Category: Professional Posters
Purpose: Automation technology has been integrated into the sterile products operations at Yale-New Haven Hospital since the mid-2000s. Most recently, an IV robotic system used in chemotherapy compounding was implemented and integrated into the oncology pharmacy workflow. This poster evaluates the impact of the productivity, accuracy, and safety of sterile IV chemotherapy compounding by implementing robotic technology at a large academic medical center.
Methods: An IV robotic system was implemented into the oncology pharmacy operations including integration with the existing IV workflow and electronic medical record systems. The robotic system has the capability to produce both patient-specific and batched compounds.
Chemotherapy sterile compounding data was analyzed over an eight month period and comparisons were drawn between the two primary IV automation technologies utilized: IV workflow systems and IV robotics. The analysis included differences in accuracy and compounding turnaround time. Through an initial analysis, process-improvement strategies were identified and implemented resulting in improved productivity of IV robot and cleanroom workflow. In addition, regular air and surface environmental sampling were conducted and monitored to evaluate the self-cleaning feature of the specific IV robotic technology. Implementation also included training and education for pharmacists, pharmacy technicians, and nursing staff throughout the process.
Results: Over an eight month period, a total of 52, 858 IV chemotherapy doses were compounded within the oncology pharmacy. On average the IV robotic system was capable of compounding 5-6 doses per hour. Through data analysis, workflow and staffing changes, the robot was able to compound up to 22.4% of the daily volume with a daily record of 80 doses. The average compounding error rate of the IV robotic and workflow systems was 1.11% and 2.98%, respectively. In comparison, a study by Flynn et al (1997) found a mean error rate of 9% for manual compounding.
The specific robot product features an automatic cleaning cycle supplemented with targeted manual cleaning. During this time period there was no growth found inside the robot during scheduled 6 month re-certifications.
Conclusion: Utilization of an IV robotic system increases patient safety through enhanced accuracy and productivity. Robotic compounding significantly reduces compounding error rates when compared to IV workflow systems and manual IV compounding. Data analysis, workflow and staffing changes are important considerations in maximizing the productivity of the IV robotic system. Additional benefits of the robot include reduced chemotherapy waste and reduction in hazardous drug exposure which is consistent with the goals of USP 800.