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Implementation of a new health information technology for the management of cancer chemotherapies
  1. Olivier Vosters1,
  2. Youssef Jaadar1,
  3. Laure-Anne Vidts1,
  4. Anne Demols2,
  5. Sophie Lorent1,
  6. Viviane Liévin1,
  7. Marc Demoulin1
  1. 1 Department of Pharmacy, Erasme Hospital, 808 Route de Lennik, Brussels, Belgium
  2. 2 Department of Gastro-enterology, Erasme Hospital, 808 Route de Lennik, Brussels, Belgium
  1. Correspondence to Youssef Jaadar, Department of Pharmacy, Erasme Hospital, 808 Route de Lennik, B-1070 Brussels, Belgium; youssef.jaadar{at}erasme.ulb.ac.be

Abstract

Background Cancer chemotherapy drugs are classified as high-risk molecules. Safety of the cancer chemotherapy process is often achieved with the implementation of a health information technology to each step or to the entire process. However, computerisation could lead to the emergence of new unintended medication errors. The aim of the study was to evaluate the impact of new software designed for the management of anticancer chemotherapies.

Method The cartography of the process and the failure modes, effects and criticality analysis were performed by a multidisciplinary team. Criticality indexes were calculated considering or not the implementation of the commercial software (CytoWeb). Quality and satisfactory indicators were measured before the implementation and during the use of the software.

Results Our results demonstrated the complexity of the cancer chemotherapy process in the hospital. Risk analysis highlighted the positive impact of CytoWeb on the process safety but pointed out some steps that were not positively influenced by the software. Although a decrease of 38.6% of error rate was observed with the electronic system, new unintended medication errors emerged. These errors were due to inadequate use of the software (encoding of the wrong drug, the wrong dose, the wrong patient parameters or lab results and lack of prescriber adherence). Our satisfaction survey showed that the hospital pharmacists and doctors were less satisfied by the software than the nurses, mostly in terms of task achievement and time saving. Survey’s results highlighted some weaknesses in the user training and in the collaboration between the medical staff.

Conclusions Our work showed the emergence of unintended medication errors linked to computerisation that were due to an inadequate use of the software. Other issues were highlighted such as the lack of collaboration between the medical staff, the lack of prescriber implication and weaknesses in the user training or in the information related to CytoWeb.

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