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DD-021 Medicine supply chain of a central pharmacy: Risk mapping of shortage
  1. F Charra,
  2. A Dubromel,
  3. X Bourge,
  4. A Meunier,
  5. F Locher,
  6. L Derain
  1. Hospices Civils de Lyon, Pharmacie Centrale, Lyon, France

Abstract

Background The central pharmacy (CP) of the university hospital is in charge of providing drugs for 5500 beds in 5 hospital sites. The supply chain was identified as a critical point in patient care; indeed supply failure could lead to treatment interruption.

Complying with the certification process of health institutions lead by the French Health Authority, we established a quality management policy on supply chain in order to avoid drug shortages.

Purpose We built risk mapping to prioritise preventive actions in the supply chain to ensure a better continuity of patient care. This analysis range was from supply order to drug storage in the CP.

Material and methods We used a failure modes and effects analysis method to identify causes leading to risk of supply disruption.

We quoted frequency and severity for each risk to determinate the gross criticality. Frequency was determined by error history analysis:

  • 1=once a year or less;

  • 3=several times a year;

  • 5=several times a month;

  • 10=several times a week.

Concerning severity, we based it on patient issues:

  • 1=acceptable;

  • 3=to monitor;

  • 10=unacceptable.

We identified the mastered level of control to determinate the net criticality:

  • 1=excellent, knowledge of a written procedures, applied and regularly assessed;

  • 3=satisfactory, application of written procedures;

  • 5=low, non-existent or not applied procedures, depends on the operator, not secured;

  • 10=insufficient, non-existent procedures.

Each risk quoted over 100 was identified as prioritised actions.

Results We identified 15 risks and 28 causes. 5 causes were prioritised to work (table 1).

View this table:
Abstract DD-021 Table 1

Conclusion The weak points identified on our supply chain led to a review of the order process and training to improve patient care. The next step will be to extend it to the delivery of the pharmacy of the 5 hospital sites supplied and consider the financial and juridical aspects of each risk.

References and/or Acknowledgements 1 Le compte qualité. HAS, 2014

No conflict of interest.

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