Infusion centers, like other complex clinical enterprises, face major operational challenges in managing increasing patient volume, efficient scheduling and resource capacity.
Infusion centers must deal with surges of patients, long wait times, mid-day peaks and overburdened nurses — all while seeking to improve the patient experience.
Hartford HealthCare’s journey to continuously improve its infusion centers, based on data, was the focus of a recent Becker’s Hospital Review webinar, sponsored by LeanTaaS. This webinar featured Stacey Barber, integration manager, and Amanda Carbray, clinical operations manager — both of the Hartford HealthCare Cancer Institute, along with Rachel Saltzman, a customer service manager at LeanTaaS.
They shared insights from Hartford HealthCare’s infusion center journey to improve its patient experience, increase capacity and decrease waste, leveraging data from LeanTaaS to improve capacity management and operating performance. Hartford HealthCare is a health system in Connecticut with seven hospitals, 14 medical oncology practices and 14 infusion centers with 188 chairs.
Three key takeaways were:
- Like many health systems, Hartford HealthCare’s infusion centers faced issues such as increasing volume, complicated scheduling and managing patient appointments linked to clinics. Those challenges had downstream effects on nurses' workloads, the infusion center’s capacity and efforts to safely and effectively serve all patients who needed care.
"Time is valuable, and there is a cost to cancer patients along that journey," Ms. Barber said. "Whatever we can do to eliminate the cost of time toxicity and any other barriers and challenges they might face is important." - The team used iQueue, LeanTaaS's sophisticated AI-powered capacity management software, as a tool to collect key data and drive as well as monitor change. "iQueue gives us a lot of great information on acuity and allocation," Ms. Carbray said. Among the metrics that Hartford HealthCare tracks with iQueue are:
- Chair turns
- Linked appointments
- Same-day cancellations
- No shows
- Days over max capacity
- Wait times
- Bottlenecks
- Staff lunch breaks
- Nurse acuity
- Nurse allocation
With iQueue, "We can create nursing assignments using a tool called nurse allocation," Ms. Carbray said. "By doing this, we can spread patients throughout the day for the nursing assignments." This helps balance workloads, ensuring that one nurse doesn't wind up with an overload of multi-drug regimens and that all nurses can take regular breaks and have lunch— resulting in a safer environment for everyone.
- Based on iQueue data, Hartford HealthCare has improved its clinical operations and improved several key performance indicators. Important changes from October 2022 to March 2023 include:
- Improved patient experience. Patients experienced decreased wait times, resulting in increased patient satisfaction.
- Improved capacity. Access to infusion centers has increased as chair turns grew from 2.6 to 2.9 and visits per day rose from 46 to 52, representing a 15 percent increase. An important step was adopting "advanced prep" procedures in which patients had appointments, labs and other requirements fulfilled before their infusion appointment date.
- Decreased waste. Cancellations were reduced and no shows declined from 2.4 to 2.0, contributing to reduced drug waste.
"Load-leveling is a major part of the iQueue program," Ms. Saltzman said. "It ensures there's access for patients to get their infusion appointments while also being conscious of a balanced workload throughout the day for nurses.”
Using iQueue has allowed Hartford HealthCare to gather the data the organization needed to build operational improvement strategies. Along with improving capacity, Hartford HealthCare achieved a more balanced workload for nurses, reduced waste and increased efficiency — resulting in overall better service for patients.
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