Throughput efficiency and service quality after process redesign at a cancer day care unit: Two sides of the coin?

Abstract

This study was designed to focus on the patient perspective in a reorganisation of care processes at a cancer day care unit (CDU). The effects of dose banding and of taking blood samples one day (or more) before the day care treatment (on Day −1) are investigated in terms of throughput efficiency and perceived service quality. Data were collected by mapping patient processes in detail and surveying patients in two CDUs at a university hospital (n = 308). A univariate model was used to investigate the effect of these factors on patient throughput time, and perceived service quality was examined with multiple linear regression. Taking blood samples on Day −1 decreases patient throughput time and increases the perceived service quality by improving the patient's perception of technical expertise and the outcome. This has a globally positive effect on patients' perceived service quality. Dose banding affected neither patient throughput time nor perceived service quality. Taking the pretreatment blood sample on Day −1 can be considered an important process design characteristic, as it increases both efficiency and service quality.

Oncologic Home-Hospitalization Delivers a High-Quality and Patient-Centered Alternative to Standard Ambulatory Care: Results of a Randomized-Controlled Equivalence Trial

“…Similar initiatives focused on the day-1 principle to reduce patient waiting times, but did not involve specialized homeinterventions. 18,19 At last, this study was prone to selection bias as result of the impossibility of blinding the intervention. A cross-over design might partially address this issue, albeit patients will always have preference for one of the two care models.…”