How Does Centralized vs. Decentralized Medication Distribution Impact Design?

In the past, most facilities used a centralized medication distribution methodology, but many facilities have now shifted to a decentralized model.

With a centralized distribution system, the pharmacy processes orders for medications and sends that day’s meds to the patient care areas.  In this approach, medication rooms typically only store a few PRN (as needed) drugs, requiring only a single half-size automatic meds dispenser and half-size refrigerator.

In the decentralized approach, many more medications are kept within the medication room, to be dispensed by the nurse from doctors’ orders.  In this scenario, multiple tower dispensers – main and auxiliary – are typically required in addition to the half-size refrigerator. Medication rooms housing multiple dispensers, counters with sinks, and wall storage can approach 160sf or more in size.

Other trends impacting design

Recent trends also include a change in responsibility for IV solutions from materials management to pharmacy, which translates into IV bag storage moving out of the clean supply room and into the medication room. Another trend is the storage of ancillary supplies associated with medication administration, such as IV tubing and syringes, to be housed in the medication room, requiring three to six feet of wall space.

Designing for flexibility

Although not all projects can accommodate the flexibility, planning the med rooms for a distributed system (even if the current method is centralized) can allow the pharmacy to change models in the future.  We have experienced projects in which the facility switched from a centralized distribution to a decentralized distribution system after construction documents were issued. In one example, the resizing of a dozen medication rooms from 110sf to 165sf cascaded into a redesign of 43 additional spaces.