Blackmer James, Amoline Kevin, Amancher Jacqueline, Vogan Eric, Zimmer Heather, Borton Meave, Earl Marc, Boyd Anthony
Johns Hopkins Hospital, Baltimore, USA.
Cleveland Clinic, Cleveland, USA.
J Oncol Pharm Pract. 2021 Sep;27(6):1454-1460. doi: 10.1177/1078155220960222. Epub 2020 Sep 24.
Many oncology infusions are provided in hospital-based infusion centers. With hospital-based infusion centers seeing increased volumes, patient wait times continue to be a priority. Extended wait times for oncology infusions have been shown to lead to patient dissatisfaction.
Advanced Preparation of oncology infusion medications allows pharmacy to verify and prepare specific medications the day before a patient's infusion appointment. Our study targeted lower cost, commonly used medications to prepare in advance. Data analyzed included turnaround time (TAT), medication waste, and oncology infusion preparation volumes. Implementation took place in two phases to allow time for the healthcare team to adjust to the new workflow. Phase I medications include a small amount of medications prepared manually by pharmacy technicians. Phase II medications included all phase I medications plus additional medications that were compounded in the intravenous (IV) robotic compounding system.
Our study demonstrated significant decrease in median TAT for medications prepared in advance. 537 infusions were prepared using the Advanced Preparation module with a median TAT of 24.2 minutes (IQR, 18.0-34.0). The pre-implementation median TAT was 45.0 minutes (IQR, 36.0-56.0), which represents a decrease of 20.8 minutes (46.2%) following implementation of the program, (p<0.001). There were a total of 149 advanced preparation doses that were wasted (21.7% of doses).
We have seen a statistically significant reduction in TAT for Advanced Preparation medications. Low volume of Advanced Preparation medications compared to total infusion volume limited impact on overall TAT.
许多肿瘤学输液在医院输液中心进行。随着医院输液中心接待量的增加，患者等待时间仍然是一个优先事项。肿瘤学输液等待时间延长已被证明会导致患者不满。
肿瘤学输液药物的提前准备使药房能够在患者输液预约前一天核实并准备特定药物。我们的研究针对低成本、常用药物进行提前准备。分析的数据包括周转时间（TAT）、药物浪费和肿瘤学输液准备量。实施分两个阶段进行，以便医疗团队有时间适应新的工作流程。第一阶段的药物包括少量由药房技术人员手工准备的药物。第二阶段的药物包括所有第一阶段的药物以及在静脉（IV）机器人配药系统中配制的其他药物。
我们的研究表明，提前准备的药物的中位TAT显著降低。使用提前准备模块准备了537次输液，中位TAT为24.2分钟（IQR，18.0 - 34.0）。实施前的中位TAT为45.0分钟（IQR，36.0 - 56.0），这表明该计划实施后减少了20.8分钟（46.2%），（p<0.001）。总共浪费了149剂提前准备的药物（占剂量的21.7%）。
我们发现提前准备药物的TAT在统计学上有显著降低。与总输液量相比，提前准备的药物量较少，对总体TAT的影响有限。
