Outsourcing inpatient i.v. compounding: expense and medication error implications

Area of Science:

• Pharmacy Practice
• Patient Safety
• Healthcare Management

Background:

• Hospital-based intravenous (i.v.) admixture programs involve complex compounding and logistics.
• Medication administration errors, particularly those of omission, pose significant patient safety risks.
• Outsourcing i.v. admixture services to specialized pharmacies is an emerging strategy for cost and efficiency improvements.

Purpose of the Study:

• To evaluate the impact of outsourcing a hospital's i.v. admixture refill program on compounding costs.
• To assess changes in the frequency of medication administration errors of omission post-outsourcing.
• To determine the financial implications of redeploying an i.v. admixture technician for i.v. recycling on nursing units.

Main Methods:

• A quasi-experimental, single-subject, pretest-posttest design was employed.
• Data were collected via direct observation before and after the outsourcing implementation.
• Key variables included medication errors of omission and direct program costs.

Main Results:

• A statistically significant reduction in medication administration errors of omission was observed after outsourcing.
• The hospital realized an estimated first-year cost reduction of $86,356.
• Redeployment of an i.v. admixture technician for i.v. recycling was part of the intervention.

Conclusions:

• Outsourcing hospital i.v. admixture refill programs can enhance patient safety by reducing medication errors.
• This strategy offers significant cost savings for healthcare facilities.
• Integrating specialized pharmacy services and internal resource reallocation can optimize i.v. medication management.