Pharmacy Design Trends, © Ian Janer and William N. Bernstein, LEED®AP, AIA

Pharmacy design has been undergoing dramatic changes in recent years, in a number of areas. A main trend has been the need to modernize and automate the production, packaging, distribution, and provision of drugs, particularly of prescription drugs, which have to be monitored and secured at all times.  Modern pharmacies --- particularly hospital pharmacies --- are looking to establish an automated system that performs all the jobs from the clean room to the patient’s bedside. Great progress has been made in moving towards a coordinated, automated pharmacy system. Clients looking to design a pharmacy will want to be cognizant of these trends.

The movement towards automation has been spurred by a number of factors, including: lower overall cost of operation, higher safety standards, and increased ability of the pharmacy to respond quickly and accurately to hospital needs. A big factor in the decrease in costs, is the ability of hospitals to reduce staff, based on the implementation of automated systems. Additionally, the new electronic systems mean fewer medication errors and tighter security, not to mention more reliably safe drugs.

Successful pharmacy plans from now on will be impacted by the need for affordable, modular design and the requirements of the increasingly complex web of computer-run production and distribution systems.

Clean rooms

Clean rooms --- rooms designed to control and limit temperature, humidity, air pressure, and particles --- have been used for years in both pharmacy and laboratory settings.  As of late, clean rooms have become much more significant for compounding and preparing drugs due to a set of guidelines established by the United States Pharmacopoeia in 2004 --- and then revised and re-issued in 2008 --- entitled “USP 797”. This guideline specifies that pharmacies that prepare CSPs (compounded sterile preparations) must have clean operating spaces, that meet ISO 7 and ISO 8 standards.

Automated Drug Management

Many hospitals have central pharmacies with multiple pharmacy stations throughout the hospital for immediate supplies. Most of the current advances in pharmacy layout design have been to automate the procedures within and in between these central and satellite units, which is possible through using automated pharmacy equipment and electronic records for each prescription.

The latest trends in pharmacy designs have been to use technology to make the various jobs of the pharmacist easier, if not perform the jobs entirely. Machines have been developed to aid in drug preparation, packaging, and dispensing. 

Pharmacy Automation Equipment with the Pharmacy

Some pharmacy automation equipment has taken over all of the tasks from packaging to dispensing. An example of such equipment is the Swisslog PillPick, which even restocks itself. In keeping with the theme of modularity, this device, like many others, is scalable based on the client’s needs. Other pharmacy automation systems include the McKesson ROBOT-Rx. Machines like the PillPick and ROBOT-Rx and its competitors are built to be integrated into the larger pharmacy system.

Pharmacy Automation Equipment Connecting the Pharmacy to Other Hospital Departments

In many hospitals, the nurse’s stations are just as important distributors of prescription drugs as the central pharmacies, so a number of hospitals have adopted new technologies in these locations as well. A design for pharmacy should incorporate improvements  aimed at providing faster, more accurate service to improve the safety and comfort of patients.

Devices such as the Pyxis Medstation --- known to anyone who is a pharmacy planner or pharmacy operator --- are used now in inpatient care units to monitor, regulate, and dispense drugs to nurses, eliminating mislabeling and theft and allowing for quicker access to drugs.  Basically they’re pharmaceutical ATMs operated by medical staff. Other similar robots have been developed to distribute individual doses of medication, and some machines come in the form of portable carts.

One of the most direct methods of distributing medication is through bedside dispensers that are timed to unlock each time the patient needs a dose of his or her medication.

Pneumatic Tube Systems

One of the most useful of all of these devices is pneumatic tubing, which promotes intra-hospital transportation of drugs.  Pneumatic tubing uses pressure to propel parcels and is now being used in some hospitals to connect the various pharmacy stations throughout.  The tubes can be used for spreading documents, small instruments and drugs from the central pharmacy to the nursing stations. Companies such as PEVCO and Swisslog have successfully installed networks of pneumatic tubing in hospitals, and this promising development might one day lead to a future where drugs can be transported directly from preparation to the bedside.

Combination Pharmacy Automation Systems

A recent development in hospital pharmacy operations is related to the combination of all of these different aspects to increase hospital automation, which can be seen at the Bumrungrad International Hospital in Bangkok, Thailand.  The hospital has decreased its human staffing needs and increased its efficiency through the use of many Swisslog devices, including conveyer belts, pill sorters, and pneumatic tubes.  This all-inclusive approach to incorporating automation into the pharmacy and incorporating the pharmacy into the hospital is a step towards the future of in-hospital pharmacy design.

Future of the Retail Pharmacy

Retail pharmacies have taken a different approach to that of hospital pharmacies. The biggest innovation in the last few years in retail pharmacy design is not investing in expensive automated machinery, but rather in creating a more welcoming, health-based, pharmacy-centered space. 

Latest trends in retail pharmacy interior design focus on aesthetics and clarity of the pharmacy’s healthy message. Such a model may have a central pharmacy kiosk and be more open and friendly than previous models. The sections within the store are to be health-themed and decorated in an open friendly manner with appropriate light quality. Instead of raising efficiency of speed and safety, these retail pharmacies focus on raising the efficiency of their marketing.

What Hospital and Retail Pharmacies Can Learn from Each Other

Although seemingly unrelated, the two types of pharmacy can potentially learn from each other to improve even further. A commercial pharmacy can gain a lot from increased speed and accountability, while a hospital pharmacy can gain at least a little from improving the experience through aesthetic design.

About Bernstein & Associates, Architects:

Bernstein & Associates, Architects has specialized in healthcare and lab design and construction since the firm's founding in 1990. This architecture firm is well-known for pharmacy planning, pharmacy design and pharmacy architecture, including a sub-specialty in usp 797 compliant pharmacy design and construction. The firm has designed over twenty new pharmacies, pharmacy renovations, and pharmacy relocations in the past five years. The firm is featured on the pharmacy design website, www.pharmacydesign.org, and the usp 797 website, www.usp797.org. The firm's principal --- William N. Bernstein, LEED®AP, AIA --- is a well known pharmacy architect. He has written extensively on pharmacy design and pharmacy construction including usp 797 compliant pharmacies. Mr. Bernstein's pharmacy design articles can be found on www.pharmacydesign.org, and his usp 797 articles can be found on the usp 797 website www.usp797.org.

For more information about healthcare and hospital design and construction, including pharmacy design and construction, contact Bernstein & Associates, Architects at:

Bernstein & Associates, Architects - PLLC
59 West 19th Street - 6A, NY, NY  10011
T: 212.463.8200
F: 212.463.9898
E: info@bernarch.com
www.bernarch.com
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