Andrea Jarzyniecki, executive director of pharmacy at Archbold Medical Center, who holds a doctorate in pharmacy
Photo: Andrea Jarzyniecki
When it comes to general inventory management or navigating drug shortages, the biggest challenge Georgia's Archbold Medical Center faced was a lack of visibility.
THE CHALLENGE
"You can't fix what you can't see, and you can't effectively strategize if you don't have access to the necessary baseline information," said Andrea Jarzyniecki, executive director of pharmacy at the four-hospital health system.
"For example, if you don't know your utilization, you can't optimize your par, your reorders, your holding costs or your inventory movement," said Jarzyniecki, who holds a doctorate in pharmacy.
"And if you don't know where you use a drug and how you use it, you can't be strategic about how you want to manage a shortage before it arises," she added.
"In these situations, critical strategic considerations include how much inventory you need on hand to prevent an issue, how you handle inventory during a period of shortage, or how to identify locations or individuals within the health system that might have the highest need for specific medications."
In the past, Archbold took a manual approach in trying to collect this baseline inventory information. Staff extracted reports from information systems and made decisions based on the data they contained. However, these reports were static and didn't tell staff much about the velocity and the shape of the movements of the drug.
"For example, did we use it in spurts, or was our usage flatter and more predictable?" she asked. "To make that kind of visibility dynamic, we would have had to extract reports constantly for every item. For a health system our size, that's about 15,000 inventory locations, with single medications spread across dozens of pockets.
"These factors make drug shortage preparedness especially difficult because you're trying to make intentional decisions about capacity and holding costs without a clean, fast way to see what's happening in real time," she added.
PROPOSAL
Archbold for a long time has used vendor Omnicell for medication management hardware, including automated dispensing cabinets, anesthesia workstations and central pharmacy carousels. The vendor proposed its Inventory Optimization Service, or IOS, to solve the foundational data visibility issue.
"The service would combine predictive analytics, workflow tools and clinical expertise to provide us with the insights necessary to make fast, informed medication inventory decisions that could help us manage drug shortages more proactively, minimize stockouts, reduce expiring medications and lower carrying costs," Jarzyniecki explained.
"At the core of IOS is cloud-based software that would collect data from all Omnicell-based automation hardware to generate dashboards of the medication metrics and trends across our entire health system," she continued. "The software also features role-based workflows, compliance monitoring and AI-based analytics designed to help us better predict, prioritize and act on inventory issues."
A variety of scorecards are also embedded in the tool that could help staff monitor financial and operational performance and get a clearer picture of medication valuation across sites.
"In addition to the software, IOS is supported by a team of clinical strategists that work with us to define inventory management goals, establish a plan to achieve them and develop strategies for continued optimization," she noted.
"Specifically, the platform's shortage management approach was positioned to help us be strategic before a shortage becomes a crisis," she added. "The goal was to support an intentional decision that combines clinical relevance and operational risk.
"We needed a system that would help us answer critical questions like the risk of shortage, the clinical relevance of specific medications and volume targets. With these answers, we would be able to decide how much holding cost to incur and how to mitigate risk."
MEETING THE CHALLENGE
Archbold integrated Omnicell's IOS platform into its routine inventory management and shortage operations workflows. Staff use the platform to manage baseline levels and determine the appropriate amount of "stock at risk" and the associated labor investment they want to incur.
"We also evaluate reorders and make inventory adjustments, leveraging the vendor's clinical strategist recommendations to discover opportunities and to guide decisions," Jarzyniecki said. "Finally, we consistently use the platform's shortage management tool to document and keep track of drug shortages.
"Key inventory reviews and decisions are made during two standing huddles," she added. "In a weekly meeting with pharmacy administrative staff and managers, the procurement coordinator pulls up the shortage management tool and reviews critical and newly flagged items one by one.
"That discussion is used to assess the status of each issue, review days on hand, decide whether inventory needs to be shifted between locations, and determine whether a shortage is already critical or still at the stage of early planning."
Then, in a separate huddle with the broader pharmacist team and several technician leaders, staff review this list once again. The check-in usually only takes about 5 to 10 minutes, and it keeps the wider team aligned on emerging shortages, current priorities and any actions that may be needed. Before Archbold had the systems in place, this process would take several hours.
"From a practical standpoint, IOS has made it much easier to see who is using a medication, where it is being used, and how frequently," she explained. "It also created a much shorter path to the movement data needed to target an intervention by consolidating information that would otherwise require staff to search across multiple locations for the right operational and strategic details."
RESULTS
The medication management approach with IOS has helped Archbold avoid about 512 medication stockouts. Operationally, staff have moved from ad hoc, harder-to-maintain processes to a consistent weekly operating rhythm, where inventory is actively tracked, reviewed and managed using easy-to-access, real-time medication data from across the entire health system, Jarzyniecki said.
"The practical impact for hospital leaders is fewer 'Saturday night' scenarios where a cabinet stocks out, and staff must work through a series of steps to figure out what to do when there's none left in the carousel," she explained. "IOS provides the visibility and structured shortage workflows that enable us to make decisions earlier so issues are addressed before they become frontline failures.
"Another concrete metric we realized was a reduction in technician labor tied to restocking," she continued. "After making intentional changes informed by drug velocity and cost data presented by IOS, monthly restocks moved from about 25,000 to closer to 20,000 – roughly a 20% reduction in technician labor associated with moving inventory to the cabinet."
Staff did this all without increasing holding costs because the additional inventory was concentrated in low-cost, high-movement items.
"Finally, IOS has been instrumental in helping Archbold successfully navigate some high-profile nationwide drug shortages," she reported. "For example, when a tornado struck a Pfizer plant in North Carolina in 2023, it impacted 25% of the nation's sterile injectable supply chain.
"Leveraging the shortage management tool in IOS, we were able to quickly identify where our risk points were and promptly ordered medications to mitigate the impact the shortages resulting from the tornado would have on our health system," she concluded. "As a result of these efforts, we never stocked out of a single medication impacted by that natural disaster."
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Email him: bsiwicki@himss.org
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