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 Netherland Cancer Institute - Antoni van Leeuwenhoek hospital (NKI-AVL). 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 risked being wasted if patients arrived too sick for treatment. Within this context, we derive explicit 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 explicit expressions allow 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 setting. Finally, the outcome from this study resulted in a new policy at the cancer centre which is expected to decrease the waiting time by half while only increasing pharmacy’s costs by 1-2%.