Personnel costs and preparation time in a centralized intravenous admixture program

Ryan, Dee M.; Daniels, Charles E.; Somani, Shabir M.

doi:10.1093/ajhp/43.5.1222

Cited by 4 publications

(5 citation statements)

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“…Many studies have implemented pharmacy process improvements in order to reduce costs associated with sterile products compounding. [15][16][17][18][19] These new processes led to decreases in both personnel and product costs that stemmed from compounding doses that were modified or discontinued by the provider during preparation. With a V2B point-of-care activation system, medications can be prepared closer to the time of administration, decreasing unnecessary compounding labor and materials, and allowing for unused drugs to be returned to the pharmacy or ADS.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Cost, Workflow, and Safety of Implementing a Vial Transfer Device for Ready-to-Mix Drugs at an Academic Medical Center

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Anger

Dell’Orfano

et al. 2020

Journal of Pharmacy Practice

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Objective: To evaluate the cost, workflow, and safety of implementing a vial transfer device system. Methods: In this retrospective analysis, pharmacy systems and electronic health record reports identified high-volume and high-cost medications prepared by a Vial2Bag® (V2B) system from July 2017 to June 2018. The major outcome was the extrapolated yearly cost avoidance (EYCA) from utilization of a V2B system, calculated by subtracting total costs of the V2B system from total cost of ready-to-use products and locally compounded sterile products. Secondary outcomes included a workflow and safety analysis. Results: Implementing a V2B system led to a total EYCA of $2 295 261. A total of 283 209 potential V2B units were available for dispensing from automated dispensing systems and 41 082 yearly sterile product room units were avoided. A 0.02% safety report incidence per V2B administration was calculated at our institution. Conclusion: Use of a V2B system resulted in a substantial cost avoidance compared to purchasing commercial products and preparing locally compounded sterile products. The V2B system appears to be a safe addition to further optimize workflow but may require further investigation in prospective analyses.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Cost, Workflow, and Safety of Implementing a Vial Transfer Device for Ready-to-Mix Drugs at an Academic Medical Center

Tran

Anger

Dell’Orfano

et al. 2020

Journal of Pharmacy Practice

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“…Several authors have examined the cost-effectiveness of various sterile product procurement and preparation techniques. 3–6 It is important for each individual institution to carefully evaluate the cost of its contracted products, the volume and mix of products, and the cost of labor, waste, and other factors. Pharmacy technicians at this institution were very interested in purchasing more premade products.…”

Section: Discussionmentioning

confidence: 99%

Use of Lean Production to Reduce Waste When Compounding Sterile Pharmaceutical Products

Davis

2009

Hosp Pharm

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Purpose The effects of a 5-batch-per-day schedule for sterile product compounding in an inpatient hospital pharmacy were studied. Summary Using lean production concepts, an interdisciplinary team implemented a system to standardize delivery locations and improve just-in-time delivery for sterile medication products in an inpatient hospital setting. The primary focus of the team was transforming the current sterile medication preparation process from a 2– to a 5–batch-per-day system. Conclusion Increasing the frequency of sterile product batches from 2 to 5 batches per day reduced rework and waste by 64%. A true just-in-time process for sterile medication compounding has the potential to be safer and more efficient than traditional batch systems. Additional work is needed to determine if a true just-in-time sterile medication compounding process is feasible in an inpatient hospital setting.

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“…Many studies were conducted of alternatives that might reduce the waste of sterile compounded products and doses. [2][3][4][5] A review of the current literature 3,[6][7][8][9][10] suggests that the well-established practice of lean intravenous (IV) methodology had a positive effect on pharmacy efficiency as well as the cost of operations. 3 The practice of lean IV preparation methods involves making batches of IV medications more frequently throughout the day, with less medications being prepared in each respective batch.…”

Section: Problemmentioning

confidence: 99%

Impact of Sterile Compounding Batch Frequency on Pharmaceutical Waste

Abbasi

2017

Hosp Pharm

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PROBLEMMultiple inpatient sterile compounded doses are prepared in "batches" in the majority of hospitals across the United States and the world.1 This is a process in which doses that are due at a given administration timeframe are prepared upfront in central or satellite institutional pharmacies to maximize operational and workflow efficiencies. The preparation of patient-specific sterile compounds is a time-consuming process that requires a great deal of attention to avoid any errors being introduced. The "batching" method is a prospective approach, where a hospital pharmacy produces several batches of medications that are tailored to the patients receiving them. There is normally a gap of several hours (or more) between the time of preparation and that of administration. During this gap, several variables can alter the intended use of dispensed medications. For example, doses might be discontinued or modified, patients might be transferred or discharged, or doses might be misplaced in the health care system requiring reproduction. These variables contribute to compounded sterile products (CSPs) being unused and eventually wasted, which costs the health care system unretrievable expenses.2 In many cases, the unused medications cannot be repurposed to other patients due to very specific dosing criteria (eg, weight-based doses) or beyond-use dating (BUD) issues. To minimize waste, an optimal balance between timely sterile compounded preparation (frequency) and personnel workload is necessary. Many studies were conducted of alternatives that might reduce the waste of sterile compounded products and doses.2-5 A review of the current literature 3,[6][7][8][9][10] suggests that the well-established practice of lean intravenous (IV) methodology had a positive effect on pharmacy efficiency as ABSTRACT Purpose: To measure the impact of increasing sterile compounding batch frequency on pharmaceutical waste as it relates to cost and quantity. Methods: Pharmaceutical IV waste at a tertiary care hospital was observed and recorded for 7 days. The batching frequency of compounded sterile products (CSPs) was then increased from twice daily to 4 times daily. After a washout period, pharmaceutical IV waste was then recorded for another 7 days. The quantity of units wasted and the cost were compared between both phases to determine the impact that batching frequency has on IV waste, specifically among high-and low-cost drugs. Results: Patient days increased from 2,459 during phase 1 to 2,617 during phase 2. The total number of CSPs wasted decreased from 3.6 to 2.7 doses per 100 patient days.

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Personnel costs and preparation time in a centralized intravenous admixture program

Cited by 4 publications

References 0 publications

Evaluation of Cost, Workflow, and Safety of Implementing a Vial Transfer Device for Ready-to-Mix Drugs at an Academic Medical Center

Evaluation of Cost, Workflow, and Safety of Implementing a Vial Transfer Device for Ready-to-Mix Drugs at an Academic Medical Center

Use of Lean Production to Reduce Waste When Compounding Sterile Pharmaceutical Products

Impact of Sterile Compounding Batch Frequency on Pharmaceutical Waste

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