
Understanding IV infusion.
- Jan 11, 2020
- 35
If your pharmacy can’t see these four numbers on one page, you’re guessing: Time-to-First-Dose (TTFD) – How fast patients get their first safe dose after RX is verified. On-Time vs. BUD – Percent of doses given before their Beyond-Use Date (BUD). Excursion Rate – How often shipments go out of their safe temperature range (or lack proof). Substitution Avoidance – How often you keep patients on the intended drug despite shortages. These KPIs protect patients, tighten operations, and support clean Medicare Home Infusion Therapy (HIT) claims. The One Idea Build a simple, shareable dashboard that updates often (hourly if you can). Keep it read-only so pharmacy, nursing, and scheduling see the same truth. Every red flag should link directly to the case note so staff can fix issues in one step—not after twelve emails.
Why These Four?
TTFD: Delays frustrate prescribers and patients. Lower is always better. On-Time vs. BUD: USP <797> says BUD is a hard stop. Post-BUD = unsafe, unbillable. Excursion Rate: USP <1079>/<1079.2> expect proof of storage temps. “Courier said it was cold” doesn’t count. Substitution Avoidance: Shortages happen. Tracking how often you stay on therapy shows resilience and reduces errors. How to Build It Fast Map data once: pharmacy (lot, BUD), logistics (pack-out, ETA), nursing (visit times, temps), quality (excursions, substitutions). Set rules: ETA + setup ≥ BUD = auto re-make. Missing temp proof = treat as out-of-range until fixed. Share it: Make the dashboard viewable to all teams with safe case IDs. Make it actionable: Click red metrics to open the exact task/note.
What Good Looks Like
No chasing couriers for missing data lat
TTFD trending down
On-time vs. BUD at ~99%
Excursion rate dropping as processes improve
Substitution avoidance rising as shortages are managed better
Compliance Guardrails
Follow USP <797>
for BUD and USP <1079>/<659>/<1079.2>
for storage/transport.
CMS HIT pays for professional services per calendar day. Accurate documentation supports coverage but does not guarantee it.
Report results in trends or percentages, not promises.
Quick Story
Saturday IVIG start: ETA = 15:10, BUD = 16:00 → dashboard row turns red. Dispatch canceled, pharmacy re-makes, courier delivers at 16:30, nurse gives dose before BUD with proof. Another case flags “temp unknown,” nurse uploads probe photo, flips status to “in range,” claim proceeds.
Two clicks, no phone tag.
References
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