Riverside Hospital’s Pharmacy Services Harvard Case Solution & Analysis

Question 3


The main goal of the management is to reduce the ADEs and work more efficiently and solve the long term problems existing in the hospital pharmacy. Saving time and cost is another goal that the management wants to achieve through the new system. It also wants to ensure that the five rights are practiced, which include The Right Patient, The Right Medication, Right Dose, Right Route, Right time.

Management Criteria:

The criterion set by the management is implementing the system, which improves the problems existing in the current system and achieves its goals with the least possible cost due to the reduction in funds by the Government.


There are many options that can be considered to overcome the persisting issues. The first option is to introduce the unit dose system. The unit dose system is a medication dispensing system in which the doses are individually prepared and packaged for each individual patient in a bubble pack, which are then labeled with the name of drug, patient, dose and the time the medication needs to be given. Moreover, each bubble has the medication for five days. The main goal is to reduce the errors in medications and medication waste, along with the nursing time involved in dispensing the medications to the patients.Also, it will reduce the inventory holding cost. The criteria would be to see if the system has reduced the errors and issues and how much cost does it saves and incur.

Even though the option might help in reducing the errors and might save time that can be used somewhere else to treat more patients, however, it isn’t cost effective and will incur more cost than the bulk purchasing.Moreover, it requires more labor as compared to bulk purchasing, which can be bought once and used for long period.

Another option available is to apply the Bar-Code Medication and Administration system (BCMAS).This system has bar codes for each drug and for nurses and the patients. Through this system, the prescription which is written by the physician is then required to be hand delivered to the pharmacy which then develops the bar code that is attached with the unit dose. Also, the dose is then given to the nurse who would scan the bar with her identification badge along with the patient’s wristband if all three match the dose that is given to the patients, and if all three don’t match then the nurse would be identify the error. The goal and management criterion of applying this system is to reduce the error committed during the processes and to save time.This is done to alert when the error has been made and who overrides the error to dispense the medications to the patient.

Even though the system can prevent wrong dispense of medications to the patients and would also warn the nurse if the bar code is not matched to reduce the errors and also to record who overrides the warning of the system.However, the system is yet to be applied by any hospital in LHIN and by using this system without any previous record.By incurring such costs it can turn out to be a disaster for the hospital.Also, in the study on the system it has identified the errors it made, with Government already considering to reduce the budgets of the hospitals, this system cost might act adversely for Riverside.

The third option for Riverside is to implement Automated Pharmacy system.This system automates the unit dose packaging, and it dispenses the medications into the workstation and storage of the medications. It will work when a physician would enter the prescription into the hospital’s approved device and the medicines would be received by the workstation and notifying the workstation that the dosage is received.

The system hasn’t been adopted previously by any other hospital in LHIN;however it has been applied in other countries like UK.In addition, it has reduced the number of errors and has also increased the efficiency by reducing the time for each technician for the prescription from 10-12 to 15 prescriptions in an hour. The cost to be incurred in this system is high and it is hard to reverse the system because of the 5 year contract that is required to be signed.It also requires BCMAS system to work, which will increase the cost to the level that might not be possible for Riverside. It also has the negative side of not being able to store all kind of medicines and also has the problem of crashing down, which will cause problems for the staff,which will then need to fill the prescriptions manually.................

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