Lack of an onsite pharmacy in the day oncology hospital provides challenges to the provision of clinical pharmacy services, including limited workspace, reliance on email, or other indirect communication, and limited direct patient contact.
To improve the clinical pharmacy service within a metropolitan day oncology hospital in the absence of an onsite pharmacy.
An on-site Day Unit Pharmacist (DUP) role was implemented to provide in-depth patient education, Medication Management Plan (MMP) completion and discharge medication record (DMR) provision for all patients receiving new cancer treatment. Workspace was created using a mobile workstation on wheels. A Clinical Lead Pharmacist role was also introduced to provide clinical leadership and support communication to the multidisciplinary team within the day hospital. Key performance indicators (KPIs) were identified with a target MMP and DMR completion rate of 90% of all new cancer treatments (excluding oral therapies). KPI data was collected using an electronic prescribing system between May and July 2017. A written questionnaire was conducted for nursing, administration and medical staff to evaluate pharmacy service changes. These questions specifically addressed efficiency, communication and the respondent’s perception of service quality.
Excluding oral therapies, there were 217 new cancer treatments administered in the day oncology hospital. MMPs and DMRs were completed in 81% and 66% of new cancer treatments respectively, falling short of initial KPI targets. Questionnaire respondents reported an improvement in pharmacy service efficiency (91%), communication (91%) and overall quality (95%) above the baseline service prior to implementation.
The implementation of two clinical pharmacist roles, mobile workspace and the introduction of KPIs related to MMP and DMR provision have all assisted in improving clinical pharmacy service provision to the day hospital in the absence of an on-site pharmacy.