Achey Thomas S, Riffle Allison R, Rose Robert M, Earl Marc
Duke University Hospital, Durham, NC
Cleveland Clinic, Cleveland, OH.
Am J Health Syst Pharm. 2018 Nov 1;75(21):1736-1741. doi: 10.2146/ajhp170367. Epub 2018 Oct 3.
The development and implementation of an operational productivity tool in an academic cancer treatment center are described.
Based on the increasing complexity of care delivery within the oncology setting, solutions were explored within Cleveland Clinic pharmacy's productivity model. Data were electronically captured based on orders processed through the outpatient oncology setting, including hazardous and nonhazardous medications. Based on current workflow, inpatient and outpatient orders were reviewed in productivity metrics. The metric defining the variability of the workload itself was weighted dispense type as it was the best representation of a mixed-skill workflow. After conducting workflow process mapping, discrete measurable steps were assessed and evaluated daily. Operational components of interest included pharmacist verification activities and technician compounding activities. Historical production data were sampled for assigning relative value units (RVUs) respective to time to normalize workload into a common unit (i.e., 1 hour) and to relate work demand in a highly variable setting. RVUs were assigned and delineated by cognitive and distributive activities for pharmacists and technicians, respectively. The Cleveland Clinic department of pharmacy developed a productivity tool to retrospectively measure workload involving time to review, verify, reconstitute, admix, and deliver chemotherapeutic agents. The weighting of each medication allowed for precise and meaningful evaluation of productivity. With RVUs assigned to 2 years of operational metrics, there now exists an opportunity to monitor performance trends within the cancer treatment center pharmacy. The data are readily retrievable within the electronic health record.
The productivity data provided precise information to assess trends in operations within the pharmacy of an outpatient cancer treatment center.
描述在一家学术性癌症治疗中心开发并实施一种运营生产力工具的情况。
鉴于肿瘤治疗环境中护理交付的复杂性不断增加，在克利夫兰诊所药房的生产力模型中探索了解决方案。基于通过门诊肿瘤治疗环境处理的订单以电子方式获取数据，包括危险和非危险药物。根据当前工作流程，在生产力指标中审查住院和门诊订单。定义工作量本身变异性的指标是加权配药类型，因为它是混合技能工作流程的最佳代表。在进行工作流程映射后，每天评估和评价离散的可测量步骤。感兴趣的运营组成部分包括药剂师核实活动和技术人员配药活动。对历史生产数据进行抽样，以便根据时间分配相对价值单位（RVU），将工作量标准化为一个通用单位（即1小时），并关联高度可变环境中的工作需求。分别根据药剂师和技术人员的认知和分配活动分配和划分RVU。克利夫兰诊所药房部门开发了一种生产力工具，以回顾性测量涉及审查、核实、复溶、混合和交付化疗药物的时间的工作量。每种药物的权重允许对生产力进行精确且有意义的评估。由于将RVU分配给了两年的运营指标，现在有机会监测癌症治疗中心药房内的绩效趋势。这些数据可在电子健康记录中轻松检索。
生产力数据提供了精确信息，以评估门诊癌症治疗中心药房的运营趋势。
