Mercy San Juan Pharmacy Upgrade to USP 797


Acute Care Hospitals, Pharmacies


Carmichael, CA


$1.4 Million

Pharmacy Upgrades With Minimal Disruption

The Mercy San Juan Medical Center Pharmacy Project consists of upgrading the existing IV Prep Room, Chemo Prep Room, and shared Anteroom to conform with USP 797 and USP 800.  It is a complex job in a 24/7 compounding Pharmacy, that requires the build out of a temporary segregated compounding area to allow the Pharmacy to continue to function during construction.

The project consists of two phases to minimize impact to the Pharmacy operations.  The first phase consists of remodeling a space for a temporary break room, converting the existing break room into a segregated compounding area, and performing make-ready scope while allowing the Pharmacy to maintain full use of their existing IV Prep and Chemo Prep rooms.  Once OSHPD, licensing, and Board of Pharmacy provide sign-off for use of the temporary segregated compounding area, the second phase can begin.  This phase consists of renovating the existing IV Prep, Chemo Prep, and Anteroom spaces to conform with USP 797 and USP 800.  Two new dedicated exhausts will be added along with a new Chemo Prep hood.  Various other pieces of equipment, including pharmacy grade refrigerators, pass-through windows, scrub sinks, shelving, and workstations will be replaced.  Staff dressing will be expanded, and the donning/doffing areas will be modified.

This project requires close coordination with the Pharmacy, hospital leadership, OSHPD, licensing consultants, CDPH, Board of Pharmacy, as well as other construction projects that are occurring simultaneously in the same building.  Licensing and Board of Pharmacy will play a vital role two times in this project.  First, midway through the project to sign off on the temporary segregated compounding area, and then again at the end to sign off on the renovated IV Prep, Chemo Prep, and Anteroom spaces.  Strict timelines are enforced for notifications to the agencies, as well as timely completion of construction once notifications are issued.