Authors (including presenting author) :
Woo ASN (1), Tong TKS (1), Wong HSY (1)
Affiliation :
(1)Department of Pharmacy, Queen Mary Hospital
Introduction :
Waiting time for chemotherapy day case for all Oncology patients in HKWC on average may take 1 to 2 hours before receiving the first drug of their chemotherapy protocol. The duration of their stay at the Chemotherapy Day Centre could vary from 3 to 6 hours from the time of registration, depending on the number of drug items for infusion.
Objectives :
(1). To shorten patients’ waiting time by reducing sub-optimal idle time.
(2). To ensure cytotoxic drug is prepared accurately and efficiently and keeping in time to use before its short expiry.
Methodology :
(1). Chemotherapies under Advance Preparation (AP) scheme were prepared in two batches: Last batch of previous day & First batch on the day of chemotherapy, to start infusion for patients as early as possible and hence reduce the waiting time for the first infusion.
(2). “First in, first out” mechanism of drug preparation for all Chemotherapy Day Centre patients by denotation of “preparation time” for every drug on labels & worksheet.
(3). New Queue Management System to electronically store and gather information on the waiting time per patient and per drug was implemented. Dashboard was available to display every patient’s waiting time for chemotherapies since receiving the protocol for monitoring purpose.
Result & Outcome :
The AP scheme has successfully reduced the average waiting time by 1.5 hours, benefiting 10% of total patients daily. Waiting time for the first cytotoxic drug for AP patients was improved for approximately 45mins as AP drugs are now ready at 9:15am, and can fully utilize the timeslots available for chemotherapy administration during early morning session. Since each chemotherapy protocol was stapled with patient’s ticket number and preparation time was denoted on every worksheet and label, the target for “First in, first out” was achieved. Time tracking of every patient and product has enabled us to easily identify which drug has been lagging behind or has been taking an unusually long preparation time, where an immediate action can be done to resolve any problems which can cause the delay.
The measures of AP scheme and New Queue Management system have greatly reduced the waiting time for an increasing number of patients in the Chemotherapy Day Centre.
