Improving Efficiency and Accuracy: Implementing Automation in King
Hamad Hospital Outpatient Pharmacy
Abstract: - Pharmacy automation is an important tool for improving the safety, accuracy, and efficiency of
medication delivery in healthcare settings. King Hamad University Hospital (KHUH) has implemented a
comprehensive pharmacy automation system to improve the quality of care provided to its patients. The
implementation of pharmacy automation at KHUH has resulted in improved patient safety and satisfaction.
Automated dispensing cabinets have reduced medication errors by providing secure storage and access to
medications. Automated medication packaging systems have improved accuracy by reducing the risk of errors
associated with manual packaging. The CPOE system has improved communication between physicians and
pharmacists by allowing physicians to electronically enter orders for medications directly into the EMR.
Additionally, the implementation of pharmacy automation has improved patient satisfaction by reducing wait
times for medications and increasing convenience for patients who need to pick up their prescriptions from the
hospital pharmacy. Overall, pharmacy automation at KHUH has been successful in improving patient safety,
accuracy, efficiency, and satisfaction. The implementation of this technology has allowed KHUH to provide
better quality care for its patients while also reducing costs associated with manual processes.
Key-Words: - Pharmacy, Robotics, Pharmacy Automation, Efficiency, Quality, Safety, Patient safety,
Automated Dispensing, Error
Received: June 23, 2022. Revised: September 4, 2023. Accepted: October 7, 2023. Published: November 2, 2023.
1 Introduction
Healthcare is a very crucial sector that affects the
daily life of everyone the way the organization
operates and the manner the different departments, or
sectors involved is what pictures the final outcome.
The way every individual operate, function in this
cycle would mirror the quality of service a patient
would receive. Healthcare sector is highly diversified
which involves large number of supporting. Quality
and productivity always remains a point of discussion
and an open door for continuous improvement. As
any business or organization the application of
technology has invaded medical field in different
aspects or sectors. Therefore, with this invasion it is
always expected to feel the difference. In the last few
years, the Middle East has seen a wide spread in the
technology of Pharmacy automation and Robotic
system [1-10]. Kingdom of Bahrain in the last few
years has initiated the concept of Smart government
in different sectors including healthcare. It is our aim
to maintain and improve the quality and efficiency of
health services. In this essence, it is an essential
aspect of the service delivery strategy to focus on
patients, their requirements and satisfaction as well
as attract, retain, nurture and support outstanding
staff [11]. To fulfill these standards Pharmacy
Automation Robotic system has been installed in
King Hamad University Hospital (KHUH) On
incorporating any newly released technology, it is
always important to assess technology application.
The principle objective of Pharmacy automation and
robotics systems as shown in figure 1, to optimize the
safety and performance of the medicine management
[12,13]. According to Donabedian (1968), illustrates
that the quality of any health care services is
evaluated by evaluation of the structure, the process
and the outcome [14]. Healthcare structure ensures
ANWAR AL-MOFLEH, MOHAMED ALSEDDIQI, OSAMA NAJAM
BUDOOR ALMANNAEI, LEENA ALBALOOSHI
Clinical Engineering Directorate, King Hamad University Hospital, Building: 2435, Road 2835, Block 228
P.O. Box 24343, Busaiteen, KINGDOM OF BAHRAIN
International Journal of Applied Sciences & Development
DOI: 10.37394/232029.2023.2.17
Anwar Al-Mofleh, Mohamed Alseddiqi,
Osama Najam Budoor Almannaei, Leena Albalooshi
E-ISSN: 2945-0454
162
Volume 2, 2023
the availability of well performing facilities and
equipment for utilization. The process, is the setup or
framework of usage of technology and system, as
well as the interaction between both people and
systems, and between providers and patients. To
assess the effectiveness of a structure and a process
is to evaluate the outcome [15, 16,17].
Fig. 1. Pharmacy dispensing robot
The objective of the article is to determine outcome
of the application of technology and automation in
healthcare and its implication on patient care as well
as cost. The article proposes the automated and
robotic system within a pharmacy would lead to
optimization in patient safety and reduction in
medication errors. The Vmax Rowa installed in the
outpatient pharmacy of KHUH which is an
automated pharmacy system designed to streamline
the dispensing process and improve medication
management in healthcare facilities. It consists of a
series of interconnected modules that can be
customized to meet the specific needs of a particular
pharmacy. The system uses state-of-the-art robotics
and barcode scanning technology to accurately and
efficiently fill prescriptions, reduce the risk of
medication errors, and increase patient safety. It is an
ideal solution for high-volume pharmacies. The
system can be integrated with other electronic health
record systems and pharmacy management software,
allowing for seamless data sharing and streamlined
workflows. In this article, examines the evidence of
the benefits of pharmacy robots.it is suggested that
there are various areas of contribution of robots
which include, explicit decrease in dispensing errors,
turnaround times as well as an enhancement in
medicine management. In addition to that the
reduction in storage area was highly efficient.
2 Methods
The study is carried on KHUH Pharmacy
Automation. It based on a case study analysis of
secondary data obtained prior and following the
implementation Pharmacy automation. KHUH is a
specialized hospital, it accommodates 739 bed in all
services. (In- patients including isolation rooms:
348, Out-patient clinics: 242, Other services: 149).
The implementation of pharmacy automation at King
Hamad Hospital's outpatient pharmacy as illustrate in
Figure 2, it has drastically improved medication
dispensing processes. The system consists of several
key components, including a Prolog machine for
automatic medication loading or manual loading
through the Rowa machine barcoding system. The
packages or cassettes are then stored in the system,
which has the capacity to hold up to 60,000 packages.
When a prescription is received, it is processed
electronically through the hospital's integrated
electronic health record system or manually entered.
The medication dispensing process is then initiated,
with the robotic arm utilizing pre-defined medication
locations and dimensions determined during the
loading process. Once the medication has been
dispensed, a pharmacist verifies that the correct
medication has been provided. All medication
dispensing and administration is documented by the
system, which can be integrated with other electronic
health record systems and pharmacy management
software for streamlined workflows and data sharing.
Fig. 2. The workflow in the outpatient pharmacy
Prior to pharmacy automation systems, pharmacist
consumed a long period, in manually counting,
filling, capping and labeling patients’ prescriptions.
In July 2018, Pharmacy Automation and Robotic
System has gone live in KHUH Outpatient
Pharmacy. Pharmacy Automation in the wards with
a centralized control from the inpatient pharmacy has
gone live. The Pharmacy Automation system in the
outpatient demanded only training of pharmacy staff,
International Journal of Applied Sciences & Development
DOI: 10.37394/232029.2023.2.17
Anwar Al-Mofleh, Mohamed Alseddiqi,
Osama Najam Budoor Almannaei, Leena Albalooshi
E-ISSN: 2945-0454
163
Volume 2, 2023
on the contrary the Automation system in the
inpatient pharmacy and wards required training of
both pharmacy as well nursing staff.
3 Results
The data analysis for automation pharmacy in
KHUH was conducted to determine the effectiveness
of the system. The data collected included the
number of prescriptions filled, the time taken to fill
each prescription, and the number of errors made in
filling prescriptions. The data was analyzed using
descriptive statistics such as mean, median, and
mode. Additionally, correlation analysis was used to
determine if there was a relationship between the
number of prescriptions filled and the time taken to
fill them. The results of the data analysis showed that
automation pharmacy in KHUH is effective in filling
prescriptions quickly and accurately. The mean time
taken to fill a prescription was 2 minutes and 30
seconds, with a median time of 2 minutes and 15
seconds. Additionally, there were no errors made in
filling prescriptions. The correlation analysis showed
that there is a positive correlation between the
number of prescriptions filled and the time taken to
fill them, indicating that as more prescriptions are
filled; it takes longer to fill them. Table 1 displays the
number of patients served on a monthly basis from
2018 to 2022, revealing variations in patient volume
over the years and Figure 3 provides a visual
representation of patient volume trends, aiding in the
identification of peak periods and growth or decline
in patient numbers.
Table 1: Number of Patient Served
Number of
Patient
Served
2018
2019
January
13973
February
12627
March
13830
April
12627
May
12328
June
12511
July
12778
12794
August
10335
9431
September
11411
10468
October
13479
12494
November
11884
9838
December
12347
11125
Table 2 presents the average waiting time for patients
before being served by the pharmacy, showcasing
variations across months and years. Figure 4
graphically illustrates changes in average waiting
times over the specified period, facilitating the
identification of trends.
Fig.3. Number of Patient Served
Table 2: Average waiting time in Minutes
Fig. 4. Average waiting time in Minutes
Table 3 shows the percentage of patients who
experienced long wait times (more than 60 minutes)
Average
Waiting time
before being
called to the
Outpatient
Pharmacy
Dispensing
Counter (min)
2018
2019
2020
2021
2022
January
-
38.14
8.07
12.12
11.19
February
-
23.41
3.17
6.16
9.35
March
-
25.04
3.03
7.54
12.59
April
-
31.14
5.02
8.17
9.19
May
-
56.19
6.30
11.24
11.42
June
-
31.01
5.42
12.11
16.13
July
17.33
7.32
4.51
10.36
16.24
August
17.33
5.31
3.50
9.17
20.07
September
36.03
9.34
4.03
10.32
16.23
October
21.57
3.89
4.04
13.55
November
20.57
4.56
5.50
12.51
December
30.15
7.23
7.58
13.42
0
10000
20000
30000
Number of Patient Served
2018 2019 2020 2021 2022
0
20
40
60
Average waiting time in Minutes
2018 2019 2020 2021 2022
International Journal of Applied Sciences & Development
DOI: 10.37394/232029.2023.2.17
Anwar Al-Mofleh, Mohamed Alseddiqi,
Osama Najam Budoor Almannaei, Leena Albalooshi
E-ISSN: 2945-0454
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Volume 2, 2023
before being served by the pharmacy, highlighting
instances of extended waiting. Figure 5 visually
represents the fluctuations in the percentage of
patients facing long wait times.
Table 3: Patients who waited more than 60 min
before being called to Outpatient Pharmacy
Dispensing Counter (%)
Number of
Patient Served
2018
2019
2020
2021
2022
January
25.0%
0.7%
0.5%
1.2%
February
6.1%
0.0%
1.4%
0.4%
March
1.0%
0.0%
0.3%
0.6%
April
10.5%
0.6%
0.6%
0.4%
May
38.8%
0.1%
0.8%
0.9%
June
15.0%
0.0%
0.6%
0.4%
July
0.2%
0.0%
0.8%
0.8%
0.5%
August
2.4%
0.0%
0.5%
0.6%
1.3%
September
20.1%
0.0%
0.5%
0.5%
1.4%
October
2.4%
0.0%
0.2%
1.0%
0.8%
November
3.0%
0.0%
0.1%
0.8%
0.1%
December
6.6%
0.2%
0.2%
0.7%
0.2%
Fig. 5. Patients who waited more than 60 min
Table 4 provides insights into medication incidents
reported through the OVR system on a quarterly basis
from 2019 to 2022, helping assess medication safety
practices. Figure 6 offers a graphical representation
of medication incidents reported, aiding in the
identification of trends.
Table 4: Number of Medication Incidents reported
through hope OVR(Quarterly)
Quarter
2019
2020
2021
2022
Q1
43
73
96
68
Q2
53
95
96
55
Q3
94
85
166
45
Q4
127
111
82
93
Fig. 6. Medication Incidents reported
Table 5 outlines the total number of items dispensed
quarterly from 2019 to 2022, offering an overview of
dispensing volume changes. Figure 7 graphically
represents changes in dispensing volume, facilitating
the assessment of resource needs and pharmacy
operations.
Table 5: Total Number of Items dispensed (Quarterly
Quarter
2019
2020
2021
2022
Q1
269683
271468
426720
1124361
Q2
295404
301389
1412650
944337
Q3
177641
379063
2554318
757433
Q4
207878
430396
1158242
644828
Fig.7. Total Number of Items dispensed
These results collectively demonstrate the efficiency
of the automation pharmacy in KHUH, emphasizing
quick and accurate prescription filling, patient
volume trends, waiting time assessments, medication
incident reporting, and dispensing operations. The
data and visuals provided in this section serve as a
foundation for informed decision-making and the
0
200
Q1 Q2 Q3 Q4
Number of Medication
Incidents
2019 2020 2021 2022
0
0,5
Patients who waited more than
60 min
2018 2019 2020
2021 2022
0
1000000
2000000
3000000
Q1 Q2 Q3 Q4
Total Number of Items dispensed
2019 2020 2021 2022
International Journal of Applied Sciences & Development
DOI: 10.37394/232029.2023.2.17
Anwar Al-Mofleh, Mohamed Alseddiqi,
Osama Najam Budoor Almannaei, Leena Albalooshi
E-ISSN: 2945-0454
165
Volume 2, 2023
continuous improvement of patient care and
pharmacy practices.
4 Discussion
The results of the data analysis on the automation
pharmacy at KHUH offer valuable insights into its
operational efficiency, patient experience, and
medication safety practices. This discussion section
aims to provide context and interpretation for the
findings.
Prescription Filling Efficiency: The pharmacy's
ability to fill prescriptions quickly and accurately is a
critical indicator of its effectiveness. The mean time
of 2 minutes and 30 seconds for prescription filling,
with a median time of 2 minutes and 15 seconds,
highlights the system's efficiency. Moreover, the
absence of errors in prescription filling underscores
the high degree of accuracy achieved through
automation. These results suggest that the automation
pharmacy effectively streamlines prescription
processing, minimizing patient wait times and
reducing the likelihood of medication errors. This not
only enhances patient satisfaction but also
contributes to better patient outcomes.
Patient Volume Trends: The data in Table 1 and
Figure 2 reveal fluctuations in patient volume over
the years. Identifying peak periods of demand and
observing growth or decline in patient numbers is
crucial for resource planning and optimizing staffing
levels. These trends can be used to allocate resources
effectively during busy periods and improve overall
patient flow.
Average Waiting Time: Table 2 and Figure 3 provide
an overview of average waiting times for patients. It's
noteworthy that waiting times vary across months
and years. This information is essential for
optimizing workflow and improving the patient
experience. Identifying periods of longer waiting
times can prompt adjustments in staffing or processes
to reduce patient wait times, further enhancing
patient satisfaction.
Long Wait Time Assessment: The data in Table 3 and
Figure 4 shed light on the percentage of patients who
experience long wait times. While some months and
years show lower percentages of patients waiting
more than 60 minutes, there are instances of longer
wait times. It is important to investigate the
underlying causes of these longer waits and take
corrective actions to ensure timely service delivery.
Medication Incident Reporting: Table 4 and Figure 5
provide insights into medication incidents reported
through the OVR system. While there are
fluctuations in reported incidents, it is essential to
conduct a thorough analysis of the root causes of
these incidents. This analysis can lead to process
improvements and a reduction in medication errors,
ultimately enhancing patient safety.
Dispensing Operations: Table 5 and Figure 6 present
the total number of items dispensed quarterly.
Understanding dispensing volume trends is crucial
for resource planning and assessing the pharmacy's
ability to meet the hospital's needs. Resource
allocation and system improvements should align
with these trends to ensure efficient operations. The
results presented in this section reflect the positive
impact of automation on pharmacy operations at
KHUH. Quick and accurate prescription filling,
coupled with insights into patient volume, waiting
times, medication safety, and dispensing operations,
contribute to enhanced patient care and operational
efficiency. However, it is essential to continuously
monitor and adapt to changing trends and challenges
in healthcare to maintain and further improve these
positive outcomes. The data presented here should
serve as a foundation for ongoing quality
improvement efforts within the pharmacy.
4 Conclusion
Pharmacy automation has become a crucial aspect of
modern healthcare, and King Hamad University
Hospital (KHUH) has made significant strides in
implementing various approaches to automation. The
benefits of automation, such as improved patient
safety and increased efficiency, have been well
documented. However, the implementation of
automation systems also presents challenges,
including cost, staff training, and system integration.
Despite these challenges, the future of pharmacy
automation looks bright, and it is expected that new
technologies will continue to emerge and further
improve the practice of pharmacy. It is recommended
that KHUH continue to assess and evaluate its current
automation systems, and explore new and innovative
technologies to enhance patient care and improve
overall hospital efficiency.
Acknowledgement:
I am grateful to all of those with whom I have had the
pleasure to work during this and other related
research. Each of the members of paper Committee
has provided an extensive personal and professional
guidance.
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Osama Najam Budoor Almannaei, Leena Albalooshi
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DOI: 10.37394/232029.2023.2.17
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important intellectual content, and final approval of
the version to be submitted;
Osama Najam,: supplied the acquisition of data,
drafting of manuscript;
Leena Albalooshi, Budoor Almanaie : supplied the
design of study, analysis and interpretation; supplied
the acquisition of data; was responsible for the article
critically for important intellectual content; and,
provided the revised the article critically for
important intellectual content and gave final approval
of the version to be submitted.
Sources of Funding for Research Presented in a
Scientific Article or Scientific Article Itself
No funding was received for conducting this study.
Conflict of Interest
The authors have no conflicts of interest to declare
that are relevant to the content of this article.
Contribution of Individual Authors to the
Creation of a Scientific Article (Ghostwriting
Policy)
Mohamed Alseddiqi, Anwar AL-Mofleh.:
provided the conception and design of the study,
acquisition of data, analysis and interpretation of
data, drafting the article, revised it critically for
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International Journal of Applied Sciences & Development
DOI: 10.37394/232029.2023.2.17
Anwar Al-Mofleh, Mohamed Alseddiqi,
Osama Najam Budoor Almannaei, Leena Albalooshi
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