Background Our centralised anticancer drug preparation unit is only open in the morning. Our annual production is 11 000 preparations for four different care units. Currently, chemotherapy infusions for afternoon patients are prepared in the morning and discarded if the administration is cancelled. To rationalise costs, the unit is considering the option of opening all day.
Purpose This study estimated the profitability of opening the unit in the afternoon compared with the loss related to cancellations of the preparations produced in the morning for the afternoon.
Material and methods The number of daily preparations, preparations dispensed in the afternoon and discarded preparations was recorded over a period of 3 months. The causes of the cancellations were listed. To determine the most profitable choice, we compared the cost of the discarded preparations (including active substance, packaging and the salary of the additional staff) and the cost of longer opening calculated on the basis of staff’s hourly rate. The costs of the preparation material (negligible) and the functioning costs of the unit (difficult to estimate) were not taken into account.
Results Over the studied period, 3086 preparations were produced: 10% were intended to be administered in the afternoon. 3% of the afternoon preparations were not dispensed (n=10) versus 1% in the morning. 50% of the cancelled preparations planned in the afternoon were not reusable (n=5), causing a loss of €1674. 90% (n=9) of the cancellations came from the haematology service. The reasons for cancellation were unpredictable in 70% of cases (n=7). The average number of preparations planned in the afternoon was 4.8 (extremes (0; 15)). The cost of the required time to produce these preparations per afternoon over the studied period was €6712, 4 times the current losses.
Conclusion The cost of all day opening is high because of staff requirements. Currently, it does not seem appropriate to extend opening hours. A return of the results of the study to the healthcare services is planned to raise awareness of predictable cancellations.
No conflict of interest
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