Retail or community pharmacy has a very tight integration between what is dispensed and what is re-ordered. At the end of each day, reports are generated as to what is short / out and reorder. Occasionally there are exceptions ... A manager or someone in purchasing would do special orders, or review the report and make adjustments, but a highly automated process. 

As UCSF inpatient pharmacy, we are out of Gelfilm for OR (absorbable gelatin film, NDC 09-0283-01) and I have to hand write it on a clipboard, so someone can order it Monday for it to come in Tuesday, maybe?? The problem is particulary acute when a weekend is involved. 

Another example, we are out of levothyroxine injectable Sunday morning. As I quickly go down the list of options: check pyxis, call Mount Zion, or borrow from OSH ... A technician saw some came in Friday night. What luck and the chance that the technician worked Friday night and Sunday morning!! The delivery came in Friday night but b/c have to log it into the inventory management system, the med were not put on the shelf yet?

Now early Monday morning, we are out of heparin lock flush 300units/3ml syringes. A very fast mover in the hospital. It would be nice to be able to see what was ordered and have some assurance that this was coming later in the morning? 

Monday morning - out of ambrisentan 5 mg tablet b/c there was a new start yesterday. None at Mount Zion and will have to borrow from an OSH.

When it comes to inventory management, there is room for improvement and better automation. APeX knows exactly what is dispensed and approxmately what gets returned. Much energy and time expended on resolving these stock out issues, and taken away from patient care.

+ One option is to empower more people the ability to order meds/supplies over the weekend so that it can arrive on Monday, possibly shortening the delay?

+ Another thought would be to assign someone to log any delivery then put on the shelf. This would alleviate missing meds that are sitting in delivery totes.

+ Have a purchasing person come in for a few hours on the weekend.