Combined services of a community hospital and clinic to provide antineoplastic drugs for outpatients.

An outpatient antineoplastic drug service that uses the services of a community hospital and clinic is described. The hospital pharmacy department assumed responsibility for preparing doses of antineoplastic drugs for use in a local medical clinic; previously, clinic nursing staff prepared the doses on a countertop. To provide this service, the hospital purchased a vertical laminar-flow safety cabinet, developed policies and procedures, and devised standard dilution protocols. The pharmacy maintains patient profiles for all outpatients. Each physician order is telephoned to the pharmacy from the clinic followed by delivery of the written order to the pharmacy via a courier service. After review of the written order by a pharmacist, the courier delivers the medication to the clinic. Since beginning the service December 1982, the pharmacy has prepared an average of three doses of antineoplastic drugs per day; about one hour of pharmacist time per day is devoted exclusively to this service. Revenue from the service has covered start-up costs and has generated profit. By using the combined resources of health professionals in the community, quality care is provided to outpatients receiving cancer chemotherapy.