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Behind the Scenes at Connecticut Children’s Central Pharmacy

11:00 am

Twenty-four hours a day, Connecticut Children’s Central Pharmacy is a brightly-lit hive of activity. Today, pharmacy technician Gina Masselli prepares oral medication syringes. The Pharmacy prepares about 300 oral syringes per day. Gina pulls a medication label from the printer, locates the medication and logs into the EPIC system. She scans both the patient-specific barcode on the label and the medication’s barcode. After finding the correct oral syringe size, based on the volume of medication to be prepared, she draws up the correct dose into the syringe. She applies the patient label and checks to see if there should be additional labeling on the dose (such as “keep refrigerated”). She caps the syringe and puts it with the medication it was prepared from, indicating that it is ready for the pharmacist to conduct a final check.

3:00 pm

In the hazardous room, pharmacy technician Hakima Mennane is suited up head to toe in protective gear—gown, booties, mask and double pair of gloves. The hazardous room is where dangerous medications, such as chemotherapy, are handled and prepared into the doses that go to patients. The Central Pharmacy prepares between 300 and 400 chemotherapy doses per month. The room itself is a negative pressure room with specialized ventilation, and all doses that come out of the room are packaged in yellow hazardous medication bags.

Meanwhile, clinical pharmacists Danielle Koubek and Kathy Brodsky sit at computers in the “quiet room,” where they verify orders that prescribers have entered into the EPIC system. Before an order is filled, every detail about the patient and medication must be double-checked. Age and weight, any organ dysfunction, other medications being taken, allergies and potential drug interactions, and proper dosage are just some of the measures that must be reviewed. If there is an issue or question that prevents an order from being verified, the pharmacist contacts the provider for clarification.

3:30 pm

Pharmacy technician Rafael DeLeon fills orders from the live inventory automated system known as the carousel. When he scans each printed order, the carousel rotates to the proper item. The carousel holds approximately 2,000 line items--everything from prescription medications to supplies like Aquaphor cream. It’s a wonder of automation. When inventory on an item runs low, the carousel system automatically sends a refill order to the wholesaler. Each nursing unit also has an automated dispensing cabinet (ADC) connected to the carousel. ADCs send information to the carousel to automate inventory replenishment throughout the hospital.

Mike Slebonick, another pharmacy technician, is in the kit check room, reviewing the emergency response kits that are found on every patient floor. Each kit is checked daily. Mike puts a kit into the kit check “oven,” a boxy machine that scans the RFID tag on each item to identify what needs to be replenished or replaced.  

In the Pharmacy’s Sterile Room, Earl Rylander is preparing IVs. Earl is one of two Certified Sterile Products Technicians at Connecticut Children’s. The Sterile Room is also where antibiotics, anti-seizure medications, blood pressure medications and other medications that cannot be contaminated in any way are prepared. By regulation, Sterile Rooms must meet stringent requirements for cleanliness and air quality. The Pharmacy prepares 400 to 600 IVs per day. 

Emergency Rx KitCheck station in the central pharmacy

3:50 pm

Mike Slebonick prepares to deliver an order of ketamine to the Hematology/Oncology floor. Because ketamine is a controlled substance, it requires a documented chain of custody from the moment it leaves the pharmacy until it is signed for on a patient floor. He scans the item’s barcode into a tracking app, then takes the elevator to the 8th floor, where nurse leader Ashley Polson signs for it.

Back in the Central Pharmacy, the 4 pm cart fill has begun. Pharmacy technicians are filling the orders for medication doses that will be needed between 10 pm and 6 am for every patient floor, except the NICU. (The NICU cart fill happens at 2 pm.)

Because Connecticut Children’s new Tower will have more beds and specialties, as well as two NICU units, the Pharmacy is growing, too. In the Tower, the Pharmacy will be almost triple its current size.

Philanthropy is key to building the tower and a brighter future.

To learn more about this project, to explore naming opportunities within our health system or to make a gift, please contact us.

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