Aboumater Hanan J, Winner Laura E, Davis Richard O, Trovitch Peter B, Berg Maureen M, Violette Katherina M, Messersmith Wells A, Maylor Karen K, Lehmann Christoph U
Center for Innovation in Quality Patient Care, John Hopkins University School of Medicine, Baltimore, MD 21287-0765, USA.
Am J Manag Care. 2008 May;14(5):309-16.
To implement an automated pharmacy dispensing prioritization system and to evaluate its effect on the timing of dispensing and administration of chemotherapy.
An electronic chemotherapy dispensing system that prioritized orders for pharmacy processing based on anticipated patient arrival at the oncology outpatient unit was implemented, followed by an educational intervention for pharmacy staff.
A time-controlled study evaluating the effect of the electronic chemotherapy dispensing system on late, early, and "within target" dispensing and administration of chemotherapy was conducted.
A total of 13,138 chemotherapies were prepared and released pending medical clearance based on laboratory results (hereafter referred to as pending counts) (8677 [66.0%]) or pending arrival of the patient (hereafter referred to as pending arrival) (4461 [34.0%]) from March 1, 2005, to March 2, 2006. Chemotherapy dispensing and administration times were retrospectively compared with chemotherapy appointment times after adjustment for late patient arrival. Dispensing times continuously decreased from a mean delay in dispensing of 12 minutes after the adjusted chemotherapy appointment time at baseline to dispensing a mean of 5 minutes ahead of the scheduled time by the end of the study. Chemotherapy treatments dispensed within target increased from 62.9% to 74.7% (pending arrival) and from 53.4% to 68.1% (pending counts), and those administered within target increased from 64.9% to 71.8% (pending arrival) and from 56.0% to 70.1% (pending counts).
An automated intervention for synchronizing chemotherapy preparation with anticipated times for administration was associated with significant reduction in wait times.
实施一个自动化药房配药优先级系统，并评估其对化疗药物配药和给药时间的影响。
实施了一个电子化疗配药系统，该系统根据预计患者到达肿瘤门诊单元的时间对药房处理的订单进行优先级排序，随后对药房工作人员进行了教育干预。
进行了一项时间对照研究，评估电子化疗配药系统对化疗药物延迟、提前和“在目标时间内”配药及给药的影响。
从2005年3月1日至2006年3月2日，共准备并发放了13138次化疗药物，这些药物根据实验室结果等待医学审批（以下简称等待计数）（8677次[66.0%]）或等待患者到达（以下简称等待到达）（4461次[34.0%]）。在对患者延迟到达进行调整后，回顾性比较了化疗药物配药和给药时间与化疗预约时间。配药时间持续减少，从基线时调整后的化疗预约时间后平均延迟配药12分钟，到研究结束时平均提前5分钟配药。在目标时间内配药的化疗治疗从62.9%增加到74.7%（等待到达），从53.4%增加到68.1%（等待计数），在目标时间内给药的化疗治疗从64.9%增加到71.8%（等待到达），从56.0%增加到70.1%（等待计数）。
使化疗准备与预期给药时间同步的自动化干预措施可显著减少等待时间。
