Improving Waiting Time for Chemotherapy with Ahead-of-Time Drug Preparation.

Waiting time for chemotherapy infusion is a fundamental factor to measure quality of care. It has been shown that a prolonged waiting time is related to a higher incidence of anticipatory nausea and poor patient adherence to scheduled appointments and recommended oncology treatment programs. Some chemotherapy regimens can be prepared hours ahead-of-time, due to long stability. We aimed to study the effect of an informatic-led workflow redesign intervention, facilitating workflow changes in the Oncology Pharmacy, on patient waiting time. This intervention included changes on EHR processes and the chemotherapy CPOE. Their main effect was allowing ahead-of-time preparation of selected chemotherapy regimes. We conducted a cross sectional study, comparing waiting times pre and post intervention periods. A total of 4600 programmed chemotherapy episodes were included. We found a 26.5 % decrease in the mean wait time in the post intervention period (p > 0.02). We were able to show a decrease in waiting time and a measurable impact of the intervention. This evaluation produced valuable and actionable data for Oncology units and adds a valuable, Latin American experience to the literature.

Semi-Structured Interviews to Evaluate a BCMA Implementation Trouble Areas.

Errors in medication administration involve risks to patient safety. "Bar-Coding Medication Administration" is implemented to prevent these errors. Adoption by nurses is one of the main determinants of their effectiveness. The Hospital Italiano de Buenos Aires implemented BCMA 6 years ago, but its adoption rate still finds resistance in certain sectors. We conducted semi-structured interviews with nursing staff to explore the barriers to the use in low-usage wards and explore the current perceptions of nurses. While nurses recognised the safety and usefulness of the BCMA system, they reported many difficulties. The feedback obtained through this process was useful for the implementation team to plan future interventions, priorities and improvements on the system. The semi-structured interview methodology proved useful as a continuous monitoring strategy.