Working out a decision-making scorecard to match staffing levels to the nature of cytotoxics to be prepared

9 October 2011

A. Secq, C. Van-Tuyckom, F. Danicourt, J.P. Résibois Service Pharmacie. Centre hospitalier de Dunkerque,
130 avenue Louis Herbeaux
59385 Dunkerque, France

The various preparation sessions for cytotoxics vary both quantitatively and qualitatively, and in the current context of reduced staffing numbers, it will be advantageous to be in a position to match the workforce to the planned level of activity. This adaptation cannot be performed solely on the basis of the number of preparations due to the fact that there is variation in the handling time for each specialty. This is the underlying reason behind the pharmacy devising a marking system to number the necessary staffing level based on a summary of the therapies planned for the next day. We timed each preparation, with a reading of the corresponding dose, 20 times per handler. We then went on to calculate the mean and the standard deviation on those times per specialty before assigning a fixed score corresponding to the average obtained. The specialties obtaining a significant standard deviation benefit from a multiplier adjustment ratio proportional to the standard deviation, and in correlation with the dose, thus allowing for greater realism.

The scores set by specialty thus have a spread from 2.42 to 15.07. The adjustment ration going from 0.6 to 1.4 was assigned to 9 specialties with their standard deviation greater than 2 minutes. When summarising the therapies, the Excel® spreadsheet developed the global score for the session planned for the following morning. It was decided after the test to reinforce staffing by tranche of 140 points: a single handler and 2 assistants, then a second handler, then a 3rd and, finally, a 4th handler and a 3rd assistant come in in turn to boost the team. It is therefore essential to know about all therapies to be dispensed the day before and have staff that can be mobilised on that activity. The preparation time is determined more objectively and allows the time present in the room to be optimised and safeguarded. This marking thus also provides arguments for the future recruitment of personnel.

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