In early 2024, the American Society of Health-System Pharmacists (ASHP) reported a record 323 active drug shortages, many affecting sterile injectable medications. This situation was exacerbated later in the year by a disruption in IV fluid production due to Hurricane Helene, which caused a manufacturing plant shutdown, leading to a severe IV fluid shortage that impacted over 86% of healthcare providers.

In my role as Pharmacy Operations Manager at Baptist Medical Center in Jacksonville, Florida, I’m focused on ensuring patient safety and consistency in our pharmaceutical supply chain, which includes drug shortage management. I’ve been a pharmacy leader for just under 10 years, and in that short time, just about every possible supply or medication has been impacted by backorders ranging from antibiotics to opioids to most recently IV fluids, and everything in between. This is why I believe it is critical to have redundancy within the supply chain and to minimize medication waste.

I’ve been fortunate to be part of implementing new technologies to support advancing pharmaceutical care for our patients, most recently upgrading our IV compounding robotics to the latest technology. Sterile compounding has traditionally involved manual processes that introduce the opportunity for workarounds and the risk of human error. The advancement of automation, including robotics within pharmacy processes, is exciting because it can help to reduce the chance of human error, which is a huge win for patient safety. Safety features including barcode scanning, image capture, and gravimetric verification within the medication compounding process are integral to these solutions, and I have personally seen significant impact by implementing these technologies.

While patient safety is our highest priority, there are many other benefits to automating sterile compounding processes. Like many health systems, Baptist Health has relied on outsourcing medications from 503B compounding pharmacies to support our hospital operations. But there have been frequent disruptions to the availability of outsourced medications, including pauses in production, complete shutdown of compounding pharmacies, or abrupt discontinuation of medications. Relying solely on a 503B facility puts your pharmacy operations at risk for not having a medication when it’s needed in a critical situation.

Implementing sterile compounding technology has allowed us to reduce reliance on outsourcing CSPs while building more flexibility into our medication supply chain. We now have the ability to quickly pivot between insourcing and outsourcing our sterile compounding needs, helping to minimize medication stockouts, disruptions of workflow, and added workload to our compounding staff.

As we continue to navigate staffing challenges, another concern is ensuring staff are appropriately trained, especially when it comes to sterile compounding within pharmacy. Sterile compounding requires a unique skill set, including an elevated need for attention to detail, while maintaining safety, sterility, and efficiency at all times. It takes time and resources to train and develop your team.

Baptist Health selected Omnicell’s IV Compounding Service to support our inhouse sterile compounding program. We’re able to leverage Omnicell resources to manage and service the robotic technology, while tapping into their drug formulary, analytics, and overall program expertise to optimize our CSP production. The ability to produce thousands of preparations a week through the Service has significantly decreased the workload demands for our team, allowing them to focus on other responsibilities.

Change management is another challenge. Keeping up with new patient care needs, like providing the latest specialized therapies, managing regulatory changes like the recent updates to USP , and various other responsibilities, all while ensuring patient safety and delivering high quality care, is of the utmost importance. Technology has helped to ease some of this burden.

Healthcare has historically lagged in adopting new technologies. But as we continue to face ongoing challenges like drug shortages and staffing concerns, we really need to challenge ourselves to recognize how innovation can positively impact our operations.

For those considering sterile compounding robotics, I recommend starting by evaluating their current compounding needs, including both insourced and outsourced products. I would also recommend considering all the benefits that are provided by having robotics. We’ve realized a positive financial return, but the additional benefits of enhanced safety, sterility, accuracy, and supply chain resiliency have made the investment worthwhile. Understanding the regulatory environment for using IV robotics is also essential.

Advancements in robotics are happening rapidly, and as this technology continues to scale, the crowdsourcing and network effect become stronger. We as pharmacy leaders need to overcome the obstacles to adopting and improving these technologies that will ultimately allow us to deliver the best patient care.

Listen to the Becker’s Healthcare Podcast to hear more about my journey with implementing IV compounding automation.

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