In mid-2022, capacity management expert LeanTaaS conducted a survey to capture data and insights from cancer center nursing directors and operational leaders from across the country to better understand current challenges in cancer centers and how AI-based technology can help.
Nearly 100 cancer center leaders from across the US responded to the survey. These included representatives of community and academic health centers as well as private oncology practices. Respondents manage between 10-30 infusion chairs in their center and the majority hold vice president, director, and administrator titles.
Critical findings for infusion center operations:
The survey found a significant number of cancer centers face common operational challenges that prevent them from functioning at their optimal capacity. 40% of infusion center leaders surveyed believe they have already run out of space and would need to physically expand to accommodate any further patient volume growth. Further, inadequate tools and strategies are hindering smooth daily operations. The following are clear areas the surveyed infusion centers need to address in order to successfully unlock capacity.
The top three focus areas for cancer centers today
1. Cancer center resource constraints
The surveyed cancer centers face resource constraints including limited infusion chairs, nurse shortages, and pharmacies that are not able to keep up with drug demand. On top of the 41% of respondents who said they would need to physically build capacity in order to accommodate additional patient growth, another 13% reported not having the resources they needed to add space or infusion chairs to help with volume growth.
COVID-19 safety measures have led to a backlog of patient demand that many centers are still working through. More than half of survey respondents need major investment in order to meet their current patient demand for appointments. Midday scheduling “peaks” are also cited as a common challenge to centers’ ability to serve their needed volume of patients effectively.
2. Staffing shortages and burnout
Survey respondents have deployed a variety of approaches to address the widespread nursing shortage impacting healthcare organizations nationwide. Most frequently, infusion centers have used travel or temporary nurses, modified shifts, and increased nurse-to-patient ratios to optimize resources.
The method centers use to assign nurses to patients greatly impacts how efficient they can be with their existing nurse resources. Fewer than 20% of respondents are using the “nurse pull” methodology, mathematically and operationally the most efficient way to manage nursing capacity at infusion centers.
Respondents were also asked what tools they use to address nurse stress and burnout. The most popular responses included offering staff recognition events and increased pay or benefits, closely followed by nurse support programs and team-building exercises. While these tools may be helpful in the short-term, they are not well-suited for long-term nurse retention while maintaining the operational and financial health of the health center.
3. Lack of access to relevant EHR data
Infusion center personnel can access EHR data to help inform decision-making, but they recognize that EHRs are not built to optimize asset utilization or improve patient access. EHRs serve many important purposes, including reporting on past or present performance and highlighting causes of past issues. But to use that data to predict tomorrow’s capacity needs is a completely different task. Optimizing capacity is a difficult math problem that can never be solved by an EHR by itself: doing so requires constraint-based optimization methods, machine learning, artificial intelligence, and simulation algorithms to solve underlying problems. This challenge is illustrated in the nearly 50% of respondents who find it somewhat or extremely difficult to access the data they need from their EHR.
Nearly half of the centers surveyed are also tracking their operational performance manually in spreadsheets, a process that is inefficient and prone to human error, especially given the complex scheduling patterns in infusion centers. An additional 42% of infusion centers have the need to employ IT analysts, and close to 10% do not have a way of accessing their center’s performance.
These responses show a clear need for an easier and more effective way to draw actionable insights from EHR data and track them automatically. Deploying AI tools on top of the EHR, which account for the particular volumes, assets, resources, and needs of a particular center, can help immediately show users the root causes of historic operational issues and support optimal schedules and assignments in the present and future.
Challenges ahead: navigating infusion center capacity in the next few years
The healthcare industry still faces the aftermath of the COVID-19 pandemic, which has undeniably exacerbated challenges in cancer center operations. Moving forward, infusion center leaders will have to cope with:
- Staffing shortages due to burnout, stress, and retirement/aging of the nursing population
- Sicker patients who have delayed cancer screenings or treatment
- Doing more with fewer resources, necessitating operational efficiency
- Innovating to accommodate patient growth without large capital investments
Providing easier access to actionable data on health center operational performance
For the complete analysis, and further discussion of AI’s role in assisting cancer centers in solving their key challenges, view the survey report here.