Providing optimal patient access to treatment requires that infusion centers maximize the utilization of their finite resources. Unfortunately, chair capacity and nurse workloads often limit access to care due to poor resource allocation.
During a September Becker's Hospital Review webinar sponsored by LeanTaaS, Ashley Frost, RN, manager of the pediatric hematology/oncology outpatient infusion center at Vanderbilt University Medical Center in Nashville, discussed how her facility improved patient flow and nurse satisfaction after adopting LeanTaaS' iQueue for Infusion Centers solution.
Three key insights were:
- Vanderbilt faced serious operational challenges. The infusion center previously experienced a high volume of appointments during peak hours, which led to a shortage of chairs. "Different infusions have different lengths," Ms. Frost said. "We would do best-guess scheduling, but it didn't always work out. The peaks were often followed by lulls, resulting in high stress for staff and inequitable workloads."
Same-day cancellations and other changes also reduced actual vs. scheduled infusion hours; vacant hours couldn't be filled immediately, disrupting patient flow and frustrating nurses.
The variation in patient volume created staffing challenges because it was difficult to ascertain how many nurses were needed to staff the facility and excessive time had to be spent manually planning nursing assignments. "It was hard to know ahead of time because we weren't looking at how long the infusions are, only at when they were scheduled," Ms. Frost said.
- The partnership with LeanTaaS shed light on three key issues that affected patient flow and nurse satisfaction. Those issues were:
- Lead times: Vanderbilt University Medical Center had a practice of booking appointments far into the future, which blocked availability for other patients while resulting in a high number of same-day cancellations (58% of appointments scheduled 10+ weeks in advance were canceled or rescheduled).
- Time-based chair utilization: Because of its hybrid nature as a hematology/oncology infusion center, Vanderbilt had both long- and short-duration appointments scheduled indiscriminately throughout the day. As a result, the infusion center struggled to accommodate rising demand for longer or all-day appointments because chair capacity was crowded out.
- Patient-nurse assignments: Historically, the infusion center pre-assigned patients to a specific nurse. But when there was a cancellation or an unforeseen change on the day of service, schedulers had to scramble to rearrange nurse assignments for the remainder of the day.
- LeanTaaS' iQueue platform helped Vanderbilt address those challenges and optimize resource allocation. After implementing LeanTaaS' solution and seeing the data on what was holding back patient throughput, the infusion center's leadership team reconceptualized its approach. This led to:
- An 85% reduction in the number of appointments scheduled 10+ weeks in advance, with the average lead time dropping from 5.5 to 3.4 weeks. This unlocked additional scheduling capacity and significantly reduced schedulers' workload.
- A shift of short-duration appointments (of 1 to 3 hours) to the afternoon, which unlocked long-duration chair capacity during peak morning and mid-day hours.
- Real-time staffing assignments, so that patients are assigned to nurses when the patient arrives. These assignments are based on nurses' current workload, including the cognitive burden.
"iQueue tells you, 'This nurse has a high-acuity case, maybe she's not the right nurse for the next patient,'" Ms. Frost said. This approach reduced unproductive time that charge nurses previously spent reassigning infusion nurses' cases and increased all nurses' job satisfaction.
For more information, click here.