Aims:

The "Six Sigma" methodology is based on the analysis of workflows and the identification of areas for improvement in order to achieve maximum efficiency in industrial and healthcare processes. The aim of this study is to compare the efficiency of a "classic" chemotherapy preparation system centralised in the Pharmacy Service versus a decentralised model.

Material and methods:

Observational study in which the efficiency of the models for the preparation of chemotherapy treatments was analysed:

Classical model (MC), which has the treatment preparation cabinets and a pharmacist located in the Pharmacy Service, and from which the preparations are supplied to the Haematology Day Hospital.

Decentralised model (MD), where both the pharmacist and the medication preparation cabinets are located in the Oncology Day Hospital.

For the evaluation of the efficiency of each system, the time elapsed from the receipt of the medical order to the administration of chemotherapy (TAQ) was compared.

Results:

The TAQ following MD was less than for MC: 13.7 [5-28] minutes versus 71.0 [42-96] minutes (p<0.001) with a mean difference of 57.3 minutes/prescription. The potential time saved with the decentralised model was 40.3 hours/day.

Conclusions:

The aim of this study was to quantify and compare the efficiency of the two models for the preparation of cytostatic mixtures, showing that the classical centralised system for the preparation of medication in pharmacy services is unfavourable.

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