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Optimizing Outpatient Radiation Oncology Consult Workflow by Using Time-Driven Activity-Based Costing: Efficiency and
Julius Weng1, Shane Mesko2, Gregory Chronowski1
1Division of Radiation Oncology, MD Anderson Cancer Center, Houston, TX.
JCO Oncology Practice
|February 8, 2024
Summary
Time-driven activity-based costing (TDABC) improved clinical efficiency in radiation oncology. Workflow changes reduced patient encounter times and costs, while enhancing patient satisfaction.
Area of Science:
- Health Services Research
- Quality Improvement Science
- Oncology Practice Management
Background:
- Clinical efficiency is crucial for value-based healthcare.
- Outpatient radiation oncology clinics face workflow challenges impacting patient care and costs.
- Optimizing patient flow is essential for improving healthcare delivery.
Purpose of the Study:
- To identify workflow inefficiencies in high-volume outpatient radiation oncology clinics using time-driven activity-based costing (TDABC).
- To evaluate the impact of implementing a new clinical workflow on efficiency and patient satisfaction.
- To quantify financial savings associated with workflow improvements.
Main Methods:
- A quality improvement study was conducted across GI, Genitourinary (GU), and Thoracic Radiation Oncology departments, plus community sites.
- Time-driven activity-based costing (TDABC) was employed to map and optimize outpatient consult workflows.
- Patient encounter metrics were collected using electronic medical records, with time metrics compared via Mann-Whitney U tests.
Main Results:
- Overall patient encounter cycle time was reduced by 21% in GI, 18% in GU, and 12% in community sites.
- Median financial savings per consult ranged from $30 to $52 USD across departments.
- Patient satisfaction remained high, with 99% reporting adequate provider time and 91% timely care.
Conclusions:
- Time-driven activity-based costing (TDABC) effectively identifies opportunities for improving clinical efficiency.
- Workflow modifications based on TDABC analysis led to significant reductions in encounter cycle times.
- The implemented changes resulted in substantial financial savings and high patient satisfaction.
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