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Operational Improvement (Chemo Therapy Unit) of the Cardinal Bernardin Cancer Center Mary Ann Collatz, Rita Flaska, Li

Operational Improvement (Chemo Therapy Unit) of the Cardinal Bernardin Cancer Center Mary Ann Collatz, Rita Flaska, Linda Flemm. Opportunity Statement.

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Operational Improvement (Chemo Therapy Unit) of the Cardinal Bernardin Cancer Center Mary Ann Collatz, Rita Flaska, Li

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  1. Operational Improvement(Chemo Therapy Unit)of the Cardinal Bernardin Cancer CenterMary Ann Collatz, Rita Flaska, Linda Flemm

  2. Opportunity Statement The challenge that the Chemotherapy treatment area faces is to schedule chemotherapy regimens that vary widely in the amount of care required, the length of treatment time and multiple day treatments.Our goal is to improve unit efficiency and decrease the wait time of greater than 30 minutes that 50% of our patients experience.

  3. Identification of Most Likely Causes Unscheduled patients (patients who arrive requesting central line dressing changes or blood draws, routine central line maintenance and nursing assessment of symptoms/concerns. Patients who have been overbooked into schedule early in the day to meet their treatment plan. Add on patients who may receive transfusion pending results from complete blood counts (CBC).

  4. Solutions Implemented Expanded Day Hospital hours. Patients informed of need to obtain appointment for all Day Hospital needs. --- Service Representatives educated on how to address change in scheduling with patients. --- Registered nurse discuss appointment requirements with the non-compliant patient population. --- Patients who have a physician visit and chemotherapy treatment on the same day are given treatment appointments in the morning or near physician visit appointment. Visits not tied to a physician appointment have been moved to the afternoon.

  5. Solutions Implemented (cont’d) • Nursing assessments of patients are now conducted in the Cancer Center’s clinics with treatments given in the chemotherapy treatment unit if the patients’ condition warrants it. • Patients who may be added onto the schedule as a new treatment for the same day as a physician visit (on the actual day of the visit) was discussed in the Hematology/Oncology Division meeting. These patients may be scheduled on a different day. • A special color coded charge ticket was created to identify patients who are waiting for CBC results and nursing RN assessment of CBC for transfusions. Service Representatives take over the task of retrieval of CBC results from nurses and give the results to them for RN to review/action.

  6. Conclusions • Quantity of overbooked patients was measured on a daily basis for one week. Changes were implemented and a steady decline in overbooking occurred over subsequent weeks. • Unscheduled patients were assessed in one week. Solutions were implemented and a steady decline was noted over the next 7 weeks. • In a one-period, the number of patients was measured for wait time over 1.5 hours for possible transfusions. Solutions were implemented and results show significant improvement.

  7. Next Steps • Ongoing monitoring of the changes. • Assess arrival times of scheduled patients. • Create dialogue for Service Representatives to address early arrivals.

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