Author(s)

Chiara Cardinali, Massimo Fioretti, Carlo Polidori

Why was it done?

In some realities, recent laws allow the administration of hospital medications in outpatients setting by defining two dedicated paths: protected discharge and taking charge directly on the territory. This therapeutic approach is made possible by the collaboration between the clinicians and the community doctors.
The project aims to examine the continuity of pharmaceutical care in our reality taking into account some clinical outcomes, management implications as well as economic aspects.

What was done?

The Pharmacy Unit analysed all documentation, including prescriptions, from 2022 to the beninning of 2025, aiming to assess safety and adherence outcomes.

How was it done?

A written survey was conducted among community doctors and clinicians in order to evaluate their level of knowledge of the law and to collect their feedback.
Analysis of the 2023 final balance sheet enabled us to make some economic considerations.
Finally, we interviewed home nurses to find out their perception of risk related to the administration of hospital medications in outpatients setting.

What has been achieved?

There were 45 total runs, and the Infectious Diseases Unit was the most active department; consistently,77% of prescriptions included antimicrobials. None of the 140 pharmacovigilance reports was related to this pharmaceutical approach.
51 doctors completed the survey: among them, only 24 doctors were familiar with this law. Both community doctors and clinicians claim that the difficulty in collaborating with each other undermines the feasibility of the approach and they require greater support from hospital pharmacists.
A total of 678 days of hospitalisation were avoided: the financial savings amounted to EUR 1,130,904 over the three-year period.
Safety and collaboration were the themes that emerged from the 11 interviews that have been collected: nurses mentioned the risk of storing medicines at home, the transcription of therapies on several documents and the lack of protocols for managing emergencies at home.

What next?

In conclusion, this law represents an important opportunity for the quality and sustainability of pharmaceutical care, but it requires a collaboration between hospital doctors, community doctors and nurses that should be implemented with a solid and tailored organisational model.

Author(s)

S. EL BOURY, B. CHAVENT, C. DUSSART, L. DERAIN

Why was it done?

Recognising medical devices is a key skill for hospital pharmacy professionals to ensure correct management and optimal patient safety. However, traditional training sessions were often theoretical and failed to stimulate engagement or long-term retention. This initiative was therefore developed to promote active learning, improve device recognition, and strengthen team collaboration in a fun and motivating way.

What was done?

A playful educational activity called “Medical device hunt” was created within the hospital pharmacy department. Inspired by an Easter egg hunt, this initiative encouraged staff to explore, identify, and learn about medical devices through an interactive and engaging game.

How was it done?

Over three days, sixteen medical devices (e.g. vascular stent, guedel airway, cardiac pacemaker) were hidden within a defined area of the pharmacy, each carrying a letter to form a mystery word. Participation was open to all pharmacy staff, including technicians, pharmacists, residents, students, and logistics agents, either individually or in teams. The top hunters were rewarded. A debriefing session, open to both participants and non-participants, presented informative cards on each device’s function and clinical use were, followed by a satisfaction questionnaire.

What has been achieved?

A total of 13 staff members participated, mainly pharmacy technicians (76.9%), with a success rate of 69.2%. All participants discovered at least one device and reported learning new information about its use. Satisfaction was high, with 92,3% declaring themselves “very satisfied.” Engagement extended beyond the game itself, as seven non-participants joined the debriefing session; among them, 85.7% were “very satisfied” and 71.4% reported having learned through the informative cards. The initiative strengthened awareness and knowledge of medical devices while fostering teamwork, communication and curiosity across the department.

What next?

The Medical Device Hunt demonstrated the benefits of gamified learning in a hospital pharmacy setting. Future editions will feature improved communication and longer participation time. The concept could also be adapted to other educational topics such as medication errors or risk management, further supporting a culture of continuous learning and safety within the department.

Author(s)

A. VARAS PEREZ1, MJ. LOPEZ MUÑOZ1, C. RODRIGUEZ MORETA1.
1HOSPITAL SERRANIA DE RONDA, FARMACIA, RONDA, SPAIN.

Why was it done?

Long-acting injectable antiretroviral therapy represents a major advancement in HIV management. This method of administration is novel, and as such, a process must be defined that involves different healthcare professionals and that must provide the patient with the training related to the administration in the best way. The intramuscular combination of cabotegravir and rilpivirine (CAB/RPV IM) offers an alternative to daily oral regimens, potentially improving adherence and patient quality of life. To ensure safe and efficient implementation, a multidisciplinary protocol was developed in a primary hospital.

What was done?

A coordinated protocol was established for the prescription, validation, dispensing, and administration of CAB/RPV IM, involving hospital pharmacy, nursing, and medical teams. Outcomes were assessed after one year of implementation.

How was it done?

A retrospective, cross-sectional descriptive study was conducted, analyzing CAB/RPV IM administrations recorded since March 2024. Inclusion criteria included virologic suppression, stable oral regimen, absence of resistance mutations to CAB/RPV, no hepatitis B coinfection, and patient commitment to scheduled visits. Electronic prescribing via Farmatools® triggered appointments with pharmacy and nursing. Pharmacists provided individualized care and scheduled doses within the ±7-day window, aligned with nursing availability. Patients received automated email reminders; missed appointments prompted follow-up calls. Delays beyond seven days were reported to the physician. Data on administration dates, discontinuations and reasons, viral load, and dosing intervals were extracted from the External Patient Module PRISMA and electronic health records.

What has been achieved?

A total of 518 doses were administered to 138 patients. Nine patients (6.5%) discontinued treatment due to adverse effects, personal/work conflicts, pregnancy, anticoagulation, or lack of appropriate needles. No virologic failures occurred. All doses were administered within the ±7-day window (mean deviation: -1.9 ± 2.0 days). The average number of doses per patient was 3.6 (range: 1–7). Nursing intervened in 4.5% of follow-up visits due to missed appointments. Email reminders reached 81.9% of patients. The protocol enabled integrated care, improved adherence, and ensured safe delivery of CAB/RPV IM therapy.

What next?

Expansion of the protocol to new candidates is planned, along with enhanced interprofessional coordination and digital tools for active follow-up. This experience may serve as a model for other centers implementing CAB/RPV IM in HIV care.

Author(s)

Hui-Yu Chen, Kai-Cheng Chang

Why was it done?

Medication safety remains a cornerstone of healthcare quality, yet adverse drug events (ADEs) continue to cause preventable harm in hospitals. Traditional manual dispensing workflows, dependent on human memory and paper-based checks, are prone to errors, particularly in large medical centers with high prescription volumes.

What was done?

We launched the “Smart Dispensing and Data Governance Project,” aiming to transform the pharmacy workflow through digitalization and data-driven quality management.

How was it done?

A two-pronged strategy was adopted: (1) deployment of smart dispensing hardware and (2) establishment of a big data governance platform. The hardware featured personalized login for accountability, closed-loop barcode verification of both medications and prescription bags, LED guidance and voice feedback for real-time alerts, and final barcode validation before dispensing. Advanced automation such as real-time stock sensing, weight-based verification, and image-assisted accuracy checks further minimized human errors. A SAS Visual Analytics–based Business Intelligence dashboard visualized error trends and enabled continuous PDCA (Plan-Do-Check-Act) improvement cycles through near real-time feedback.

What has been achieved?

Implementation led to substantial quality improvements: the dispensing error rate decreased by 78.3% (0.023‰ to 0.0050‰, P < 0.05); data analysis time for error monitoring shortened from 4 hours to 10 minutes (-98.3%, P < 0.05); and pharmacist training time reduced from 10 days to 3 days (−60.0%). All indicators showed statistically significant enhancement in accuracy and efficiency. Integrating smart dispensing systems with big data governance effectively advanced medication safety and operational efficiency. This model established a scalable, data-driven, and high-reliability pharmacy workflow, transforming quality management from reactive correction to proactive prevention and serving as a replicable benchmark for digital hospital transformation.

What next?

We plan to apply AI algorithms to dynamically optimize drug storage locations based on usage and safety risk, and to digitalize all storage displays through an integrated electronic shelf–label system. These enhancements will further strengthen accuracy, reduce human-factor variability, and advance a highly reliable smart dispensing workflow.

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Author(s)

Sebastian Philip, Andreas Lundgaard

Why was it done?

The screening aimed to ensure the rational use of antibiotics, contributing to the fight against antibiotic resistance and potentially shortening hospital stays by optimizing treatment.

What was done?

A systematic screening of antibiotic treatments for patients was conducted as part of the daily tasks performed by clinical pharmacists at The Medical Acute Care Unit, Bispebjerg Hospital.

How was it done?

For each patient receiving antibiotic treatment in the emergency department, the chosen therapy was systematically reviewed against regional antibiotic guidelines, considering factors such as allergies, resistance profiles, renal function, clinical indication and overall condition of the patient. Recommendations of adjustment of treatment were discussed with the attending physician for potential changes in therapy, including changes to dosage, frequency, route of administration, alternative antibiotic drug, or discontinuation of treatment. All interventions were documented, including the details of the therapy, the recommendation, and whether the attending physician approved the suggested changes.

What has been achieved?

A large dataset has been collected, detailing the number of patients receiving antibiotic treatment, the number of interventions conducted, the specific antibiotic treatment each patient received, the type of intervention performed and its indication, and whether the intervention was approved or rejected by the responsible physician.
The project has laid the groundwork for understanding the clinical pharmacist’s role in enhancing rational antibiotic pharmacotherapy.

What next?

It is planned to analyze the collected data to determine the types of changes in therapy most commonly recommended by clinical pharmacists and to which degree the interventions were approved or denied by the attending physician.
This will provide insights into the pharmaceutical contributions to more rational antibiotic use, highlighting commonly observed ‘areas for improvement’ that could potentially be addressed through education.

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Author(s)

Adeline HERLIN, Hermine ZIGA, Pauline PAYOT

Why was it done?

The aim is to continuously improve quality and efficiency.

What was done?

In the interests of continuous quality improvement, we have set up a suggestion box in the pharmacy’s unit repackaging sector.

How was it done?

We have set up a suggestion box for technician and pharmacists.
Each person can submit ideas or questions, anonymously or not.
After one month, the box was unpacked. The ideas and queries were analysed and discussed.

What has been achieved?

Eight points were raised.
 One point concerns procedures.
The existing procedures on the intranet network are not well known to users. We have provided an easy-to-access binder.
 Three points relate to packaging methods (list of products according to packaging method, removal of expired packaged products, mismatch of the Eticonform® label with the blister pack).
A decision tree was made (Euraf®: large quantities, multi-dose vials, magistral formula, small blister packs). The printing of the ledgers indicates the packaged products and their expiry dates. The removal of expired products is done according to the ledgers. A precaution must be taken when editing labels Eticonform® “laboratory” labels. Indeed, the size of the blister packs differs from one laboratory to another.
 The fifth point concerns the organization.
Technicians wish a storage area dedicated to repackaged specialties to compensate for stock errors.
After discussion, we did not retain this proposal.
 The other point concerns the lack of equipment.
A stool and a ruler were provided.
 The penultimate point concerns the use of returns from services in multi-dose vials.
We propose the packaging of small units with expiry dates < 3 months with the Euraf® bagging machine.
Otherwise (e.g. Carbimazole), we propose the packaging of sufficient quantities for 7 days in the vials with pre-printed labels with an expiry date of one week.
 The last point concerns the labelling of blisters with desiccant capsule (e.g. Nicorandil).
We offer Eticonform® re-labelling with a statement: USE BY xx/xx/202x (30 days after re-labelling).

What next?

The involvement of the technician team in a proactive approach to risk management is essential. We wanted to harness their practical expertise and energize the team.
The box will be integrated into our current practice.

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Author(s)

Henrik Kjer, Christina Laustsen, Rasmus Riis, Caroline Rasmussen, Jeanette Bajrami, Christian Rubek, and Steffen Jørgensen

Why was it done?

An atypical medication room (AMR) was established at Herlev Gentofte Hospital, Denmark to centralize the storage and handling of medications not part of the standard assortment (i.e. atypical medication). The project aimed to improve the efficiency of medication management, reduce medication waste, and streamline workflows associated with the use of atypical medicines. To enhance the accuracy and efficiency of inventory control, the ScanPill technology was developed as a tool for digital tracking and updating of medication stock.

What was done?

Atypical medications are often stored across various departments with low turnover, leading to potential waste and time-consuming retrieval processes. Centralizing these medications in an AMR and using ScanPill aimed to reduce waste due to expiry, improve stock management, and simplify medication retrieval for healthcare professionals.

How was it done?

Atypical medications from multiple departments were collected and stored in the AMR. The ScanPill system was developed to facilitate the scanning of QR codes and barcodes on medication packaging, allowing for precise tracking of stock levels and easy updates to the atypical medication list. Staff were trained to use the AMR and ScanPill to ensure smooth transitions in retrieving, returning, and documenting atypical medicines. Regular inventory checks and updates were conducted to maintain an accurate database of available medications.

What has been achieved?

The AMR, supported by ScanPill, led to improved handling and management of atypical medications. The centralized storage reduced the need for duplicate stock across departments and enabled quicker access to necessary medications, reducing retrieval time and potential waste. The ScanPill technology improved inventory accuracy and streamlined the process of checking medication in and out, ensuring up-to-date records. Staff feedback has been positive, noting enhanced workflow efficiency and reduced medication waste.

What next?

Future steps include evaluating the economic impact of the AMR and its effectiveness in reducing medication waste. Efforts will be made to refine the use of ScanPill, enhance staff training, and explore potential applications of the AMR model across other departments. Continuous monitoring will ensure optimal performance and identify further areas for process improvement.

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Author(s)

MC. SÁNCHEZ ARGAIZ, A. TRUJILLANO RUIZ, E. MÁRQUEZ FERNÁNDEZ, M. GALLEGO GALISTEO, E. CAMPOS DÁVILA

Why was it done?

A multidisciplinary approach is essential for addressing chronic pain from multiple perspectives, ensuring that treatment is personalized and effective for each patient. This structure enables faster, more coordinated solutions for patients whose chronic pain is difficult to manage.

What was done?

The Pain Management Unit(PMU) is a multidisciplinary team responsible for the comprehensive treatment and management of patients with chronic pain. The team includes: anesthesiologists, traumatologists, rehabilitation specialists, rheumatologists, internists, primary care physicians, and now a clinical pharmacist.

How was it done?

When a physician is unable to adequately manage a patient’s chronic non-oncologic pain, the patient is referred to the PMU. The unit holds weekly meetings to discuss cases and propose medical solutions, including interventional procedures such as injections or nerve blocks. The clinical pharmacist plays a key role in this process by reviewing the patient’s current analgesic therapy and chronic medications in advance, assessing their appropriateness, potential drug interactions, and considering alternative analgesic strategies. Additionally, the pharmacist provides recommendations on the temporary suspension of antiplatelet and anticoagulant therapy for patients scheduled for procedures. On a quarterly basis, the pharmacist also identifies patients with chronic non-oncologic pain who are prescribed high-dose opioids, facilitating a review by the treating physician to promote safer and more rational opioid use.

What has been achieved?

-Optimization of analgesic therapy: Through collaborative reviews with the team, analgesic treatments have been more precisely adjusted, reducing unnecessary opioid use and favoring safer, multimodal approaches.
-Prevention of hemorrhagic and thromboembolic complications: Timely recommendations on the suspension of antiplatelet and anticoagulant therapy before invasive procedures have minimized risks.
-Promotion of safe opioid use: The quarterly identification and review of patients on high-dose opioids has reduced the risk of overdose, dependence, and adverse effects, ensuring safer pain management.

What next?

The integration of the clinical pharmacist into the PMU has shown a clear positive impact on the safety and effectiveness of chronic pain treatments. Moving forward, it would be beneficial to evaluate, at six-month intervals, the interventions proposed by the pharmacist and accepted by the medical team. This evaluation would provide valuable insights into the long-term benefits of pharmacist involvement and help refine the collaborative approach to pain management.

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Author(s)

Castejón Grao, I; García Zafra, V; RodrÍguez Morote, M; Jiménez Pulido, IP; Andujar Mateos, A; Murcia López, AC.

Why was it done?

The pharmacist is responsible for magistral formulations in hospitals. Paper-based methods can lead to errors so the software was integrated between 07/2022-06/2023 aiming to reduce human errors,optimize preparation times,standardize procedures,improve stock management, formula traceability and enable statistical analysis capabilities of the area.

What was done?

CPFarma® software was implemented to control the programming, preparation, validation, and dispensing of magistral formulas. It facilitated proper management of the processes involved in galenic preparations at a tertiary-level university hospital.

How was it done?

The implementation of CPFarma® software involved the following stages:
1. Creation of user accounts and permissions.
2. Introduction of active pharmaceutical ingredients and raw materials, including batch and expiry details.
3. Inclusion of packaging materials,tools and required clothing for each preparation.
4. Transfer of Standard Operating Procedures(SOPs) in three phases:
4.1. Integration of the original SOP for each formula.
4.2. Revision and validation of SOPs and associated calculations.
4.3. Determination of active and passive SOPs.
5. Association of patient information sheets.
6. Drafting of a programme use protocol.
7. Training personnel on software use.
8. Validation in daily practice situations.

What has been achieved?

Until August 31, 2024, 249 SOPs (averaging 85 monthly) have been incorporated into the database, 74,7%(186) active and 25,3%(63) passive status, standardizing procedures. The system also includes 67 primary packaging materials and 275 components (185 active ingredients,16 base formulations and 74 excipients), improving stock control.
A total of 1279 magistral formulas have been prepared and validated by a pharmacist:54%(693) for usual stock,40%(510) for specific patients and 6%(76) with no record available. Each formula includes a preparation guide that includes detailed records to ensure traceability, such as patient information,prescriber details and preparation order number. There is also a computerized recipe book with histories filterable for statistical analysis.
No human errors have been detected in the preparation since the program’s implementation, and the patient information sheet helps prevent medication errors.

What next?

Efforts are being made to improve the system by adding features like a barcode reader for batch entry and registering personnel that dispense and collect medication. CPFarma® has optimized magistral formulation management, so Pharmacy Services without specialized software could benefit to improve their practices through its implementation.

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Author(s)

(NFR) Nathalie Fogh Rasmussen
(MS) Maja Schlünsen
(JHPR) Joo Hanne Poulsen Revell
(LJK) Lene Juel Kjeldsen

Why was it done?

Exchanging medication stocks between hospital wards is a common method for reducing pharmaceutical waste at hospitals. However, the impact of such systems is unclear. Therefore, we aimed to calculate the annual economic cost savings after the establishment of a medication exchange system at the University Hospital of Southern Denmark in Aabenraa.

What was done?

A medication exchange system at a Danish hospital was evaluated according to avoidance of medication waste and potential economic impact.

How was it done?

For two weeks in February 2024, pharmaconomists registered all medications that were exchanged between six hospital wards representing 147 of 302 hospital beds. The quantity of the excess medications when returned was registered and the amount of pharmaceutical waste was calculated. This was compared to the amount of waste incurred by ordering a whole package for the ward. Moreover, the economic cost was calculated based on the value per package and compared to the economic costs of purchasing whole packages.

What has been achieved?

In total, 244 exchanges were registered. The pharmaceutical waste was estimated to 13-26%. The Department of Pulmonary Diseases, followed by the Department of Gastrointestinal Diseases, caused the greatest waste. The exchanged medicine had an economic cost of 3,566 DKK (478 euro). In comparison, the cost of purchasing whole packages was estimated to 21,042 DKK (2,822 euro). Thus, the total cost saving was ((21,042-3,566 DKK)x(52/2 weeks)=454,376 DKK (60,935 euro), corresponding to ((454,376/147) x 302)= 933,480 DKK (125,146 euro) for the entire hospital. The results led to establishment of a physical medication room to store the excess medication available for other clinical wards. All medications are registered electronically to support optimal use of excess medication throughout the hospital.

What next?

The economic evaluation may be replicated for comparable medication exchange systems at other hospitals, and thus, generate evidence for the economic and environmental impact of the system.