Fig 1.
Shift distribution and staffing allocation for PTAs and CPs for 1,680 UDDS beds.
The x-axis represents the hours of the day, and the y-axis denotes the shifts for PTA (purple, pharmacy technical assistant), and CP (blue, clinical pharmacist). Break times for both are presented in light yellow. Each shift is accompanied by a pictogram indicating the number of FTEs assigned to it. (A) Working hours and FTE allocation from Monday to Thursday, including early and late shifts for both groups. (B) Schedule specific to Fridays and (C) for Saturdays.
Table 1.
Time and FTE requirements for UDDS workstreams at a teritary care hospital supporting 1,680 beds.
Fig 2.
Key performance metrics for unit-dose operations (2020–2024).
Performance trends are illustrated across rollout and maintenance phases separated by a dotted line. (A) Supplied beds over time: Growth depicted by blue diamonds, with monthly data presented during the rollout phase, transitioning to yearly averages in the maintenance phase. (B) FTEs over the years (blue squares). (C) Yearly production volumes: Box plots illustrate the annual production of pouches (light blue) and tablets (orange), revealing significant increases from 2022 to 2024 compared to 2021. Dotted lines highlight significant differences relative to 2023, marking the first year of the maintenance phase. P-values <0.05 were considered statistically significant, based on ANOVA with Dunnett’s post hoc test. (D) Cost per pouch with the median benchmark indicated by a transparent blue area.
Fig 3.
Enhancements in UDDS efficiency.
(A) Efficiency trends in canister (orange squares) and tray (gray triangles) production show a steady increase in canister output with tray production remaining constant. ANOVA with Dunnett’s post hoc test, using 2023 as the reference point, showed significant increases in canister production efficiency whereas tray production remained unchanged after 2022 (p < 0.05). (B) Decrease in repairs per 10,000 pouches (dark blue triangles) from January-September 2024.
Fig 4.
FTE efficiency metrics for UDDS from 2021 to 2025.
(A) Heat map showing FTE staffing normalized per workload output: per 10⁴ cases, per 10⁶ tablets, and per 10⁶ drug requirements. The color gradient ranges from dark blue (low values, close to 1.0 FTE) to bright yellow (high values, up to 5.5 FTE). (B) Percentage decrease in FTE staffing across the three benchmarks: per 10⁴ cases (black squares), per 10⁶ tablets (white squares), and per 10⁶ drug requirements (blue triangle). FTE levels in 2021 served as the reference and were set at 100%. The vertical dotted line indicates the transition from rollout to maintenance.
Fig 5.
Cost–savings trade-off of UDDS implementation.
(A) Development of UDDS operating costs between 2021 and 2024. Fixed costs (light blue) include room and UDDS machine implementation costs; variable costs (dark blue) represent pharmacy staff (FTEs). The table below indicates corresponding FTEs and annual costs in thousands of euros. (B) Nursing time savings achieved through UDDS implementation. Bars compare UDDS operating costs (blue bar) against the estimated nursing workload reduction expressed as fictive cost savings from [3] (pink bar). The table below is indicative of the calculated number of nursing FTEs, and the corresponding number of patient-days, with the associated cost savings modelled at Helios expressed in euros.