5 strategies to modernize a hospital pharmacy
Hospital pharmacy upgrading projects are among the most difficult and complicated for healthcare providers, due to extensive regulations, infrastructure limitations and inevitable setbacks. In past projects we’ve encountered everything from changed code requirements that changed mid-project to mechanical, electrical, and plumbing (MEP) systems that needed to be replaced unexpectedly.
Upgrading a pharmacy to achieve USP 797-800 compliance requires a commitment to flexibility, while maintaining the highest level of quality. The safety of hospital staff and patients is at stake, and there is no room for error. The pharmacy design approach should be focused on effectively treating a variety of different problems that may arise in the process.
Here are five ways to get it right:
Promptly inform regulators
It is not enough to be able to name the names of the agencies that regulate pharmacy upgrades in your state. You should also understand their specific strategies for approving these projects in order to anticipate and avoid conflicts. Are regulators overloaded due to understaffing? Do they have a new management which now applies a more stringent approach on key elements?
Your team should include veterans of the project approval process who can tell you what they’ve observed. In California, for example, pharmacies must be licensed by the Office of Statewide Health Planning and Development (OSHPD), soon to be renamed Department of Health Care Access and Information (HCAI), which oversees the construction of health care. They must also be licensed by the California Department of Public Health (CDPH) and the state Board of Pharmacy.
To help the customer fully understand the implications of code requirements, it is essential to prepare a code compliance log that is updated at each design phase. This type of documentation is useful, especially if regulations need to be updated or changed while a project is in progress. Another way to avoid issues is to prepare room data sheets (one sheet per room) that capture all of the design requirements for each space being renovated. Once completed, the part data ‘book’ can also be used as a valuable reference document to help explain everything about the project, such as existing conditions, staging requirements, and other construction requirements. coordination of facilities.
Many design companies may not care about this level of detail. We have found that including chamber datasheets in our OSHPD preliminary reviews helps give them a more complete understanding of how the project was put together and the extent of the phased work that will take place in a future. about a year.
Examine existing infrastructure and make tough calls
For any pharmacy upgrade, it is essential to be pragmatic and realistic about whether existing MEP systems can be retained. This is especially true in older hospitals where older recording drawings may not reflect current conditions.
To remedy this situation, we believe that the best strategy is to start with a thorough assessment of the condition of the facilities and a feasibility study. Don’t be surprised if this process takes 5-8 weeks, but it will be time well spent. The aim is to detect and deal with any unforeseen conditions that may have a negative impact on the project budget.
It is common to find systems that are old or have been incorrectly repaired or replaced. Be prepared to make tough calls about systems that are past their useful life and need to be removed and replaced. Then you can schedule the changes you need right away instead of having to rearrange everything after discovering a problem.
Consider alternatives to temporary pharmacies
In many upgrades, hospitals are building temporary pharmacies that can be in place for six months to a year. As hospital administrators are well aware, this can be a complicated, labor-intensive and costly process; the rules are the same for temporary and permanent pharmacies. But alternatives may allow you to keep pharmacy staff and equipment in place until the new facility is ready to move in. A key consideration is to identify services that do not need to be located in the hospital, where space is at a premium. Can they be moved to an offsite location instead?
For example, if you could move the administration elsewhere, such as an office building on campus or on the street, it would allow you to reclaim that space for the permanent pharmacy. Administrative areas are much cheaper to move. You can even move them in a trailer outside until a permanent home is found. These strategies can reduce project time and be less disruptive to pharmacy staff.
Prepare for new technological needs
An upgraded pharmacy might not immediately need a data port or extra cabling space, but the future may be another story. New equipment may need to be installed. Will you be able to add more bandwidth? Will you be able to provide sufficient connectivity? Always keep these questions in mind and allow for as much flexibility in the future as possible.
One approach is to plan for additional expansion space in computer rooms to handle more downstream capacity. This kind of anticipation goes beyond an additional outlet here or there. Consider what you might need in 5-10 years and even beyond for the whole space.
Clear the way for future renovations
Things often change during construction. As we have seen in our pharmacy projects, a prep room can be omitted or a refrigerator can be added. You have to imagine how things will change and when a renovation will be needed. We must act now to make this process as smooth as possible.
The best strategy is to commit to thoroughly documenting the construction process, especially any changes made to the original plans. By creating a BIM model, we can provide digital documentation on each asset that can be archived. In addition to helping facilitate construction sequencing, by taking full advantage of the model, the owner will be able to export a project inventory that lists every door, light fixture, outlet installed that may require maintenance.
Photo: LPA Design Studios