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      Descentralización de la elaboración de los tratamientos antineoplásicos. Optimización de los recursos Translated title: Decentralisation of the preparation of antineoplastic treatments. Resources

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          Abstract

          Resumen Objetivos: La metodología “Six Sigma” se basa en el análisis de los flujos de trabajo e identificación de los puntos de mejoras con el fin de lograr una máxima eficiencia en los procesos, tanto industriales como sanitarios. El objetivo de este estudio es comparar la eficiencia entre un sistema “clásico” de elaboración de quimioterapia centralizado en el Servicio de Farmacia frente a un modelo descentralizado. Material y métodos: Estudio observacional en el que se analizó la eficiencia de los modelos de elaboración de preparaciones quimioterápicas: Modelo clásico (MC), a partir del cual se suministran las preparaciones al Hospital de Día de Hematología: las campanas de elaboración de tratamientos y el farmacéutico están presentes en el Servicio de Farmacia. Modelo descentralizado (MD): el farmacéutico y las campanas de preparación de la medicación se encuentran en Hospital de Día de Oncología. La eficiencia de cada sistema se evaluó mediante el tiempo transcurrido desde la recepción de la orden médica hasta la administración de la quimioterapia (TAQ). Resultados: El TAQ siguiendo el MD fue inferior que para el MC: 13,7 [5-28] minutos versus 71,0 [42-96] minutos (p<0,001) con una diferencia media de 57,3 minutos/preparación. El tiempo potencialmente ahorrado con el modelo descentralizado fue de 40,3 horas/día. Conclusiones: Con el presente trabajo hemos querido cuantificar y comparar la eficiencia de los dos modelos de elaboración de mezclas citostáticas, siendo desfavorable para el sistema clásico de centralización para la preparación de la medicación en los Servicios de Farmacia.

          Translated abstract

          Summary 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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          Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods

          Estimates of the worldwide incidence and mortality from 36 cancers and for all cancers combined for the year 2018 are now available in the GLOBOCAN 2018 database, compiled and disseminated by the International Agency for Research on Cancer (IARC). This paper reviews the sources and methods used in compiling the cancer statistics in 185 countries. The validity of the national estimates depends upon the representativeness of the source information, and to take into account possible sources of bias, uncertainty intervals are now provided for the estimated sex- and site-specific all-ages number of new cancer cases and cancer deaths. We briefly describe the key results globally and by world region. There were an estimated 18.1 million (95% UI: 17.5-18.7 million) new cases of cancer (17 million excluding non-melanoma skin cancer) and 9.6 million (95% UI: 9.3-9.8 million) deaths from cancer (9.5 million excluding non-melanoma skin cancer) worldwide in 2018.
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            Applying the Toyota Production System: using a patient safety alert system to reduce error.

            In 2002, Virginia Mason Medical Center (VMMC) adapted the Toyota Production System, also known as lean manufacturing. To translate the techniques of zero defects and stopping the line into health care, the Patient Safety Alert (PSA) system requires any employee who encounters a situation that is likely to harm a patient to make an immediate report and to cease any activity that could cause further harm (stopping the line). IMPLEMENTING THE PSA SYSTEM--STOPPING THE LINE: If any VMMC employee's practice or conduct is deemed capable of causing harm to a patient, a PSA can cause that person to be stopped from working until the problem is resolved. A policy statement, senior executive commitment, dedicated resources, a 24-hour hotline, and communication were all key features of implementation. As of December 2006, 6,112 PSA reports were received: 20% from managers, 8% from physicians, 44% from nurses, and 23% from nonclinical support personnel, for example. The number of reports received per month increased from an average of 3 in 2002 to 285 in 2006. Most reports were processed within 24 hours and were resolved within 2 to 3 weeks. Implementing the PSA system has drastically increased the number of safety concerns that are resolved at VMMC, while drastically reducing the time it takes to resolve them. Transparent discussion and feedback have helped promote staff acceptance and participation.
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              Implementing Six Sigma in The Netherlands.

              Six Sigma, a process-focused strategy and methodology for business improvement, can be used to improve care processes, eliminate waste, reduce costs, and enhance patient satisfaction.
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                Author and article information

                Journal
                ofil
                Revista de la OFIL
                Rev. OFIL·ILAPHAR
                Organización de Farmacéuticos Ibero-Latinoamericanos (Madrid, Madrid, Spain )
                1131-9429
                1699-714X
                September 2023
                : 33
                : 3
                : 270-272
                Affiliations
                [3] San Cristóbal de La Laguna Tenerife orgnameComplejo Hospitalario Universitario de Canarias orgdiv1Servicio de Oncología Médica España
                [1] San Cristóbal de La Laguna Tenerife orgnameComplejo Hospitalario Universitario de Canarias orgdiv1Servicio de Farmacia España
                [2] San Cristóbal de La Laguna Tenerife orgnameComplejo Hospitalario Universitario de Canarias orgdiv1Unidad de Investigación España
                Article
                S1699-714X2023000300009 S1699-714X(23)03300300009
                10.4321/s1699-714x2023000300009
                e1631b69-bf4c-45d6-bdf8-7a846c508d82

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 10 January 2022
                : 21 December 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 8, Pages: 3
                Product

                SciELO Spain

                Categories
                Originales

                antineoplastic treatments,chemotherapy,Six Sigma,Hospital de Día,Servicio de Farmacia,modelo descentralizado,modelo centralizado,tratamientos antineoplásicos,quimioterapia,Oncology Day Hospital,Pharmacy Service,decentralised model,centralised model

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