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Reducing Wait Time Between Admission and Chemotherapy Initiation.

Arjun Gupta1, Jenny Li1, Bernard Tawfik1

  • 1University of Texas Southwestern Medical Center; Parkland Health and Hospital System, Dallas, TX; and ASCO Quality Training Program, Alexandria, VA.

Journal of Oncology Practice
|April 13, 2018
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Summary
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Streamlining chemotherapy initiation significantly reduced delays for patients. Implementing quality improvement methods cut the time from arrival to treatment by over 30%, improving patient care and hospital efficiency.

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Area of Science:

  • Oncology
  • Healthcare Quality Improvement
  • Patient Flow Management

Background:

  • Reducing hospital length of stay is a key healthcare goal.
  • Delays in starting chemotherapy negatively impact patient satisfaction and prolong hospital stays.

Purpose of the Study:

  • To decrease the median time from patient arrival to chemotherapy initiation.
  • Targeted a 35% reduction, from 6.2 hours to 4 hours, within a 6-month period.

Main Methods:

  • A multidisciplinary team utilized Plan-Do-Study-Act (PDSA) cycles.
  • Identified process bottlenecks: inconsistent lab orders, communication gaps, and variable arrival times.
  • Implemented solutions: timed arrivals, secure messaging, and pre-admission lab requirement clarification.

Main Results:

  • Median time from arrival to chemotherapy initiation decreased from 6.2 hours to 3.2 hours.
  • This represents a significant reduction, exceeding the initial 35% target.
  • Control charts demonstrated a sustained improvement in the process.

Conclusions:

  • Classic quality improvement methodologies and multidisciplinary teamwork effectively reduce chemotherapy initiation delays.
  • Further refinement of PDSA cycles is planned to ensure lasting change.
  • Optimizing patient flow is crucial for enhancing cancer care delivery.