Planning an Outpatient Pharmacy: Small, Medium, or Large?

Most outpatient pharmacies that are located within a hospital or in an ambulatory care center (on- or off-campus) fall into one of four categories ― minimal, small, medium, or large. Assuming that outpatient demand has been established based on the availability and convenience of similar services and potential competition from commercial pharmacies, the primary determinant of an outpatient pharmacy’s size is the average number of daily prescriptions (scripts) that will be filled during the busiest eight-hour shift. This generally determines the numbers and sizes of rooms or areas and overall department gross square feet/meters (DGSF/DGSM). Larger outpatient pharmacies may be equipped with an automated picking and dispensing carousel, reducing storage space and improving staff productivity.

MINIMAL SIZE — less than 100 daily scripts — 500 DGSF  (46.5 DGSM)

SMALL SIZE — 100 to 300 daily scripts — 900 to 1,000 DGSF (83.6 to 92.9 DGSM)

MEDIUM SIZE — 300 to 500 daily scripts — 1,600 to 2,200 DGSF  (148.6 to 204.4 DGSM)

LARGE SIZE — 500+ daily scripts — 2,300+ DGSF (213.7+ DGSFM)

TYPES OF SPACES REQUIRED

Female Pharmacist Holding BottleRegardless of the number of daily scripts, most outpatient pharmacies require the following spaces:

  • Customer service area includes one or more dispensing/cashiering windows, waiting area, consult cubicle, and space to display over-the-counter medications and other retail items. An optional injection cubicle (with sink) may also be provided depending on the scope of services.
  • Filling/assembly area includes space for order processing and review and a combination of automated equipment and manual workstations for unit-of-use packaging, extemporaneous compounding (non-sterile, non-hazardous), storage, and dispensing. The need for active storage shelving for medications and prepackaged items required for filling prescriptions will depend on whether a carousel storage and retrieval system is provided. Also, depending on the degree of automation, a separate room may be provided for dispensing and storing of controlled substances.
  • Compounding area includes optional space for compounding sterile non-hazardous drugs, nonsterile hazardous drugs, and sterile hazardous drugs.
  • Production support space includes separate areas for receiving and unpacking hazardous and non-hazardous drugs, various types of storage space, and space for the holding/disposal of trash and hazardous waste.
  • Staff/administrative space includes administrative offices and workstations, a staff lounge/break room, and other staff amenities that do not need to be within the production area.

Most outpatient pharmacies dispense compounded hazardous drugs in final dosage form — already prepackaged by the manufacturer in a pill or capsule that does not require manipulation. In this case, the pharmacy only counts and repackages it or dispenses as-is packaging (e.g., birth control pills). Outpatient pharmacies do not typically compound hazardous drugs because the additional space can be substantial. A pharmacy needs to provide over 500 DGSF (46.5 DGSM) of additional space to compounding sterile hazardous drugs as described in Understanding the Impact of USP 800 on Pharmacies.

An outpatient pharmacy should be located in an area with a high volume of outpatient traffic and the entrance should be convenient and highly visible from the main circulation corridor.

Note: Department gross square feet/meters (DGSF/DGSM) represents the footprint of a department or functional component and includes the net area of the individual rooms as well as the space occupied by internal circulation corridors, walls/partitions, and minor utility shafts. More detailed information can be found in the SpaceMed Guide.

See related post: The Hospital Pharmacy — Now a Sophisticated Manufacturing Plant.

This article is an update of previous post.