Reducing Infusion Clinic Wait Times Using Quality Improvement

Abstract

PURPOSE: Long wait times are a common occurrence for chemotherapy infusion patients and are a source of decreased patient satisfaction. Our facility sought to decrease outpatient infusion clinic wait times by 20% using the Model for Improvement, quality improvement tools, and Plan-Do-Study-Act cycles. METHODS: A multidisciplinary team was formed to address clinic wait times. Patient interviews, time studies, process mapping, brainstorming sessions, affinity diagrams, fishbone diagrams, and surveys were used to define the problem and to develop an intervention. Wait times from check-in until medication administration were analyzed using statistical process control charts. Our Plan-Do-Study-Act cycle led to the addition of a “fast-track” clinic title for patients not waiting for laboratory results on the day of treatment and changes in clinic communication. The fast-track clinic signaled for those patients to have priority for vital sign collection and earlier notification to pharmacy to begin preparing medications. RESULTS: Baseline wait times for patients not requiring laboratories on the day of treatment averaged 1 hour and 33 minutes. After intervention, using statistical process control charts, a shift was observed with a new average wait time of 1 hour and 12 minutes (a 23% decrease). Wait times for patients requiring laboratories on the day of treatment did not change significantly. CONCLUSION: Implementation of a fast-track clinic title and improving communication resulted in a significant reduction in wait times for patients not requiring laboratories on the day of treatment. Future efforts will focus on sustainment and improving wait times for all patients.

Achieving a multilevel evidence-based approach to improve cancer care in the U.S. post-COVID era: What is the role of management?

“…The findings of a national survey of hospitals and their use of quality improvement studies offer potential to improve the care process, as measured by standard indicators of hospital performance [ 44 ]. Such approaches are receiving recognition as an important component of quality cancer care along the care continuum, including survivorship planning [ 45 ]; reducing infusion wait time [ 46 ]; participation in interdisciplinary conferences [ 47 ]; and improving tobacco cessation in a clinic setting [ 48 ].…”

Development of a Quality Assessment Tool for Outpatient Infusion Clinics: A Literature Review and Pilot Survey

“…Studies have also shown that quality improvement (QI) initiatives aimed at reducing wait times at outpatient cancer infusion centers have also contributed to patient satisfaction 18,19. These studies serve as an example of how targeted QI initiatives can help improve the care provided in outpatient infusion settings.…”

ENTIMOS: A Discrete Event Simulation Model for Maximising Efficiency of Infusion Suites in Centres Treating Multiple Sclerosis Patients

“…Infusion centres serve patients with neurological diseases and other conditions (e.g., oncological and rheumatological) with finite resources, putting them at risk of being overburdened. Literature indicates that infusion centres commonly experience long waiting times: the time from treatment decision to administration, and waiting times from patient arrival until start of infusion [ 9 ]. This can lead to suboptimal clinical outcomes and patient dissatisfaction [ 9 , 10 ].…”

“…Literature indicates that infusion centres commonly experience long waiting times: the time from treatment decision to administration, and waiting times from patient arrival until start of infusion [ 9 ]. This can lead to suboptimal clinical outcomes and patient dissatisfaction [ 9 , 10 ]. Delays in treatment administration warrant more effective short-term resource utilisation.…”

“…The waiting time and queue size in infusion centres are influenced by capacity constraints, such as the number of available infusion chairs and available staff, scheduling techniques, time taken from patient’s arrival to infusion start, last-minute additions or appointment cancellations, and time taken to manage infusion-related adverse events [ 9 , 11 ]. Other factors that impact waiting time and queue size include patient resistance to treatment decision and insurance-related issues [ 12 – 14 ].…”