Prescription Errors with Chemotherapy: Quality Improvement through Standardized Order Templates

Area of Science:

• Oncology
• Healthcare Quality Improvement
• Pharmacy Practice

Background:

• Chemotherapy orders are often handwritten in Lebanon, despite guidelines recommending standardized templates.
• This study addresses the need for improved chemotherapy order completeness in a Lebanese tertiary teaching hospital.

Purpose of the Study:

• To describe the implementation of standardized chemotherapy order templates (COT).
• To evaluate the impact of COT on chemotherapy order completeness.

Main Methods:

• A baseline assessment of handwritten chemotherapy orders was conducted.
• Over 300 standardized COTs were developed based on NCCN templates.
• Kotter's 8-step model guided the implementation, involving healthcare providers and barrier removal.

Main Results:

• Initial handwritten order completeness was 49.5%.
• After COT implementation, completeness increased to 77.6% (Phase 1) and 87.6% (Phase 2).
• This represents a 38.1% improvement in order completeness.

Conclusions:

• Standardized chemotherapy order templates significantly improve the completeness of chemotherapy orders.
• The study provides a successful prototype for COT implementation in similar healthcare settings.
• This initiative promotes quality improvement in cancer care and supports the move towards computerized physician order entry (CPOE).