Chemotherapy daycare pharmacy workflow and workspace assessment

Healthcare Human Factors


When the Princess Margaret Hospital’s Chemotherapy Daycare (CDC) Pharmacy needed an assessment of their workflow and workspace, they approached Healthcare Human Factors based on its expertise in the healthcare industry and environment design. The motivation for the project was a growing need to accommodate more chemotherapy patients in the CDC via an alternate day patient booking model (i.e. two-day model), and a need to improve the efficiency of the pharmacy within its limited space.

Human factors experts conducted semi-structured interviews with stakeholders to understand the work processes and unit issues, and to gain context for observations. The team conducted thirty hours of observation, where pharmacists and pharmacy technicians were shadowed while performing their regular duties. The team also measured the physical dimensions of the workspace, and kept a visual record by taking photographs. These methods allowed HHF to capture the workflow involved in preparing different chemotherapy treatments, and to map the physical layout of the pharmacy.

Armed with key insights from the shadowing and interview sessions, the team identified several workflow issues that impacted safety and efficiency. Significant issues included:

  • Congested layout
  • Lack of standardization in the workflow for dispensing chemotherapy treatments in preparation
  • Inefficient use of available storage space
  • Undesirable work postures

Recommendations to improve these issues were developed, and included:

  • Modifications to the layout
  • Conducting a standardized clean up (also known as a 5S evaluation)
  • Implementing ergonomic adjustments to workstations


With the recommendations implemented, the team expects improvements in both the efficiency of the unit and staff morale. In addition, based on the evaluation HHF concluded that the two-day model for order processing, which was the process already implemented at the facility, was successful at mitigating bursts of activity, and steadied the pace of workflow.