Retour d'expériences de management collaboratif pour l'amélioration du processus de dispensation des médicaments expérimentaux dans un centre de lutte contre le cancer

The Clinical Pharmacy Department manages nearly 600 phase 1 to 3 CT clinical trials and, in 2019, dispensed up to 15,500 experimental drugs. Following numerous non-conformities, a reorganization of the CT unit based on a process oriented management approach according to Lean healthcare was started. The objectives of this work were to report an experience and to highlight the lessons learned in the implementation of this type of approach. Two phases were considered to conduct this transformation. The first consisted of a process mapping using the basics of Lean Healthcare and resulting in the development of a priority action plan. The second corresponded to the continued restructuring of the CT Unit by a collaborative method using a ‘‘bottom-up’’ approach, based on the EPEHo method and using problem-solving workshops. The mapping of macro-processes resulted in a plan of 7 priority actions. Some pharmacists were trained to facilitate in an appropriate manner the workshops. In total, 14 sessions were carried out allowing 18 solutions to be implemented. These workshops provided a new perspective on process improvement and problem solving. This work illustrates in real life a successful experience of continuous improvement through a collaborative approach. The solutions put in place through these workshops are a success both in terms of improving the performance of the pharmaceutical service and in transforming the adherence to work of collaborators.