Introduction to medical distribution systems

Hello, I am Chia-Lin Chou from Taipei Veterans General Hospital. Today’s program is going to be concerned with the medication distribution system in hospital pharmacy. We know that the pharmacist’s role is to ensure that patients get the appropriate medication in an appropriate dosage form, and improve patients outcomes. At different times, pharmacy’s responsibilities changes. So the role of the pharmacists seems to receive more attention.

In early days, pharmacies were mainly like institutional pharmacy, so the pharmacist’s role only focused on drug delivery that reduced medication errors and cost. As time goes by, pharmacists have become more and more involved in clinical responsibilities. Until now, the pharmacists do various clinical service. The role of the pharmacists become more diverse than before. However, medication distribution is still to be an important responsibility of pharmacists, especially for hospital pharmacy.

The medication distribution system have evolved in recent decades, from the floor stock system to unit dose system, and in the future, the popular distribution system may be an automated system. Since this change, the hospital pharmacist’s role also change to be as a member of the healthcare team. That means pharmacists are not only doing dispensing and compounding, pharmacists could review individual patient medication orders.

The pharmacist would read those orders against patient medication records before they prepare and dispense patients’ prescriptions. Thus, hospital pharmacists started to take the responsibility for a patient’s pharmaceutical therapy. With technological progress, the traditional medication distribution system have been improved to be more reliable. The American Society of Health-System Pharmacists has published a book, Introduction to Hospital and Health-System Pharmacy Practice.

In this book, the author introduces the history of medication distribution system and how these distribution systems have changed with the social development and progress of the times. In today’s program, I would like to use this book as a reference to give a brief overview of the history about the medication distribution system, a discussion and analysis of different distribution system and different technologies that assist drug distribution today.

I will introduce the medication distribution systems in 3 lectures. In today’s lecture, I am going to introduce the history of medication distribution system and describe the medication distribution models used in hospital pharmacies from the past till now. And discuss the role of medical staffs, nurses and pharmacists, in different medication distribution models. And the advantages and disadvantages of different distribution system. And we will spend some time to introduce the design of medication bags and labels in different distribution models.

After this lecture, you may understand the evolution of medication distribution systems in hospital pharmacies. And you can list the attributes of a good medication distribution system. And you may enable to describe the advantages and disadvantages of different medication distribution systems. And we can discuss the evolution of medication distribution over time, and its impact on the professional role of pharmacists. Now, let’s start to introduce medication distribution system.

The full medication use system is basically from drug procurement, inventory control, and then medication distribution. So medication distribution is from physician prescribing, pharmacist dispensing and then patient administrating. When we talk about the types of medication distribution systems, it is more like to introduce the history of distribution systems development. There are 4 types of medication distribution system, including the floor stock system, the oldest distribution system, then the patient prescription system, then the unit dose system, and then the newest automated medication dispensing system. In the first two models, floor stock system and patient prescription system, the pharmacists’ job is to help nurse to refill the medications for patient use.

In the real world, pharmacies may apply several kinds of distribution systems together or use a mixed type of distribution system to meet their working process. In the following slides, I will introduce the working process and staff’s responsibilities in each distribution system, discuss the advantages and disadvantages, and take the pharmacy in a medical center in Taiwan as an example to explain how we adapt these distribution systems in current pharmacy practice.