A total quality management system for the reconstitution services at Mater Dei Hospital

Abstract

To operate a patient-focused Reconstitution Unit in the 21st Century and beyond, one must avoid the illusion that the Unit is an island. It must be borne in mind that the Unit functions both as a client and also provides a service or preparations to its own clients. For many, there is an unfortunate but avoidable tendency to forget about clients, both internal such as wards and patients and external such as patients' relatives and other health care units. The tentative establishment of a total quality management (TQM) system in this facility may help to change this tendency. The Reconstitution Unit of the Pharmacy department at Mater Dei Hospital caters for adult haematology patients, paediatric oncology patients, extemporaneous preparations and repackaging of bulk procured medicines. No official TQM system exists, however, certain practices had been developed in order to standardise the service offered by the unit. By developing a TQM system, it is perceived that there will be a decrease in turnaround time for the preparation of medicines, an improvement in the cooperation between the unit and both the internal and external clients and an increase in the product throughput for repackaging hence ensuring that if the product is in stock in hospital, it will be made available as a repackaged unit (if necessary) without delay. For a TQM system to work efficiently, it must be coupled with a good knowledge of the chemistry of the products being handled within the unit. If the final aim of a good TQM system is the safety of the client, then this means that the ultimate client, normally the patient, must be administered a medicinal product possessing the attributes of good quality, safety and efficacy. Without these characteristics a preparation will not be fit for its intended purpose. Thus, when devising a TQM system for the Reconstitution Unit the chemical stability, contamination, incompatibilities and Health and safety issues must all be addressed. A properly devised TQM system will take into consideration all incoming and outgoing factors and processes which in turn will ensure the stability of all chemical processes involved in the preparatory services offered by the unit and hence guarantee that a good quality product is being offered to the client.