Aim

An oncology pharmacy observational “app” electronic audit tool was developed with the aim to improve quality and reduce the variance in quality across a multi-site hospital pharmacy provider.

Method

A literature review of Australian and international oncology pharmacy practice standards was undertaken. Four domains were created; personnel, occupational health and safety, oncology pharmacist responsibilities, and cytotoxic transport and storage. Each domain was numerated to enable a scoring system which supported both intra- and inter-site quantitative analysis. A total of 17 oncology pharmacy services were audited twice over a two year period. The audits were completed by five senior and experienced oncology pharmacy staff who received training in application of the audit tool. Auditors were not permitted to undertake audit of sites where they had responsibility.

Results

The baseline audit resulted in an organizational-wide mean compliance result of 71% (ϑ=13.9%). Following the second year of the audit cycle, organizational-wide compliance increased to a mean of 80% (ϑ =8.3%). The improvements in compliance at the end of the second year were statistically significant [paired t(16)=-2.57, p=.02]. Statistically significant improvements were evident across the domains of oncology pharmacist responsibilities [paired t(16)=-3.04, p=0.004] and cytotoxic transport and drug storage [paired t(16)=-2.56, p=0.01]. Improvements were also noted across the personal and occupational health and safety domains, although these did reach significance.

Conclusions:

This electronic audit tool provides a method for systematically assessing compliance with oncology pharmacy quality standards. Use of the electronic “app” has demonstrated significant improvements in compliance with quality standards over a two year period. Implementation of the tool has also facilitated the identification of support materials required such as group wide policies and mandatory training plans which aim to create consistency and reduce variation in practice among oncology pharmacy sites.