Productivity and robotization: promises kept ?

Marion Jobard, Cyrille Cros, Lorry Hachon, Sophie Dumas, Coline Guillet, Sophie Vincent, Marie-Laure Brandely-Piat, Rui Batista. Service de Pharmacie Clinique, Groupe des Hôpitaux Universitaires Paris Centre, site Hôtel-Dieu, 1 place du Parvis Notre Dame, 75004 Paris, France

Background

A chemotherapy-production robot, Kiro Oncology® (Kiro Grifols, Spain) has been set up in our production unit due to a stronger activity. The robot has been in production since June 2016. It ensures a part of the production with the help of an operator. The aim of this work was to establish a report of production activity performed with the robot.

Material and methods

The robot works in cycles. It can produce from 1 to 8 preparations per cycle, depending on their composition. It has two robotic arms. The left arm extracts the drug from the anticancer solution vial and injects it into the final container. The right robotic arm allows the reconstitution of lyophilized drugs, their shaking and the management of leftovers vials. Eligible preparations for robot-assisted production are sent from the software Chimio® (Computer engineering, France) to the software of the robot. Data were recorded for one year (06/01/2017 – 05/31/2018) and included: listing of configured drugs, number and type of performed preparations, number of destroyed preparations and reason for destruction, number of running days and stopping days of the robot and reason for stopping.

Results

Twenty four drugs were configured including 6 lyophilized drugs. Over the period analyzed, 5086 preparations were completed using the robot (220 standard doses and 4866 individualized preparations) i.e. 19% of our hospital’s production. Twenty one preparations were destroyed (0.4%): 8 due to a problem of drug extraction, 6 because they were outside the specifications and 5 due to a problem of injection into the final container. The reason for the destruction was unspecified for 2 preparations. The robot worked 166 days over the 250 working days (67%). It was shutdown 27 days due to technical reasons and 57 days due to understaffing. Over this analyzed year, the mean productivity was 30.5 preparations/day. It increased to 41.4 [min 12 – max 61] over the last three months.

Discussion/Conclusion

After a long period of development and solving of technical problems, productivity with Kiro Oncology® has improved significantly. It is possible to reach a satisfactory level, especially in this context of a patient-by-patient production. Several actions will be implemented to continue to increase productivity since the concept has been proven: increase the part of standard doses, reduce the inter-cycle dead time by modification of the unloading process at the end of cycle, better distribute the preparations between manual and automated manufacturing.

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