Preparation of chemotherapy drugs: Planning policy for reduced waiting times

This study investigates the impact of pharmacy policies on patient waiting time in the Chemotherapy Day Unit of the Netherlands Cancer Institute—Antoni van Leeuwenhoek hospital. The project evaluated whether a reduction in waiting time resulting from medication orders being prepared in advance of patient appointments was justified, given that medications prepared in advance are wasted when patients arrive too sick for treatment. Within this context, we derive analytic expressions to approximate patient waiting times and wastage costs, allowing management to see the tradeoff between these two metrics for different policies. Using a case study and a simulation model, the approximations are evaluated. The use of analytic expressions allows the analysis to be easily repeated when medication costs change or when new medications/protocols are introduced. In the same vein, other hospitals with different patient case mixes can easily complete the analysis in their settings. Finally, the outcome from this study resulted in a new policy at the cancer center which is expected to decrease the waiting time by half, while only increasing pharmacy's costs by 1–2%.

► Chemotherapy medications are expensive, time consuming to prepare, and have a limited shelf life.
► Preparing medicines in advance decreases patient waiting times at the risk of wasting medications.
► The described model evaluates the tradeoff between waiting and costs for a variety of policies.
► The approach used to design a new policy for the collaborating pharmacy is described in detail.
► The analytic approach is readily repeatable as medications change and in other hospital setting.