To investigate safety, time, and cost-saving benefits of implementing remote pharmacist verification of cancer medicine prescriptions within a day oncology hospital.
Following implementation of electronic prescribing technology, remote pharmacist verification was identified as a method of increasing clinical support to regional and metropolitan hospitals.
A pre-implementation risk assessment graded risks on the severity of impact and likelihood of occurrence. Medication incidents resulting from insufficient clinical handover or absence of electronic medical records were the most significant risks prompting intervention. A procedure was written and staff were validated for competency using in-house assessments. Remote verification occurred when clinical workloads exceeded staffing levels. The primary and secondary outcomes were to determine 1) safety and viability of remote verification and 2) cost-saving benefits of using existing staff versus employing additional staff. The analysis took place over eight weeks and data collected included: number of prescriptions, time taken, issues referred to the site pharmacist and medication incidents recorded in Riskman. Cost-saving benefits were determined by comparing time taken to verify prescriptions remotely versus costs of associated with pharmacist overtime.
Median number of prescriptions remotely verified per week was 38. Median time taken to remotely verify a chemotherapy prescription was 4 minutes versus 3.5 minutes when conducted at the site. The most frequent issues referred to site pharmacists were: outdated patient weight (35%), laboratory monitoring (13%) and new patients or treatments requiring pharmacist counselling (11%). No medication incidents related to remote verification were recorded in Riskman during the pilot. Despite increased time taken, remote verification saved a median of 2.5 additional onsite pharmacist hours per week.
Electronic prescribing technology has enabled remote verification of cancer medicine prescriptions. Implementation of this practice had no adverse impact on medication safety and enables greater support and cost-savings across a hospital network.