How oncology automation can streamline workflow from prescription to administration

Anyone leading a healthcare organisation is constantly working to balance the cost/benefit equation to ensure that the maximum number of patients can be safely treated with the best results in the most cost-effective way.

This is brought into particularly sharp focus in oncology, where rising budgets cannot keep pace with increasing demand, and there is constant pressure to do more with limited resources.^1,2,3

BD has solutions to address these challenges. They involve the move away from manual processes to a more automated workflow within the oncology pathway.

Issues caused by manual processes

Manual workflow processes can be time consuming and inefficient. Many healthcare organisations still use paper files for the recording and transfer of patient data between departments, which are at risk of being misplaced or misread, whilst information relayed during phone calls can be easily misinterpreted or forgotten. Manual checks and calculations are prone to human error, especially in busy departments where staff are already over-stretched and working to their limits, which can compromise patient safety.

Here, we will discuss how moving away from manual processes to a more automated workflow can help oncologists, pharmacists, technicians and nurses minimise safety failures, reduce drug waste, and increase efficiency within the oncology pathway, unlocking capacity to treat more patients.

Improve patient safety

Manual compounding using a volumetric checking process within pharmacy is not only prone to errors, but many errors can go undetected and end up reaching the patient.

BD Cato™ is an automated* integrated intravenous medication workflow software system that provides support throughout all stages of the oncology pathway, from prescribing through to compounding and administration. During compounding, it provides step-by-step instructions to guide the user through the process, and combined with barcode scanners, gravimetric scales and cameras, helps ensure the correct preparation of a drug.

Not only does BD Cato™ remove the requirement for in-process manual second checks, but it also detects errors during compounding that a manual checking process would not. This was demonstrated by a study across 10 hospitals in Europe that reported the gravimetric workflow software system detected 59,890 errors that could have caused critical therapy implications – that’s 7.89% of the 759,060 doses analyzed – and concluded these errors were unlikely to have been detected using a manual compounding process alone4 . Not only is this concerning with regards to patient safety, but there would also be cost implications associated with having to manage the potential harm caused by these errors.

Improve inventory management and reduce medication waste

BD Cato™ can help to deliver comprehensive inventory and dispensing management, such as by providing oversight of when stock runs low or is nearing the end of its shelf life. This can help prevent stock-outs, which could otherwise have had an impact on the treatment success of a patient. Effective inventory management to prevent stock expiring can also help reduce drug wastage, and therefore drug expenditure.

The quantity of unused drug remaining in a vial after compounding and its stability date can be tracked using BD Cato™ and returned to inventory. The system will then suggest the use of this vial the next time the drug requires compounding, helping to ensure part-used vials are used up first, resulting in less drug waste. Over time, BD Cato™ can be used to analyse stock usage and establish the most appropriate vial sizes to order to ensure you are choosing the right sizes for your needs. This can help reduce waste and therefore save money, freeing up budget to be used elsewhere.

Streamline workflows and free up staff time

BD Cato™ ensures a streamlined workflow for oncologist, pharmacists, technicians and nurses. Examples of how this is achieved include: electronic prescribing using pre-defined drug and dosage protocols, automatic dose calculations, alerts if the oncologist tries to prescribe a dosage outside of the recommended dose limits, elimination of handwritten prescriptions or therapy plans, electronic prescriptions being sent automatically from the oncologist to the pharmacist when complete, automatic workload prioritisation within the aseptic lab based on the oncology day unit schedule, and a barcoding system to help ensure the right drug is given to the right patient.

Identifying and correcting errors at the point they occur within the oncology process is a crucial step in improving efficiency, and using automation to do this negates the requirement for manual, in-process checks. A study conducted in an oncology ambulatory care pharmacy demonstrated the impact of BD Cato™ on efficiency - it reported a reduced mean technician preparation time of 34% and reduced mean pharmacist checking time of 37%⁵. The study concluded this was due to identifying errors at the point they occurred.

Preventing errors from occurring in the first place can also improve the efficiency of the oncology pathway. One study showed that BD Cato™ Prescibe** reduced prescribing errors by 53% compared to manual paper-based prescribing⁶.

BD Cato™ transforms a paper-based workflow system to an electronic one. This helps minimise miscommunication, reduces errors, and eliminates many resource-intensive tasks, all of which can help improve efficiently and consequently free up staff time. This was demonstrated by a study in a hospital oncology day unit that showed after the implementation of BD Cato™ ReadyMed - a handheld barcode scanner used by nurses during the drug administration process - 3 hours and 24 minutes of nursing time was saved daily⁷.

A further study showed that by combining BD’s whole-pathway solutions, which comprised BD Cato™, BD MicroBore Secondary Set and BD PhaSeal™ Closed-System Transfer Device, a saving of up to 39% of clinical time could be made⁸. This means staff can be redeployed to do other patient-facing or value-added tasks elsewhere. Capacity is unlocked and so more patients can be treated with the same resources.

In summary

Automation that covers the whole oncology pathway brings benefits that can maximise the investment in oncology care. Specifically, it can help to:

• Optimise communication between oncologists, pharmacists, technicians and nurses
• Optimise the efficiency and safety of the prescribing process through pre-built protocols, dose calculations and test result integration.
• Ensure workflow efficiency by streamlining the compounding process and reducing pharmacist checking time.
• Enhance patient safety by reducing errors along the patient care pathway, identifying errors at the point they occur and negating the requirement for manual, in-process checks.
• Potentially increase hospital capacity as a result of time saved throughout the pathway, and a reduction in time spent in hospital by patients due to more efficiency and fewer errors.
• Reduce drug waste through effective inventory management which, in turn, saves money.
• Reduce time and resources required for filing and archiving, as all documentation is stored electronically.

With BD, you can meet the demand to prepare more drugs and treat more patients. You create a better environment in which staff delivering cancer treatments can perform efficiently, effectively and most important of all, safely

Unmistakably BD Oncology.

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