review, online forums, and a face-to-face “World Cafe” workshop in Bangkok, Thailand. Results The global survey on the initial Basel Statements included input from 334 respondents from 62 countries. The majority of respondents agreed that most of the initial Basel Statements were acceptable as written and did not require revision. In total, 11 statements were judged by more than 10% of respondents as needing revision or deletion. The FIP HPS executive committee used the survey results to develop 69 initial revised draft statements. After an online discussion with the international Hospital Pharmacy community, including individuals from 28 countries representing all six World Health Organization regions, a final set of draft statements was prepared for the live discussion involving participants from 20 countries. The final 65 revised Basel Statements were voted on and accepted. Conclusion Systematic revision of the FIP Basel Statements resulted in an updated reflection of aspirational goals for the future of Hospital Pharmacy practice. While this revision reflects the development of new goals for Hospital Pharmacy practice, the core principles of the Basel Statements remain an essential foundation for the discipline.
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use of the international pharmaceutical federation s basel statements to assess and advance Hospital Pharmacy practice a scoping review
The Canadian Journal of Hospital Pharmacy, 2016Co-Authors: Jonathan Penm, Betty Chaar, Rebekah MolesAbstract:ABSTRACT Background: The Basel statements of the International Pharmaceutical Federation, which provide the first global, unified vision for the Hospital Pharmacy profession, have recently been revised. Originally released in 2008, the Basel statements have since been made available in 21 languages, and thus have the potential for great impact around the world. Objective: To conduct a scoping review to examine the extent and nature of research activity related to the Basel statements. Methods: Google Scholar, PubMed, and International Pharmaceutical Abstracts were searched using the key term “Basel statements” for relevant research articles. From each included study, data were extracted on geographic location, study design, study outcomes, and use of the Basel statements. Results: The search strategy generated 113 results. Further refinement resulted in 14 English-language articles that met the inclusion criteria. Four of these articles focused on adapting the Basel statements to European practice, an initiative of the European Association of Hospital Pharmacists that led to development of the European statements of Hospital Pharmacy. Six studies focused on monitoring Hospital Pharmacy practice in Uganda, the Pacific island countries, and the Western Pacific Region. These studies provide valuable baseline data to measure and track the development of Hospital Pharmacy practices in their respective countries and regions. The remaining 4 studies used qualitative methods to explore the barriers to and facilitators of implementation of the Basel statements in South Africa, China, and Australia. Conclusion: The Basel statements have led to multiple initiatives around the world, involving more than 70 countries. The European and Western Pacific regions have been the most active. Current initiatives should be continued to ensure identification and resolution of issues related to sustaining their use over time. RESUME Contexte : Les declarations de Bâle de la Federation international pharmaceutique, qui offrent la premiere vision mondiale unifiee pour la pharmacie Hospitaliere, ont ete revisees recemment. D’abord rendues publiques en 2008, les declarations de Bâle ont ete traduites en 21 langues; elles peuvent ainsi avoir une grande portee partout dans le monde. Objectif : Realiser un examen de la portee et de la nature des recherches liees aux declarations de Bâle. Methodes : Google Scholar, PubMed, et International Pharmaceutical Abstracts ont ete interroges a l’aide du mot cle « declarations de Bâle » afin de trouver des articles de recherche pertinents. Pour chaque etude retenue, on a extrait des donnees sur le lieu, le plan de l’etude, les resultats de recherche et l’utilisation des declarations de Bâle. Resultats : La strategie de recensement bibliographique a permis de trouver 113 articles. Une selection plus affinee a permis de cerner 14 articles en anglais qui repondaient aux criteres d’inclusion. Quatre articles portaient sur l’adaptation des declarations de Bâle aux pratiques europeennes; une initiative de l’European Association of Hospital Pharmacists qui a mene a l’elaboration des Declarations europeennes de la pharmacie Hospitaliere. Six portaient sur la surveillance des pratiques de la pharmacie Hospitaliere en Uganda, dans les Etats insulaires du Pacifique et dans la region du Pacifique occidental. Ces etudes fournissent d’importantes donnees de reference qui en retour permettent de mesurer et de suivre l’evolution des pratiques de la pharmacie Hospitaliere dans chacun des differents pays et regions. Dans les quatre derniers articles, des methodes qualitatives ont ete employees pour etudier les elements qui font obstacle ou qui facilitent la mise en oeuvre des declarations de Bâle en Afrique du Sud, en Chine et en Australie. Conclusion : Les declarations de Bâle ont mene a de nombreuses initiatives partout dans le monde, auxquelles participent plus de 70 pays. La region de l’Europe et celle du Pacifique occidental ont ete les plus actives. Les initiatives actuelles devraient etre poursuivies afin d’identifier les enjeux lies au developpement durable et de leur trouver des solutions.
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validating a Hospital medicines formulary survey in the western pacific region a global Hospital Pharmacy initiative based on the basel statements
Research in Social & Administrative Pharmacy, 2012Co-Authors: Jonathan Penm, Betty Chaar, Rebekah MolesAbstract:Abstract Background In 2008, the Basel Statements were developed to reflect the future of Hospital Pharmacy worldwide. Included were a key set of statements regarding the expanding role of Hospital pharmacists' influence on prescribing from the management of medicines formularies to being an active member of the therapeutic decision-making process. Objectives This study aimed to validate a survey to measure Basel Statement 26 regarding the role of medicines formularies and the factors that affect its use in the Western Pacific Region (WPR). Methods The survey was developed in consultation with a WPR advisory group and current literature. The survey was translated using the forward-backward method into Chinese (simplified) and Vietnamese. The instrument was pilot tested in a stratified random sample of 260 Hospital Pharmacy directors in the WPR. Principal components analysis (PCA) was applied to the data to assess construct validity of the Medicines Formulary Scale that assessed responders’ perceptions of their formulary and impact on utilization. Results The Medicines Formulary Survey was completed by 107 Hospital Pharmacy directors or equivalent. The survey contained the Medicines Formulary Scale in addition to questions regarding the content and review process of the Hospital’s formulary as well as demographic questions. Application of the PCA procedures resulted in a parsimonious 2-factor solution in which 33.8% of the variance was explained. The Cronbach alpha for the 17-item scale was found to be 0.70. The Cronbach alpha values for the first and second factor/subscales were 0.76 and 0.68, respectively. Conclusion The Medicines Formulary Survey appears reliable and valid for assessing Hospital Pharmacy directors’ perceptions of Hospital medicine formularies in the WPR. Further development of validated instruments to assess other areas of Hospital Pharmacy practice will help track the progression of Hospital Pharmacy and aid in globalization of the profession.
Erica Featherstone - One of the best experts on this subject based on the ideXlab platform.
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cost benefit analysis of a Hospital Pharmacy bar code solution
JAMA Internal Medicine, 2007Co-Authors: Saverio M Maviglia, Tejal K Gandhi, William W Churchill, Erica Featherstone, David W Bates, Jane Y Yoo, Calvin Franz, Eric G PoonAbstract:Methods: We performed a cost-benefit analysis of a bar code–assisted medication-dispensing system within a large, academic, nonprofit tertiary care Hospital Pharmacy. We took the implementing Hospital’s perspective for a 5-year horizon. The primary outcome was the net financial cost and benefit after 5 years. The secondary outcome was the time until total benefits equaled total costs. Single-variable, 2-variable, and multiple-variable Monte Carlo sensitivity analyses were performed to test the stability of the outcomes. Results: In inflation- and time value–adjusted 2005 dollars, total costs during 5 years were $2.24 million ($1.31 million in 1-time costs during the initial 3.5 years and $342 000 per year in recurring costs starting in year 3). The primary benefit was a decrease in adverse drug events from dispensing errors (517 events annually), resulting in an annual savings of $2.20 million. The net benefit after 5 years was $3.49 million. The break-even point for the Hospital’s investment occurred within 1 year after becoming fully operational. A net benefit was achieved within 10 years under almost all sensitivity scenarios. In the Monte Carlo simulation, the net benefit during 5 years was $3.2 million (95% confidence interval, �$1.2 million to $12.1 million), and the break-even point for return on investment occurred after 51 months (95% confidence interval, 30 to 180 months). Conclusion: Implementation of a bar code–assisted medication-dispensing system in Hospital pharmacies can result in a positive financial return on investment for the health care organization. Arch Intern Med. 2007;167:788-794
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medication dispensing errors and potential adverse drug events before and after implementing bar code technology in the Pharmacy
Annals of Internal Medicine, 2006Co-Authors: Eric G Poon, Jennifer L Cina, William W Churchill, Jeffrey M Rothschild, Erica Featherstone, David W Bates, Nirali Patel, Carol A Keohane, Anthony D Whittemore, Tejal K GandhiAbstract:The authors measured the results of using bar code technology to identify drugs in a Hospital Pharmacy. Compared with the preimplementation period, dispensing errors and potential adverse drug even...
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how many Hospital Pharmacy medication dispensing errors go undetected
The Joint Commission Journal on Quality and Patient Safety, 2006Co-Authors: Jennifer L Cina, Tejal K Gandhi, William W Churchill, John Fanikos, Michelle Mccrea, Patricia Mitton, Jeffrey M Rothschild, Erica Featherstone, Carol Keohane, David W BatesAbstract:Article-at-a-Glance Background Hospital pharmacies dispense large numbers of medication doses for Hospitalized patients. A study was conducted at an academic tertiary care Hospital to characterize the incidence and severity of medication dispensing errors in a Hospital Pharmacy. Methods Direct observation of dispensing processes was undertaken to determine presence of errors with review by a physician panel to determine severity. Results A total of 140,755 medication doses filled by Pharmacy technicians were observed during a seven-month period, and 3.6% (5,075) contained errors. The Hospital pharmacist detected only 79% of these errors during routine verification; thus, 0.75% of doses filled would have left the Pharmacy with undetected errors. Overall, 23.5% of undetected errors were potential adverse drug events (ADEs), of which 28% were serious and 0.8% were life threatening. The most common potential ADEs were incorrect medications (36%), incorrect strength (35%), and incorrect dosage form (21%). Discussion Given the volume of medications dispensed, even a low rate of drug distribution process translates into a large number of errors with potential to harm patients. Pharmacy distribution systems require further process redesign to achieve the highest possible level of safety and reliability.
William W Churchill - One of the best experts on this subject based on the ideXlab platform.
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cost benefit analysis of a Hospital Pharmacy bar code solution
JAMA Internal Medicine, 2007Co-Authors: Saverio M Maviglia, Tejal K Gandhi, William W Churchill, Erica Featherstone, David W Bates, Jane Y Yoo, Calvin Franz, Eric G PoonAbstract:Methods: We performed a cost-benefit analysis of a bar code–assisted medication-dispensing system within a large, academic, nonprofit tertiary care Hospital Pharmacy. We took the implementing Hospital’s perspective for a 5-year horizon. The primary outcome was the net financial cost and benefit after 5 years. The secondary outcome was the time until total benefits equaled total costs. Single-variable, 2-variable, and multiple-variable Monte Carlo sensitivity analyses were performed to test the stability of the outcomes. Results: In inflation- and time value–adjusted 2005 dollars, total costs during 5 years were $2.24 million ($1.31 million in 1-time costs during the initial 3.5 years and $342 000 per year in recurring costs starting in year 3). The primary benefit was a decrease in adverse drug events from dispensing errors (517 events annually), resulting in an annual savings of $2.20 million. The net benefit after 5 years was $3.49 million. The break-even point for the Hospital’s investment occurred within 1 year after becoming fully operational. A net benefit was achieved within 10 years under almost all sensitivity scenarios. In the Monte Carlo simulation, the net benefit during 5 years was $3.2 million (95% confidence interval, �$1.2 million to $12.1 million), and the break-even point for return on investment occurred after 51 months (95% confidence interval, 30 to 180 months). Conclusion: Implementation of a bar code–assisted medication-dispensing system in Hospital pharmacies can result in a positive financial return on investment for the health care organization. Arch Intern Med. 2007;167:788-794
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medication dispensing errors and potential adverse drug events before and after implementing bar code technology in the Pharmacy
Annals of Internal Medicine, 2006Co-Authors: Eric G Poon, Jennifer L Cina, William W Churchill, Jeffrey M Rothschild, Erica Featherstone, David W Bates, Nirali Patel, Carol A Keohane, Anthony D Whittemore, Tejal K GandhiAbstract:The authors measured the results of using bar code technology to identify drugs in a Hospital Pharmacy. Compared with the preimplementation period, dispensing errors and potential adverse drug even...
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how many Hospital Pharmacy medication dispensing errors go undetected
The Joint Commission Journal on Quality and Patient Safety, 2006Co-Authors: Jennifer L Cina, Tejal K Gandhi, William W Churchill, John Fanikos, Michelle Mccrea, Patricia Mitton, Jeffrey M Rothschild, Erica Featherstone, Carol Keohane, David W BatesAbstract:Article-at-a-Glance Background Hospital pharmacies dispense large numbers of medication doses for Hospitalized patients. A study was conducted at an academic tertiary care Hospital to characterize the incidence and severity of medication dispensing errors in a Hospital Pharmacy. Methods Direct observation of dispensing processes was undertaken to determine presence of errors with review by a physician panel to determine severity. Results A total of 140,755 medication doses filled by Pharmacy technicians were observed during a seven-month period, and 3.6% (5,075) contained errors. The Hospital pharmacist detected only 79% of these errors during routine verification; thus, 0.75% of doses filled would have left the Pharmacy with undetected errors. Overall, 23.5% of undetected errors were potential adverse drug events (ADEs), of which 28% were serious and 0.8% were life threatening. The most common potential ADEs were incorrect medications (36%), incorrect strength (35%), and incorrect dosage form (21%). Discussion Given the volume of medications dispensed, even a low rate of drug distribution process translates into a large number of errors with potential to harm patients. Pharmacy distribution systems require further process redesign to achieve the highest possible level of safety and reliability.