Safety nets
To improve patient safety, Dana-Farber is labeling chemotherapy and fluid bags like this one, held by pharmacist Barbara Jones Finley, with barcodes in preparation for future scanning before infusions.
Cancer care at Dana-Farber and its partners is not only more effective and comfortable today, it is much safer. The Institute has continually learned from its medical mistakes (and near-errors) and has become a national and international model for patient safety and patient and family-centered care.
Technology barely imagined during Sidney Farber's day is responsible for much of that progress. Computerized systems for ordering chemotherapy and other drugs, equipped with many internal safety checks and systems, have replaced hard-to-decipher, handwritten notes – limiting the chance of prescribing the wrong therapy or dose. Implanted devices help caregivers administer drugs and other fluids without regular needle sticks. "Smart pumps" ensure that infusions are dispensed properly. Bar codes on patients' wristbands and on medications will soon offer another line of defense.
In addition, patient information is easier for caregivers to find these days with online medical record systems that contain a patient's health history, lab results, treatment details, and notes from members of his or her medical team. Pellerin, who has been in oncology for 36 years (most of them at Dana-Farber or Brigham and Women's Hospital), served as evening nurse supervisor before the Institute's adult inpatient beds moved to BWH in 1997. "One of the banes of my existence was looking for a chemo consent form," Pellerin says. "When I'd looked everywhere I could think of, I'd call the head of Medical Records. She'd say, 'Let me think, doctor so-and-so was seeing him/her for something; did you check that office?' So off I'd go, and there the chart would be. Some nights I spent hours looking for charts to find consent forms, because nursing won't give the chemotherapy without them. Now, with the electronic medical record, the consent is right there. That's huge."
Another major change: Caregiver roles are more specialized today. "It used to be that doctors and nurses mixed [chemotherapy] drugs on their desks, and the interns administered them in the hospital," notes Dana-Farber Chief Medical Officer Larry Shulman, MD, whose oncology career began in the mid-1970s. "Now, a physician orders, the pharmacist prepares, and the nurses administer." Although human mistakes can still occur, "we've used technology to take out as much uncertainty as we can."
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- Cancer pioneers: 1 | 2 | 3 | 4 | 5
