The Roll of Pill Cutting in Hospital Operations

August 8, 2024

Reading Time: 7 min.

Pill Cutting Can Be Time Consuming

Connie Vigil | 8 August, 2024

The State of Pill Cutting in Healthcare Facilities

In hospital operations, dividing tablets is necessary for accurate dosing—especially in children’s hospitals. Providing smaller doses is critical to these patients, as many drugs are not made in children-friendly doses. It is crucial, then, that medications are cut correctly. If a drug is cut inaccurately, this could lead to potential safety concerns. Should the cut produce a dose too small, the dose is not effective for the patient. Should the cut produce a dose too large, it can be too much and cause toxicity.

What’s more, pill cutting can bottleneck a pharmacy’s workflow. Manual tablet splitting can be time-consuming and tedious. Not surprisingly, it takes a technician longer to manually cut a tablet than to have a system do it for them. They also tend to be less accurate.

For patient safety, inpatient pharmacies can’t compromise on accuracy. If there is a specific dose they do not carry or is on back order, technicians must calculate the correct dose and make sure they split it to accurately obtain the dose they want to package in bulk. It is also important that those split tablets are packaged and completed in a timely manner for patients to receive their medications on time.

To address these challenges, companies are turning to automation. Automation technology significantly reduces the time-consuming process of manual tablet splitting while improving accuracy. This allows technicians to focus on other tasks while the system efficiently handles the splitting of hundreds of tablets. The technology can also separate broken or incorrectly cut tablets into one container, while correctly split tablets are placed into another thus ensuring that technicians receive accurately cut tablets without needing to inspect for faulty ones.

Why Pills Need to Be Cut

There are a couple of reasons why pills need to be cut. One of the most common is a lack of inventory for a certain dose. Medications are constantly on back order, which can be problematic for pharmacies when patients need a dose that is specific to their condition. In fact, a 2024 report from the American Society of Health-System Pharmacists (ASHP) states that drug shortages are at an all time high in the United States. Pharmacies must take advantage of available inventory and split a tablet to make the dose needed. Another situation is for children’s hospitals or hospitals that provide care for new mothers and babies. Infants need to have a dosing that may not be made or available.

Accuracy Matters in Pill Cutting

Pharmacies must be precise when providing medications, whether to nursing staff or directly to the bedside. Nurses and providers rely on the pharmacy to ensure the correct patient, medication, dosage, route, and timing. Pharmacists meticulously verify that the drug is intended for the correct individual, that it's the right medication and dose, administered via the correct route — whether oral or injectable — and that it's given at the proper time. Efficiency and accuracy are paramount in pharmacy operations, as every process must prioritize patient safety.

user pouring pills into automated pill cutter — Pictured: Swisslog Healthcare ezCUT

How Pill Cutting Harnesses Economies of Scale

Many hospitals buy drugs that are blistered or in big bulk bottles; however, blistered medications can be costly compared to a bulk bottle. Pharmacies can reduce their costs by purchasing a bulk bottle and using it to split the tablets into a smaller dose. This leads to a lower cost of purchasing and easier inventory management.

Furthermore, tablet splitting is an easier way to make dosing adjustments instead of having to purchase multiple doses of the same drug. Patients can easily obtain a dose when a tablet is split from a dose that is already made. For example, a patient may need to have a tablet that is increased over a period to get to the dose they need to be at. Or a patient may need to taper down from a dose to have a smaller amount. During those increases or decreases, the patient must increase or decrease by an amount that may not be available or made by a manufacturer. By splitting the tablets, the dose changes needed by patients can be achieved.

Using a tablet splitter can significantly reduce waste and optimize medication use, addressing a common and costly issue in pharmacies. By maintaining a more streamlined inventory, pharmacies can better meet dosing needs and goals. Tablet splitting helps minimize the amount of unused product that would otherwise be discarded after a certain period.

Often, pharmacies receive a medication strength that is infrequently used, resulting in a product that may only serve one or two patients before sitting unused and eventually expiring. Even if only a few tablets are removed from the package or bottle, the rest must still be discarded. However, by regularly using tablet splitting, pharmacies can reduce waste and better fulfill patients' medication needs.

Benefits of Commercial Pill Cutting in Pharmacy Workflows

Commercial automated pill cutting technology greatly improves an organization's ability to manage medication, leading to a more streamlined pharmacy workflow. By minimizing errors and inconsistencies in dosage administration, this technology drastically speeds up drug fulfillment while ensuring accuracy.

This reduction in manual splitting tasks allows pharmacists to focus on other essential responsibilities, improving their ability to manage and oversee medication processes. The result is a smoother workflow, where pharmacists, nurses, and healthcare providers can collaborate more effectively, ultimately enhancing patient care.

Conclusion

In short, splitting tablets is an effective workflow process that pharmacy personnel can do to help their facility obtain the doses they need while decreasing cost and reducing waste. Using automation solutions — like ezCUT offered by Swisslog Healthcare — can enhance this workflow process by accurately splitting tablets while pharmacy personnel can perform elsewhere. It is less time-consuming than traditional manual tablet splitting and can provide less risk and increase safety for patients.