title: ReCAP: Comparison of Independent Error Checks for Oral Versus Intravenous Chemotherapy.
abstract: OBJECTIVE
  Intravenous (IV) chemotherapy is routinely delivered to patients in hospital settings, where safeguards such as independent checks and guidelines govern their administration. In contrast, oral chemotherapy, which is typically ordered in a cancer center but dispensed and administered in the community and home, respectively, is subject to fewer controls. Research in the United States has found that few safeguards in routine use for IV chemotherapy have been adopted for oral chemotherapy; however, less is known about the Canadian context. The objective of this study was to determine whether similar safeguards, in the form of independent checks, existed to identify potential errors related to both formulations.
  
  
  METHODS
  Human factors specialists conducted observations and interviews in cancer center clinics, a cancer center pharmacy, and four community pharmacies across Nova Scotia. Processes were analyzed to determine if an independent check was performed, which qualified provider completed the check, and at what point of the process the check occurred.
  
  
  RESULTS
  A total of 57 systematic checks were identified for IV chemotherapy, whereas only six systematic checks were identified for oral chemotherapy. Community pharmacists were the only qualified professionals involved in independent systematic checking of oral chemotherapy, which occurred during ordering and dispensing.
  
  
  CONCLUSIONS
  There is an enormous opportunity for pharmacists and other qualified professionals to take on an expanded role in improving patient safety for oral chemotherapy. Greater involvement of pharmacists, in both the clinic environment and the community, would facilitate increased systematic checking, which could improve patient safety related to oral chemotherapy.
authors.affiliation: HumanEra, University Health Network; Institute of Biomaterials and Biomedical Engineering, University of Toronto; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Cancer Care Nova Scotia; Capital District Health Authority; and School of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada melissa.griffin@uhn.ca.
authors.forename: Melissa C
authors.initials: MC
authors.lastname: Griffin
authors.affiliation: HumanEra, University Health Network; Institute of Biomaterials and Biomedical Engineering, University of Toronto; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Cancer Care Nova Scotia; Capital District Health Authority; and School of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Gilbert
authors.affiliation: HumanEra, University Health Network; Institute of Biomaterials and Biomedical Engineering, University of Toronto; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Cancer Care Nova Scotia; Capital District Health Authority; and School of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Larry H
authors.initials: LH
authors.lastname: Broadfield
authors.affiliation: HumanEra, University Health Network; Institute of Biomaterials and Biomedical Engineering, University of Toronto; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Cancer Care Nova Scotia; Capital District Health Authority; and School of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Easty
authors.affiliation: HumanEra, University Health Network; Institute of Biomaterials and Biomedical Engineering, University of Toronto; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Cancer Care Nova Scotia; Capital District Health Authority; and School of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Trbovich
authors.affiliation: HumanEra, University Health Network; Institute of Biomaterials and Biomedical Engineering, University of Toronto; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Cancer Care Nova Scotia; Capital District Health Authority; and School of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada melissa.griffin@uhn.ca.
authors.forename: Melissa C
authors.initials: MC
authors.lastname: Griffin
authors.affiliation: HumanEra, University Health Network; Institute of Biomaterials and Biomedical Engineering, University of Toronto; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Cancer Care Nova Scotia; Capital District Health Authority; and School of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Gilbert
authors.affiliation: HumanEra, University Health Network; Institute of Biomaterials and Biomedical Engineering, University of Toronto; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Cancer Care Nova Scotia; Capital District Health Authority; and School of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Larry H
authors.initials: LH
authors.lastname: Broadfield
authors.affiliation: HumanEra, University Health Network; Institute of Biomaterials and Biomedical Engineering, University of Toronto; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Cancer Care Nova Scotia; Capital District Health Authority; and School of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Easty
authors.affiliation: HumanEra, University Health Network; Institute of Biomaterials and Biomedical Engineering, University of Toronto; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Cancer Care Nova Scotia; Capital District Health Authority; and School of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Trbovich
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D002173:Cancer Care Facilities / Q000592:standards; D057189:Checklist; D003157:Community Pharmacy Services / Q000592:standards; D011307:Drug Prescriptions / Q000592:standards; D006801:Humans; D008508:Medication Errors; D009674:Nova Scotia; D010595:Pharmacists / Q000592:standards
chemical_list: D000970:Antineoplastic Agents