Measuring chemotherapy appointment duration and variation utilizing real-time location systems (RTLS).

Abstract

154 Background: Clinical schedules drive resource utilization, cost, and patient wait time. Accurate appointment durations ensure appropriate staffing ratios to the daily caseload and maximizes scarce resources. Dana-Farber Cancer Institute (DFCI) adjusts infusion appointment durations for each chemotherapy regimen using a consensus method of experts including pharmacists, nurses, and administrators. Utilizing RTLS, we examined the accuracy of appointment duration compared to suggested duration. Methods: Appointment duration was calculated using RTLS in three disease centers at DFCI between August 1st and September 30th, 2013. Duration was defined as the amount of time a patient occupied an infusion chair. The top 10 administered infusion regimens were statistically investigated (n=805). Results: All median observed appointment durations were statistically different than the suggested durations. Appointment duration was shorter than scheduled 98% [C], 95% [I], and 75% [F] of the time and longer than scheduled 77% [A] and 76% [G] of the time. Almost all C and I appointments were more than 30 minutes shorter than scheduled. Among A appointments longer than scheduled, 56% were more than 30 minutes longer than scheduled. Conclusions: RTLS provides reliable and unbiased data to improve schedule accuracy. Replacing consensus with system-based data may improve clinic flow, relieve staff stress, and increase patient satisfaction. Further investigations should elucidate factors that cause variation in appointment duration. [Table: see text]