Implementation of a visual appointment system to enhance oncology infusion suite efficiency at Norris Cotton Cancer Center (NCCC).

Abstract

301 Background: Infusion suite patients were experiencing excessive delays for administration of chemotherapy, blood products, and hydration. Manually collected data revealed that 80% of patients did not start their infusion appointments on time, though there was limited additional data available for further analyses. The scheduling system allowed for booking a "start time" for infusion therapy, but there was no connection between the appointment slots and the actual number of infusion stations, length of the infusions, and available nursing staff. There was an identified need for 1) a “visual” scheduling system that would aid in better matching available resources with patient demand and 2) real time collection of electronic timestamps to better understand patient flow and improve efficiency. Methods: An already existing and supported visual scheduling system was introduced to the infusion schedulers. This system works by assigning patients to available resources (chairs and nurses) and timeslots. The system was piloted for four months before fully implemented. An electronic interface was created between the existing scheduling system and the visual system, eliminating the need for dual entry. Nursing began using the system to record the actual arrival and discharge times for patients. Scheduling guidelines were updated and additional functionality within the system was employed. Results: Adherence to the arrival and discharge processes are tracked on a monthly basis and shared with the infusion suite leadership and nursing staff. As compliance with check-in/out processes increase, actual utilization of the infusion suite by oncology service and treatment regimen is being evaluated. These data are useful in the identifying opportunities to reduce treatment delays and improve efficiency. Conclusions: Maximizing efficiency and utilization of infusion suite services is a goal of NCCC. Access to detailed electronic data that facilitates understanding of the demand for services and capacity of the system is critical to achieving this goal. It is our belief that a more efficient infusion suite will result in less treatment delays for patients.