Is the preparation of Automated Doses Dispensing (ADD) impacted by tasks interruptions (TIs)?
Tasks interruptions are a contributing factor to the medication circuit’s dysfunction.
The aim of this survey is to evaluate the production and control of the ADD’TIs as well as the management strategy for these Tis.
Materials and Methods
Direct observational study of 5 pharmaceutical technicians (PT) for a 5-day period using an audit grid inspired by the HAS.
Results - Discussion
On average, a rate of 5.8 TIs per hour of production was found.
The analysis of the process stages reveals that 70% of the TIs happen during the control stage, which is the longest and most critical stage.
The majority of TIs are inherent to the production process and are mainly due to the filling of empty cassettes. Only one PT controls the doses and manages the production.
Thus, the "disruptor" is, for 62%of the cases, the PT itself. The phone was not responsible for any TI because no one can receive calls from the outside.
The demand / supply of information between PTs generates the second cause of IT; 2/3 of those interruptions are about production.
Therefore, one quarter of deferred TIs can be improved.
In terms of TIs management, 40% of the PTs finish the task, 38% suspend, answer and then restart their task while 78% restart at the TI (the good practice is to restart at the beginning of the task). 22% keep on going while answering (an attitude that should be avoided).
The presentation of this work to the pharmacy staff allowed to objectify the TIs, particularly during the control of the ADD, critical point of the process.
Paths to improvement include:
- pre-filling of the cassettes before the beginning of the production
- setting up on the production area a poster inviting "the disruptor" to wonder if his question is truly urgent
- creation of a TIs procedure focusing on the methods of work recovery.
A second remote study will evaluate the impact of the proposed solutions on the TIs rate.