Alternative Outpatient Chemotherapy Scheduling Method to Improve Patient Service Quality and Nurse Satisfaction

Huang, Yaoxian; Bryce, Alan H.; Culbertson, Tracy; Connor, Sarah L.; Looker, Sherry; Altman, Kristin M.; Collins, James; Stellner, Winston; McWilliams, Robert R.; Moreno-Aspitia, Alvaro; Ailawadhi, Sikander; Mesa, Ruben A.

doi:10.1200/jop.2017.025510

Cited by 17 publications

(13 citation statements)

References 24 publications

(18 reference statements)

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“…[9][10][11][12][13] Several initiatives have been published to address one or more of these factors. 3,5,6,[10][11][12][13][14][15] In a large National University Health System in Singapore, chemotherapy prepreparation coupled with telephone triage reduced patient wait time without increasing chemotherapy waste. 10 We sought to determine the feasibility of a multidisciplinary intervention ensuring advanced completion of orders, laboratory assessment, and chemotherapy prepreparation at a community hospital in Houston, Texas, using Plan-Do-Study-Act (PDSA) cycles.…”

Section: Introductionmentioning

confidence: 99%

Successful Implementation of a Multidisciplinary Chemotherapy Efficiency Initiative at a Community Hospital

Parkes

Nusrat

Tomasso

et al. 2019

JOP

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PURPOSE: Long wait times at chemotherapy infusion centers adversely affect patients’ perception of quality of care and result in patient dissatisfaction. We conducted a quality improvement initiative at a busy community hospital to improve infusion center efficiency and reduce patient wait time, while maintaining patient safety and avoiding chemotherapy waste. METHODS: We used a coordinated and collaborative effort between providers, infusion center nurses, and pharmacists to ensure completion of orders, review of laboratory data, and prepreparation of chemotherapy 1 day ahead of each patient’s scheduled infusion center appointment. Monthly Plan-Do-Study-Act cycles were conducted for 6 months beyond the pilot month to refine and sustain the intervention. RESULTS: The average patient cycle time, measured as time from patient check-in to check-out from the infusion chair, decreased from 252 minutes to 173 minutes in the last 4 months evaluated (30% decrease) after the intervention. Similarly, the average chemotherapy turnaround time, measured as time from chemotherapy request by nursing to pharmacy delivery, improved from 90 minutes to 27 minutes after the intervention (70% decrease). Infusion center capacity was unaffected by the intervention. The cost of wasted chemotherapy was minimal after the first postintervention month. Surveys revealed extremely high patient and employee satisfaction with the new system. CONCLUSION: A strategy involving prepreparation of chemotherapy on the day before the scheduled infusion is feasible to implement at a busy community hospital infusion center and is associated with significant improvement in infusion center efficiency as well as patient and employee satisfaction.

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Section: Introductionmentioning

confidence: 99%

Successful Implementation of a Multidisciplinary Chemotherapy Efficiency Initiative at a Community Hospital

Parkes

Nusrat

Tomasso

et al. 2019

JOP

View full text Add to dashboard Cite

show abstract

“…A model aimed at improving patient service and nurse satisfaction for outpatient chemotherapy scheduling was proposed by Huang et al (2018). The model schedules different types of patients on the basis of their treatment duration, with the aim of optimising nurse staff utilisation and minimising constraint violations such as beds or chairs, time constraints and patient-to-nurse ratios.…”

Section: Literature Reviewmentioning

confidence: 99%

Master chemotherapy planning and clinicians rostering in a hospital outpatient cancer centre

Carello

Landa

Tànfani

et al. 2021

Cent Eur J Oper Res

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In the past years, the number of patients in need of chemotherapy treatments has been constantly increasing. Chemotherapy treatments must be carefully planned to provide a suitable and timely care. They are often provided within an outpatient setting. Clinicians and nurses staff must face the increasing demand for chemotherapy treatment with limited resources, such as exam rooms, beds, and seats. In this work, we consider a cancer centre shared among different oncologist specialties, as suggested by the Organisation of European Cancer Institutes. We focus on the oncologist visit that each patient must undergo before the drug infusion, to check if the patient's conditions are compatible with the drug infusion. We consider the problem of planning the weekly assignment of consultation rooms to cancer pathologies, referred to as Master Chemotherapy Planning. Further, we jointly address the problem of selecting a clinician with suitable skills to cover each consultation room in the weekly schedule, given the cliniciansávailability over a month. Several criteria are considered, such as the number of visits in overtime, the amount of met demand and the clinicians' workload. The problem is formulated as a lexicographic multiobjective optimisation problem B Paolo Landa

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“…The objective of this study is to create a scheduling template minimizing the violation between resource assignment and treatment requirements. Huang et al [17] presented an optimization model to determine when to schedule patients according to their visit durations. The model improves chair utilization and reduces staffing resource violations measured by nurseto-patient ratios during the workday.…”

Section: Literature Reviewmentioning

confidence: 99%

Multi-stage appointment scheduling for outpatient chemotherapy unit: a case study

et al. 2021

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This paper deals with a multi stage hybrid flow-shop problem (HFSP) that arises in a privately Chemotherapy clinic. It aims to optimize the makespan of the daily chemotherapy activity. Each patient must respect the cyclic nature of chemotherapy treatment plans made by his referent oncologist while taking into account the high variability in resource requirements (treatment time, nurse time, pharmacy time). The problem requires the assignment of chemotherapy patients to oncologists, pharmacists, chemotherapy beds or chairs and nurses over a 1-day period. We provided a Mixed Integer Program (MIP) to model this issue, which can be considered as a five-stage hybrid flow-shop scheduling problem with additional resources, dedicated machines, and no-wait constraints. Since this problem is known to be NP-hard, we provided a lower bound expression and developed an approximated solving algorithm: a tabu search inspired metaheuristic based on a constructive heuristic that can quickly reach satisfying results. To assess the empirical performance of the proposed approach, we conducted experiments on randomly generated instances based on real-world data of a Tunisian private clinic: Clinique Ennasr. Computational experiments show the efficiency of the proposed procedures: The mathematical model provided optimal solutions in reasonable computational time only for small instances (up to 10 patients). Meta-heuristic’s results demonstrate, also, that the proposed approach offers good results in terms of solution quality and computational times with an average relative gap to the MIP solution equal to 3.13% and to the lower bound equal to 5.37% for small instances (up to 15 patients). The same gap to the lower bound increases to 25% for medium and large size instances (20-50 patients).

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Alternative Outpatient Chemotherapy Scheduling Method to Improve Patient Service Quality and Nurse Satisfaction

Abstract: We conclude that the proposed optimization approach with regard to nursing resource assignment and workload balance throughout a day effectively improves patient service quality and staff satisfaction.

Cited by 17 publications

References 24 publications

Successful Implementation of a Multidisciplinary Chemotherapy Efficiency Initiative at a Community Hospital

Successful Implementation of a Multidisciplinary Chemotherapy Efficiency Initiative at a Community Hospital

Master chemotherapy planning and clinicians rostering in a hospital outpatient cancer centre

Multi-stage appointment scheduling for outpatient chemotherapy unit: a case study

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