Title : Improving speed, efficiency, and communication of infusion treatments for medical oncology patients
In the past decade the number of patients with cancer who receive chemotherapy at hospital-based outpatient centers has risen and this trend is likely to continue. Reducing chemotherapy wait times can dramatically affect patient experience, relieve employee frustration, and create opportunities for increasing institutional revenue. This project was developed to meet this increased demand and improve present processes. It addresses the problem of delays in getting infusion treatment started related to orders not being signed, unclear or incomplete orders, or questions regarding clarification.
The purpose of this quality improvement project was to improve speed and efficiency in the adult infusion center by utilizing enhanced communication methods between nurse and provider. The overall goal was to reduce the delay in the start of treatment by an average of 5 minutes related to unsigned or incomplete orders, and other clarification needed before proceeding with infusion treatment.
A retrospective chart review of patient delays related to unsigned or incomplete orders was completed over a 2-month period. A two-part implementation of new communication process and education was tracked for 4 months post implementation. Intervention phase one included dashboard reports in EPIC for the physicians to see unsigned orders, utilization of Spok secure messaging and interdisciplinary physician and nurse education. Phase two was implemented after initial intervention meetings with charge nurses and providers. These meetings occurred to determine the most essential information to be communicated. Bold orange colored communication cards were developed to leave at provider workspace.
The pre-implementation data average wait was 16 mins. After phase one implementation, the average wait decreased to 3.5 mins. After phase two implementation, the average wait time was 9.5 minutes, which is a 6.5 average wait time reduction from the pre-implementation. The results of this project show that the overall goal was met and superseded with a reduction of an average of 6.5 minutes. Additionally, there was an increase in the number of nurse provider communications which could indicate improved interdisciplinary communication and teamwork. These findings are consistent with research that shows that interdisciplinary communication is key to patient safety and improved outcomes
Audience Take Away:
- The audience will be able identify the practical improvement processes implemented to improve efficiency and communication in an outpatient oncology infusion center. This implementation process may relate to other areas outside of oncology as well.
- This information may help the audience distinguish specific interventions to the improve communication process between nurses and providers. This may allow for modification of these interventions to meet the needs of their specific facility.
- The audience may relate the findings to other oncology and infusion settings to increase efficiency to allow for more scheduled patients.
- The audience will be able to identify further research studies that can be done in inpatient or emergency department settings to determine if similar interventions would improve efficiency.
- The audience will be able to describe the increase in patient satisfaction related to decreased delays.