Better communication and a fast-track clinic option were associated with improved wait times for patients receiving chemotherapy infusions, according to a report published in JCO Oncology Practice.
The study was conducted at the Birmingham VA Medical Center in Birmingham, Alabama. The infusion clinic associated with the facility’s oncology department was staffed by 4 nurses, had 8 chairs for infusions, and had held more than 4200 appointments for infusions during the previous year. In an effort to support patient satisfaction with the process, clinic staff participated in an effort to address the causes of longer wait times.
The team identified common delays in the infusion process and likely reasons for them. Some suspected causes of delay were related to patient factors. Others, however, related to staff procedures. These included bottlenecks in medication preparation, chemotherapy consults, clinic communication, and complexities around incorporating laboratory testing into the process.
Communication was chosen as a bottleneck to address in this study. The researchers’ intervention consisted of clearly indicating those patients who did not need day-of-treatment laboratory tests and scheduling them using a new fast-track option that expedited the collecting of vitals and chemotherapy preparation for this group.
At baseline, the average patient wait time was 2 hours and 21 minutes, or 1 hour and 33 minutes for the approximately 50% of patients who did not need laboratory tests on the day of treatment. At an assessment 2 months after starting the intervention, the average wait had fallen to 1 hour and 12 minutes for patients not requiring laboratory testing on the day of treatment.
The researchers wrote in their report, “our team was able to implement a fast-track clinic with improved clinic communication to decrease wait times by 23% for a large subset of our infusion patients without adversely affecting our balancing measures.”
Plourde CL, Varnado WT, Gleaton BJ, Das DG. Reducing infusion clinic wait times using quality improvement [published online March 6, 2020]. JCO Oncol Pract. doi:10.1200/JOP.19.00643