The following article features coverage from the 2018 Oncology Nursing Society’s Annual Conference in Washington, DC. Click here to read more of Oncology Nurse Advisor‘s conference coverage. 

WASHINGTON, DC — The implementation of a new scheduling guideline has led to improved efficiency and overall capacity at the Infusion Suite of the Norris Cotton Cancer Center at Dartmouth Hitchcock Medical Center, according to an oral presentation at the 2018 Oncology Nursing Society (ONS) Annual Congress. 

“We knew that infusion scheduling was guided by three capacities: our chairs, our pharmacy, and our nursing,” said Megan Howe, MSN, RN, OCN, “but our nurse capacity was pretty vague, and we were finding often that 1 or more of these capacities were reached and were struggling to schedule our patients.” This led to inefficiencies in scheduling, delays in receiving or even initiating treatment, and frustration for both patients and providers. 

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For this study, the infusion team applied the Define, Measure, Analyze, Improve, and Control (DMAIC) method in order to better understand nursing staff workflow and capacity. Howe recognized that in the mornings, chairs were primarily empty, pharmacy was able to redistribute their work and increase their ability to prepare more chemotherapies, and nursing resources were underutilized. 

After several pilots, results showed that there was a sustainable improvement of patients receiving their treatment on time, increasing to 84% from 77%. Patients also completed their treatments on time or even early 88% of the time compared with 83% prior to updating the scheduling guidelines. Overall, the infusion suite was able to increase their capacity by 15% to 20%. 

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The infusion suite staff also reported experiencing less frustration scheduling patients, as well as having a more manageable workload. 

Howe concluded that, “Nursing capacity is an essential component of overall infusion suite capacity, and must be integrated with chair and pharmacy availability in order to implement an efficient infusion system. Comprehensive understanding of infusion capacity, implementation of scheduling guidelines, and ongoing system monitoring are important keys to improving patient and staff experience”


Howe M, Brown M, Brooks G, Chadwick A, Crosby D, Hickman J. Scheduling to ALL infusion limits. Oral presentation at: ONS 43rd Annual Congress; May 17-20, 2018; Washington, DC.