Chemotherapy outsourcing : "supplier-customer" audit

7 October 2016

M. Cussenot1, A-L. Pouliquen2, Y. Cano Y Gil3, P. Cuny4 1 Hôpital Privé de l’Ouest Parisien, Pharmacie, 14 Avenue Castiglione Del Lago, 78190 Trappes, France
2 Hôpital Privé d’Antony, Pharmacie, 1 rue Velpeau, 92160 Antony, France
3 Hôpital Privé des Peupliers, Pharmacie, 80, rue de la Colonie, 75013 Paris, France
4 Siège Ramsay Générale de Santé, Direction Pharmacie, 96 avenue d’Iéna, 75016 Paris, France


According to the French law, outsourcing anticancer chemotherapy preparation is subject to Regional Health Agency authorization. Three Private Hospitals (PH) (Antony, Ouest Parisien and Vert Galant) subcontract their chemotherapy preparation to the Chemotherapies Preparation Unit (CPU) based in PH Peupliers (30 000 preparations/year). In an effort to improve quality and regulatory compliance, we conducted a “supplier-customer” audit. This audit aims to verify CPU compliance with the regulations, guidelines and learned societies recommendations.


The audit grid was developed based on applicable requirements (regulations, guidelines or recommendations). The grid is spited into 25 categories, covering the entire process from prescription to waste disposal. It does include 127 criteria. Each criterion was assessed during the audits following three categories (complies/does not comply/not applicable) depending on the compliance level to the applicable requirement. The audit lasted one day and was led by three pharmacists.


Among all assessed criteria from the audit grid, 9.4% were identified to be improved. The identified issues concern the degraded mode operating procedures, headcount, staff protection, signposting and waste management. Highlighted strengths identified by the auditors are the structured organization of tasks by CPU staff and Good Practices compliance for the Preparation. Out of the 127 evaluated criteria, 5% did not apply to the CPU.


All the results were shared with 4 institutions; therefore, stakeholders engaged in the subcontracting agreement were able to gain insight into this process. The CPU initiated an action plan in collaboration with customer-pharmacists to make improvements and prioritize actions. The audit was extended to other CPU within Ramsay GDS Group and will be annually renewed.

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