Gustav optimises oncology pathways with new prescription features
November 15, 2021

As part of the opening of the new integrated cancer centre in Quebec City (CIC), HOSPITALIS, in collaboration with the Quebec City University Hospital, has developed new prescription functionalities integrated into the Gustav software to optimize care trajectories for chemotherapy patients with the objective of creating a paperless environment.

This achievement was achieved through an iterative agile co-development approach with the HOSPITALIS team and a multidisciplinary team of professionals from the CHU de Québec in order to meet the needs of the various stakeholders involved. These iterations, born of systematic meetings, resulted in a product refined to meet the needs of the community.  

Facilitating the chemotherapy treatment pathway

The project was ambitious, as it had to implement a multidisciplinary and structuring software for electronic prescription of chemotherapy for oncology treatments. 

The major needs were to:

  • Bringing together two cancer departments at the CHU de Québec that operate differently
  • Harmonise, optimise and make more secure the processes surrounding the prescription of chemotherapy
  • Establishing better prescribing and communication pathways for stakeholders
  • Ensure a paperless solution to avoid errors, reduce risks and contribute to a greener working environment
  • Enable traceability to promote sharing between teams while reducing the likelihood of errors

Collaboration was at the heart of this project, as all stakeholders needed to be able to work together comfortably despite the difference in function. The objective was to integrate a secure and easy-to-use software to harmonise the care pathways for chemotherapy patients.

Collaboration at the heart of development

The means to be put in place in order to achieve an efficient and easy to master result for all users were exhaustive. Transversal collaboration between all levels of management was obviously necessary. 

In order to promote an optimal exchange between the various users, a tactical committee composed of multidisciplinary stakeholders was created. This was done in close collaboration with the HOSPITALIS team throughout the process. 

The analysis of the current care pathways and the ideal chain was constantly being updated. It was imperative to implement the improvements in progressive phases while maintaining close communication to adapt the management tool to its user. 

In addition, the teams were trained and supported throughout the process. The Gustav software allowed different types of professionals to have access to their respective editing rights. It also lightened the workload thanks to the protocolisation of prescriptions and the automatic calculation of doses according to weight and height. 

Innovations in chemotherapy treatment

The results of this collaborative method are striking. The importance of information integrity was noted with 87.6% of prescriptions having at least one addition or modification to it by another stakeholder. 

It is also more than 515 prescriptions configured in the Gustav software to support patients undergoing chemotherapy treatment. This includes 308 prescriptions from the outpatient clinic for intravenous chemotherapy, 60 prescriptions for oral anticancer drugs and 147 prescriptions for drugs under research protocol. 

The project also gradually implemented pre-printed prescriptions for parenteral chemotherapy. The average number of prescriptions increased to 177 per week after the first 15 weeks of implementation. Thus, the Gustav software saves 8 steps in the prescription process compared to the paper pathway. 

This is a major improvement that has addressed the need for safety and efficiency in the use of chemotherapy prescriptions. Traceability and ease of use are also key factors in demonstrating the breadth of support offered by Gustav software. It is important to note that no other software offered such flexibility and efficiency.

Moreover, the software engineering know-how of the HOSPITALIS team has enabled the development of generic prescription functionalities that can be fully configured by pilots according to clinical needs and thus fully serve the needs of other specialties.

Beyond expectations

The project was particularly effective. There has been a significant time saving in the transmission of documents between stakeholders. Restricted access to sections according to the type of stakeholder and the traceability of changes on each file have also greatly improved security. 

The harmonisation of paths so that the different teams can collaborate efficiently according to the type of document is major. It has enabled a total of 19,272 steps to be removed in 15 weeks, which represents a significant time saving. 

The entire team was able to adopt the project in just nine weeks. Despite a reluctant attitude in the beginning, they showed a significant satisfaction following the implementation of the project. It is a successful paperless innovation that has had a direct impact on the safety and quality of patient care and the efficiency of multidisciplinary clinical teams.

A highlighted contribution

The innovation that HOSPITALIS has brought to the management of the oncology trajectory has not gone unnoticed. The project will be exhibited at the virtual congress Together, in network, to overcome cancer edition 2021 on 18 and 25 November.

With manpower shortages a major problem in health care institutions, it is becoming imperative to optimize management tools. The evolution of Gustav will open up new possibilities while having a direct impact on the well-being of patients.

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