Risk reduction in a cancer chemotherapy production unit: Contribution of an automated drug dispensing system

Abstract

Objective The purpose of our study was to evaluate the contribution of an automated drug dispensing system in securing cancer chemotherapy production process at the pharmacy of the National Institute of Oncology in Rabat. Methods The failure modes and effects analysis method was applied to the chemotherapy production process in two phases: Phase 1, using an open shelf for storage then phase 2, using an automated drug dispensing system. The failure modes were defined and their criticality indexes was calculated on the basis of the likelihood of occurrence, the potential severity for the patients and/or the impact on the process and the detection probability. The criticality indexes of the two phases were prioritized and compared. Results We identified 35 failure modes for phase 1 and 37 for phase 2. The sum of criticality indexes was 5957 and 4586, respectively, for phase 1 and phase 2, corresponding to a criticality reduction of −23%. The greatest improvements concerned that the needed drug is missing during the picking, storage of potential expired drugs, and double compounding. Conclusion Our study highlighted the contribution of automated drug dispensing system in risk minimization. The use of automated drug dispensing system is a part of security improvement in chemotherapy production unit.

Risk assessment on drug production safety based on Grey-Analytic Network Process

“…Lorely et al (Mila et al, 2010(Mila et al, , 2012 used a risk analysis methodology, failure mode effects analysis (FMEA), as a quality risk assessment and control tool for the vaccine production process to perform risk assessment of the entire production process of hepatitis B vaccine. Jean-Marie et al (Ouedraogo et al, 2021) also applied FMEA as a risk assessment tool for the production of cancer chemotherapy drugs and concluded that automated dispensing systems can minimize production risks. Laure et al (Pujol et al, 2013) combined quantitative microbial risk assessment techniques and risk management indicators to evaluate and control the high-temperature transient sterilization process in pharmaceutical production.…”

“…Failure mode effects analysis (Mila et al, 2010(Mila et al, , 2012Ouedraogo et al, 2021) The quantitative method has the advantage of higher accuracy compared to the qualitative method, but does not take into account the interaction between risk factors and is difficult to obtain data information…”

Plan d’urgence sanitaire appliqué à une pharmacie hospitalière durant la pandémie COVID-19 : le retour d’expérience de l’Institut national d’oncologie marocain

“…Nombreux sont les établissements hospitaliers ayant augmenté le nombre d’APS au cours de la pandémie COVID-19 [22] . En plus de limiter les risques d’erreurs médicamenteuses et de réduire les coûts [23] , [24] , les APS permettent un suivi en ligne des consommations des services de soins. Un rapport d’activité est généré en fin de chaque journée de travail ouvrable au niveau de la PC, récapitulant les consommations de chaque service.…”

Application of the Failure Mode and Effects Analysis (FMEA) to identify vulnerabilities and opportunities for improvement prior to implementing a computerized prescription order entry (CPOE) system in a university hospital oncology clinic

“…It has been proven effective many times for safety risk management in chemotherapy care. 18,20,21 Our group recently developed a CPOE software called ONCO-Expert that also fulfills the following purposes: collect patient data in real time, monitor the chemotherapy prescription and perform research activities. This software leverages assets from the platform we have been using for antimicrobial stewardship since 2010.…”