Background Today, cancer is mostly managed in outpatient clinics. Quality and optimisation of this management have become a daily issue in oncology and pharmaceutics departments. In 2012, Argenteuil Hospital looked after 748 patients in outpatient clinics, providing 5926 chemotherapy sessions. The chemotherapy preparation is extemporaneously centralised at the Pharmacy. A change of practice is being considered, either by preparing some of the chemotherapy treatments in advance or by preparing dose-banded chemotherapy.
Purpose To audit an oncology outpatient clinic by charting the patient treatment process.
Materials and methods A schedule of the chemotherapy process has been established. 6 steps have been defined and timed: patient welcome (step 1), medical prescriber interview (step 2), nurse interview (step 3), chemotherapy delivery to the department (step 4), administration (step 5) and patient release (step 6). The analysis was performed over one week on a sample of 85 patients. A diagnostic tool was used for data analysis.
Results Results are expressed in average times by steps and days on graphs. While the patient is in hospital, 47% of the time is dedicated to chemotherapy administration itself. The average time taken between prescription and delivery to the department is 41 min. This audit has underlined both dysfunctional and positive aspects of the treatment process. The waiting time before nurse care differs over the day and is one of the points requiring reorganisation. A considerable delay has been pointed out for patients who did not have a biological check-up the day before. Indeed, patient care involvement is a major part of proposed ways to improve.
Conclusions This audit gives us a global view of the patient treatment process concerning chemotherapy in an outpatient clinic. Adjustments have been made and this evaluation process should be used again to measure their efficiency.
No conflict of interest.
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