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So many things could have gone wrong when Center Street Pharmacy transitioned from removing an older automated dispensing cabinet (ADC) platform to the NexsysADC system in 10 long-term care facilities at once. The project was during the COVID-19 pandemic. Facilities were in lockdown. Staffing shortages were a constant. And the team gave itself just one month start-to-finish to complete the project.
And yet, to Sara Grice’s pleasant surprise, nothing did go wrong. “It was so easy to migrate to Nexsys,” says Grice, the VP of Pharmacy for Center Street, an institutional pharmacy in Apex, NC. Center Street Pharmacy services a group of long-term care facilities in central and eastern North Carolina. She oversaw the 2022 project and shared the details of a complex transition that was executed to perfection.
Old Technology Plus COVID-19 Challenges
Center Street Pharmacy opened in 2020 and began providing medications for a group of nursing facilities. Early on, Center Street implemented the eMed Solutions automated dispensing cabinet. The system was intended to safely store medication doses that the nursing staff would need on hand for its geriatric residents. The system held both common maintenance medications as well as controlled substances (usually for pain management). Grice says that the previous pharmacy administration acknowledged their choice to install eMed Solutions was driven by price. Soon after, staff members at the LTC facilities expressed dissatisfaction.
When Grice joined Center Street in late 2021, the pharmacy decided to transition away from eMed Solutions to a new automated dispensing cabinet system. “We were now hitting obstacles that were nonexistent before, like lockdown, staff turnover, diverting resources, so we couldn’t train people how to use the system in person,” Grice says. “There was going to be no way to easily transition from one ADC platform to another, with minimum delay, confusion, infection spread, and complications … but we knew we had to get it done.”
NexsysADC Chosen
Leadership decided to replace eMed Solutions with NexsysADC from Capsa Healthcare. All of the 10 facilities that Center Street supports had used Capsa’s Gen 1 ADC system, FirstDose, in the past and the experience had been positive. NexsysADC was not the cheapest option, but leadership had learned the hard way with eMed Solutions to avoid repeating that mistake.
Creative Installation & Training
All 10 facilities across North Carolina needed at least one ADC. Three of the largest facilities had two med rooms apiece so Center Street installed a 2nd NexsysADC cabinet in those facilities. The pharmacy was using Softwriters’ FrameworkLTC software, and the interface to NexsysADC was seamless.
Training during a pandemic was a major challenge. But Capsa Healthcare provided pharmacy and nursing facility training remotely and via pre-recorded help videos. And Capsa’s implementation and project management team, led by Mike Lueck and Ciro Castro, ran their plan flawlessly during the 1-month blitz that involved:
“We used the training videos a ton,” Grice says. “There was no way we could have done a traditional in-person rollout and I credit the Capsa team for being so creative and responsive.”
Center Street spent the next few months making its own adjustments and customization of the highly flexible NexsysADC platform. The pharmacy team has relied on the reports and data to precisely monitor all medication inventory, expiration dates, and nursing access.
Positive Outcomes
Center Street Pharmacy has reduced its on-call service costs by 30% since the installation of the Nexsys cabinets. Most medication doses are onsite when the nursing staff needs them for a resident’s immediate needs. This buys the pharmacy plenty of time during normal business hours to adjust the resident’s medication delivery. Center Street Pharmacy was able to avoid having pharmacy staff overnight, lessening any overutilization of on-call services. “This saved a tremendous amount of cost,” Grice says.
Restocking NexsysADC cabinets is simpler than the eMed Solutions cabinets that relied on loading individual cartridges. Now the pharmacy prestocks and a nurse at each facility physically handles the loading by following the prompts onscreen.
The system enables Center Street to customize and change the medication stock for each facility’s ongoing needs. “Not all 10 of the facilities get the same medications, and we like the ability to quickly adjust what’s inside and what we restock,” Grice says.
Nurse training – whether it is for a new hire or a refresher for a particular operation on NexsysADC – is simple with the full library of help videos.
“This was unorthodox in many ways because of our aggressive timelines and the overhanging COVID-19 challenges,” Grice says. “But I have no regrets in how Capsa and our pharmacy staff managed the transition to NexsysADC. It was surprisingly simple start to finish.”
More about Center Street Pharmacy