Kaizen-led utilization improvement at medical oncology daycare unit.

Abstract

293 Background: Optimizing utilization of oncology day care units is key in throughput, patient experience and minimizing errors. At our oncology center, the medical oncology day care (MODC) unit was at a infusion chair/bed utilization rate of 92% with a turnaround time for multiagent or long-infusion chemotherapeutic regimens of 275 minutes. This resulted in prolonged wait times for patients and delayed treatment initiations appointments. Therefore, we set out to improve the utilization of the treatment chairs and chemotherapy turnaround time at the MODC. Methods: The goal of this project was to increase MODC chair/bed utilization up to 150% and decrease chemotherapy infusion time by 30% by the end of 4/2024. The interventions integrated Agile Project Methodology to ensure adaptability and responsiveness, with DMAIC (Define, Measure, Analyze, Improve, Control) serving as the guiding quality improvement tool for the improvement plan. Interventions began with project charter approval involving stakeholders from all relevant departments, followed by a comprehensive assessment and gap analysis using DMAIC to identify and address wasted steps in the process. This involved process mapping to streamline operations and eliminate unnecessary tasks. Key interventions included pre-chemotherapy blood work 48 hour prior to treatment, patient segmentation based on treatment session-length, proactive communication with patients regarding treatment session times, and coordination with the chemotherapy pharmacy for medication readiness. Furthermore, strict adherence to defined timelines for patient assessment and chemotherapy order placement was enforced. A sensitive Key Performance Indicator (KPI) structure was developed to measure the outcomes of the interventions, aligning with Agile principles for continuous improvement. Sustainability was ensured through the creation of a sustainability plan aligned with a dashboard to maintain success thresholds. Results: The results demonstrated significant improvements; MODC median bed utilization increasing to 168%, single-agent infusion turnaround time reduced to 150 minutes (33% decrease), and long-agent infusion turnaround time decreased to 210 minutes (30% decrease). Sustainability studies are now underway. Conclusions: These findings underscore the effectiveness of interventions in not only increasing chemotherapy infusion center capacity but also decreasing chemotherapy turnaround time utilizing a Kaizen-led approach.Results of these interventions are expected to enhance efficiency and improve patient care within the MODC unit.