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IMPLEMENTATION OF INTRAVENOUS WORKFLOW TECHNOLOGY FOR PEDIATRIC CHEMOTHERAPY: ENHANCING SAFETY, COMPLIANCE, AND OPERATIONAL EFFICIENCY

European Statement

Patient Safety and Quality Assurance

Author(s)

Natalie Kuchik PharmD, MS, BCSCP and Jacalyn Rogers PharmD, MS, BCPS, CPEL, FASHP

Why was it done?

Pediatric chemotherapy compounding requires exceptional precision and strict adherence to USP and standards due to the high-risk nature of the medications and vulnerable patient population. Traditional manual compounding workflows are prone to human error and operational inefficiencies, especially in busy hospital settings. To address these challenges, IV workflow technology was implemented to enhance patient safety, improve compliance, and streamline pharmacy operations.

What was done?

An IV workflow technology system was introduced in a pediatric hospital pharmacy to support chemotherapy compounding. The system included barcode scanning for drug and diluent verification, image capture of each preparation step, and remote pharmacist verification. This allowed pharmacists to review compounding steps in real time without being physically present in the cleanroom, improving both safety and workflow efficiency.

How was it done?

The implementation was carried out prospectively, with pharmacists transitioning to remote in-line verification using the IV workflow platform. The system flagged incorrect drug or diluent scans and captured images of each preparation step for pharmacist review. This setup enabled pharmacists to detect and intervene in real time when errors occurred, such as incorrect labeling or volume discrepancies. Data were collected on scan alerts, image-based interventions, and workflow metrics, including preparation throughput and pharmacist time allocation.

What has been achieved?

The technology successfully identified all instances of incorrect drug and diluent selections before finalization, significantly reducing the risk of medication errors. Image review further enhanced error detection, particularly for labeling and preparation accuracy. Removing pharmacists from the cleanroom improved workflow flexibility and reduced interruptions, resulting in a 25% increase in preparation throughput. Compliance with USP and standards improved due to automated documentation and verification processes.

What next?

Future steps include expanding the use of IV workflow technology to other high-risk compounding areas and evaluating its impact on broader pharmacy operations. Additional enhancements may include integrating the system with electronic health records and exploring further automation to support scalability. Continued monitoring of safety, compliance, and efficiency metrics will guide optimization and inform best practices for pediatric and adult oncology settings.