To implement a centralised governance system across multiple pharmacies using a single oncology software management database (CHARM™) for the provision of oncology services.
6 pharmacies across Australia were included in the project, each providing oncology services to different hospitals and operating independently within one CHARM™ database. The protocols in the database were reviewed to determine if evidence-based and up-to-date (using eviQ as the reference). An assessment of the database user roles and existing supportive tools was also conducted.
1414 of the 2673 protocols identified were inactivated in the database as not assigned to patients in ≥ 3 years. Of the remaining 1259 protocols, 581 (46.1%) were assessed as identical to eviQ, 396 (31.5%) were flagged as ‘Need Reference’ as not an exact match, and 282 (22.3%) were flagged as ‘Query’ as required further site input, for example, duplicate protocols with different continuous infusion presentations. Local site administrator roles were inactivated and a new centralised team was recruited to facilitate consistency of practice and independent review and advice. A toolkit was developed to support continuing governance, including email templates for protocol requests, template checklists for protocol review, guidance documents for user roles and an overarching policy for inclusion in the oncology pharmacy training plan. Additionally, a hierarchy of evidence was developed for protocol assessment, including criteria for approval and inclusion in the CHARM™ database. No incidents relating to drug or protocol set-up have been reported in the 4-months post-implementation, compared to approximately 1 per month previously.
A centralised Charm governance framework was successfully implemented across multiple pharmacies providing independent oncology pharmacy services, improving the safety and quality of the oncology software system and its associated use.