Background The Capital Region Hospital pharmacy prepares more than 90,000 bags of cytotoxic treatments a year. There has been no tradition in the pharmacy of systematically monitoring essential parameters in the productions units. Because of an increasing need for treatments on the wards, the delivery time for cytotoxics went up to 5 hours, resulting in complaints from patients. The number of products that were rejected was very high. In 2010, the cost of rejected products was more than €200,000. Analysing and addressing root causes when nonconformities arose could take up to one year.

Purpose To reduce production time and make it more stable while improving quality and reducing costs.

Materials and Methods Three Key Performance Indicators (KPIs) were introduced: Delivery, Rejects and GMP non-conformities, in order to ensure a stable, short production time and a constant focus on cost and product quality. The three KPIs are continuously monitored and posted on boards in the production area. The KPIs are discussed with the staff in weekly meetings.

Results Overall delivery time has been reduced. 75% of patients are now waiting less than 1½ hours and 90% of the pre-ordered treatments are delivered on time.

1. The number and types of rejects are now known. The goal is to reduce the value of rejects by 15% in 2012.

2. Processing time for non-conformities is now a maximum of 21 days.

Conclusions By defining the relevant KPIs, and having an on-going dialogue with employees about the KPIs, it has been possible to significantly increase awareness among the employees of the overall performance of the production process. The increased awareness has resulted in a significantly improved performance that provides value for our patients.

No conflict of interest.