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Reducing Time to Discharge after Chemotherapy by Standardizing Workflow and Providing Outpatient Intravenous
Jitsuda Sitthi-Amorn1,2, Allison Ast1,2, Erin Harper1
1Hospitalist Medicine Program, St. Jude Children's Research Hospital, Memphis, Tenn.
Pediatric Quality & Safety
|July 8, 2021
Summary
Streamlining discharge for chemotherapy patients receiving cyclophosphamide or ifosfamide with outpatient hydration significantly reduced wait times. This approach is safe and feasible for selected patients, improving the chemotherapy experience.
Area of Science:
- Oncology
- Pharmacology
- Quality Improvement
Background:
- Patients undergoing cyclophosphamide or ifosfamide chemotherapy require hydration to prevent hemorrhagic cystitis.
- Selected patients can complete post-chemotherapy hydration as outpatients to reduce hospital stay.
- This study focused on optimizing discharge processes for these patients.
Purpose of the Study:
- To reduce the time to discharge after mesna therapy completion.
- To evaluate the impact of a redesigned discharge workflow on patient throughput.
- To assess the safety and feasibility of outpatient hydration post-chemotherapy.
Main Methods:
- A quality improvement initiative was implemented.
- Medical records were reviewed to track time to discharge and readmission rates.
- Discharge workflow was redesigned to increase patient involvement.
Main Results:
- A 76.6% reduction in median discharge time (from 2.82 to 0.66 hours) was observed for patients opting for outpatient hydration.
- The overall median time to discharge for the entire cohort did not change.
- No patients experienced readmission within 48 hours.
Conclusions:
- Redesigned discharge workflows effectively reduced time to discharge for patients choosing outpatient hydration.
- Outpatient intravenous hydration is a safe and feasible option for select patients receiving cyclophosphamide or ifosfamide.
- Optimizing discharge processes can improve patient flow in chemotherapy services.
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