The Effect of Changing Batch Frequency, Lead Time and Installing an I.V. Workflow Management System on Intravenous Admixture Operations in a Pediatric Hospital

URPOSE: The purpose of this dissertation was to study the effect of changing the i.v. batch schedule (changing i.v. batch frequency and changing preparation lead time) and installing the new i.v. workflow management system: DoseEdgeRTM system with the current CCHMC i.v. operations. The hospital database analysis, mathematical model and computer simulation model were applied as study research tools. The final goal was to determine the two i.v. batch schedules that would offer the maximum savings of monthly wasted cost. One of the i.v. batch schedules for the pharmacy i.v. operation was without the DoseEdgeRTM system, and the other i.v. batch schedule for the pharmacy i.v. operation was with the DoseEdgeRTM system. OBJECTIVES: The objectives were: (1) to estimate the number of wasted i.v. doses, cost of wasted i.v. doses and the number of extra i.v. dose errors in the existing CCHMC i.v. operations, (2) to estimate the effect of changing i.v. batch frequency and lead time on the number of wasted i.v. doses, cost of wasted i.v. doses and the number of extra i.v. dose errors, (3) to estimate the effect of installing the DoseEdgeRTM System with various combinations of batch frequency and lead time on completion rate of i.v. batch schedule, utilization rate of hoods, utilization rate of pharmacists and utilization rate of technicians, and (4) to determine the optimal i.v. batch schedule (combination of i.v. batch frequency and lead time) with or without the DoseEdgeRTM System for the CCHMC i.v. operations. RESULTS: The study site is Cincinnati Children's Hospital Medical Center (CCHMC), which is a 512-bed pediatric hospital located in Cincinnati, Ohio. The CCHMC i.v. room is located in the main pharmacy at the Division of Pharmacy. The DoseEdgeRTM i.v. workflow management system was installed in 2011. The database analysis results of the current CCHMC i.v. operation from October 2011 to March 2012 showed that the monthly number of i.v. wasted doses was 8,599, the monthly cost of i.v. wasted doses was...