title: No time to waste: decreasing patient wait times for chemotherapy administration using automated prioritization in an oncology pharmacy system.
abstract: OBJECTIVE
  To implement an automated pharmacy dispensing prioritization system and to evaluate its effect on the timing of dispensing and administration of chemotherapy.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  An automated intervention for synchronizing chemotherapy preparation with anticipated times for administration was associated with significant reduction in wait times.
authors.affiliation: Center for Innovation in Quality Patient Care, John Hopkins University School of Medicine, Baltimore, MD 21287-0765, USA. habouma1@jhmi.edu
authors.forename: Hanan J
authors.initials: HJ
authors.lastname: Aboumater
authors.forename: Laura E
authors.initials: LE
authors.lastname: Winner
authors.forename: Richard O
authors.initials: RO
authors.lastname: Davis
authors.forename: Peter B
authors.initials: PB
authors.lastname: Trovitch
authors.forename: Maureen M
authors.initials: MM
authors.lastname: Berg
authors.forename: Katherina M
authors.initials: KM
authors.lastname: Violette
authors.forename: Wells A
authors.initials: WA
authors.lastname: Messersmith
authors.forename: Karen K
authors.initials: KK
authors.lastname: Maylor
authors.forename: Christoph U
authors.initials: CU
authors.lastname: Lehmann
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001071:Appointments and Schedules; D002173:Cancer Care Facilities; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D010607:Pharmacy Service, Hospital
chemical_list: D000970:Antineoplastic Agents