At the Winter 2023 Transform Infusion Center Operations Virtual Summit, Ashley Joseph, an expert in using AI solutions to optimize infusion center operations, discussed the recent “impossible” accomplishments centers have made in adapting their resources to do more and the potential for transforming how infusion care is delivered in the future.
Missed the event? Explore this session and others from leading infusion centers on the Transform Hospital Operations Virtual Summit page.
Question: Your company LeanTaaS partners with a large number of infusion centers across the country to use AI solutions to improve their operations and maximize their capacity. What’s your overall perspective on LeanTaaS’ relationship with your infusion center partners, the state of cancer care today, and your potential impact on cancer care?
Ashley Joseph: At LeanTaaS, we’ve seen inside of the 700 infusion centers we partner with, and we service about 13,750 chairs overall. Our team has years of experience helping deploy our iQueue for Infusion Centers AI technology solution to optimize the use of these chairs, as well as nursing and other resources, so infusion centers can deliver critical life-saving care to more patients.
Our experience with infusion centers is also broad and deep. In November 2023 we published a survey of about 100 cancer center leaders, who represented academic and community health systems as well as private practices across the country. They tended to share similar concerns and goals, with 64% citing continual nurse staffing shortages that led to higher nurse-to-patient ratios and longer wait times, while 51% frequently experienced overbooking that exacerbated care delays. At the same time, centers are moving beyond pandemic restrictions, with 49% of respondents actively expanding the services they offer. These are all opportunities LeanTaaS is equipped to help infusion centers seize as we continue to work together.
Given our reach, scope, and understanding, I believe that the LeanTaaS team and our infusion center customers have the power to truly transform infusion care in the United States. If we commit to continuing the work we’ve done throughout the COVID pandemic to optimize our infusion resources and increase access to critical care, we can make great things happen.
We have to recognize our accomplishments during that crisis, and now that we’re in a post-crisis stage, we have to apply those learnings to accomplish more now and in the future.
Q: Can you talk about what being “post-crisis” means? Which “post-crisis” phase do you think infusion centers are in now, and what does that look like?
AJ: Per the academic field that studies crises, the post-crisis period has four primary phases. This is a helpful framework to show how far infusion centers have come post-COVID.
The first phase is Restore. Most centers were here early last year, when they put upended processes back to the way that they were pre-crisis. Infusion centers replaced the chairs that they removed for social distancing and began fully using their waiting rooms again. They have also adjusted resources to address the nursing crisis, and many nurses who left for travel positions have now returned. Overall, most of the large changes made to cope with COVID have reverted back to their pre-COVID state.
Most of the infusion centers we work with are currently in the second post-crisis phase, Return to Normal. This is when people’s attitudes and behaviors adapt to the restored processes. Infusion center leaders, nurses, and staff are back to focusing on the day-to-day operations that the pandemic disrupted. Centers are able to manage COVID surges as part of a routine. The crisis appears to be in the rearview mirror.
Now it’s time for us, infusion center teams and technology partners, to collectively move into the next phase, to Learn. In some ways, this means learning future best practices from handling the COVID crisis, as many centers already are.
But we can learn a very important broader lesson in the infusion world as well, that we are able to do hard things. In the first few weeks of the pandemic, and throughout it, LeanTaaS’ infusion center partners achieved accomplishments that they would have said even two weeks prior were absolutely impossible.
Q: What are some “impossible accomplishments” you’ve seen at infusion centers, both during the COVID crisis and now, that you’re particularly impressed by?
AJ: In terms of optimizing resources, the area that iQueue for Infusion Centers technology solution supports, we’ve seen infusion centers accomplish extremely impressive transformations. Some of our customers created strategies to treat patients with COVID in the exact same facility that served highly immunocompromised patients, while keeping both patient populations safe. Some discovered how to treat 100% percent of their patients with only 70% of the nurses they had previously.
An accomplishment that particularly stands out to me was a total change in approach to infusion nurse staffing. One of our large academic medical centers in the Southeast decided to implement “nurse pull” at one of its infusion centers. “Nurse pull” is the optimal patient assignment method that lets nurses choose patients to take on as they arrive. This transition was originally planned to take place over several weeks, but due to acute staffing challenges, the center made the change overnight. This abrupt shift in how nurses were assigned to patients turned out to be enormously positive, in terms of both efficiency and nurse satisfaction.
AI technology like iQueue for Infusion Centers is a key support for initiatives like these, as it helps centers account for patient data and suggests the best configurations of chairs, nurses, and appointments for both that day and in the future. But it takes the people in infusion centers to bring the expertise and execute actions like these successfully, and it was their motivation that made these changes happen.
All these adjustments for the better seemed completely impossible to infusion centers right up until they made them, because there was no luxury of saying they couldn’t. I think infusion centers will discover it’s possible to optimize even further.
Q: What would you like to see infusion centers accomplish to drive change in the future, and what do you believe makes this possible?
AJ: If we took every problem we know still needs to be solved in the world of infusion, and approached it with a similar mindset we had during COVID, that not solving it was not an option, we’d see even more powerful transformations happen. Now as we pass through our third post-crisis phase, Learn, we enter phase four, Upgrade, where we start to look at what comes next and how we can improve on where we are.
Infusion centers have started returning to the strategic initiatives they had pre-COVID, like reducing overall patient wait times and consistently smoothing midday appointment peaks. Our iQueue solution has already helped many infusion centers by finding and solving the underlying capacity problems that caused challenges. By doing so, they have achieved an average of 15% patient volume growth, 30% reduction of patient wait times, and 50% less overtime for staff. There’s an opportunity now for infusion centers to build on these solutions and go further, addressing some of the toughest problems they deal with now.
These tend to involve changing our mindsets around people. We tend to assume all patients, for example, would be too inconvenienced to come in for labs the day before their appointments, even though they may be open to this if they understood they’d be able to discuss all their lab results with their providers, instead of just the basic ones. We also assume all nurses prefer to have an exactly equal mix of appointment types fully set in their schedules, when in fact many would be highly motivated by choosing which appointments they handled every day. Unlinking even a few patient appointments across two days, and allowing even a few nurses to proactively choose their infusion patients as they arrive and are ready, might dramatically simplify how we build efficient appointment schedules and optimize nurses and chairs. If we ask, and show them the benefits, we might find that many patients and nurses prefer these arrangements.
Our LeanTaaS team is pushing ourselves to look at these problems, and would encourage infusion centers to do so as well. Our technology gives us the data that shows the benefits of unlinking appointments and transforming our approach to nurse assignments, and we can use this information to work with our patients and providers to help us move the needle even a small amount. That would change the game for delivering infusion care.
I want to challenge us to say, as we move forward in our post-crisis journey in 2024, that nothing is impossible. Let’s make next year about having big wins, doing challenging things, and sharing those with our infusion colleagues across organizations.
To learn more from Ashley Joseph and the infusion centers who partner with her team, check out the Transform Hospital Operations Virtual Summit page.