Reduction of waiting time in daycare infusion therapy
Abstract:
Background and objective: Daycare infusion therapy is an integral aspect of oncology, but increased waiting time raises concerns for patients. Patient-reported experience measures prompted the need to evaluate reasons for prolonged appointment delays. This study seeks to analyze and address patients’ concerns, to streamline the process flow and reduce waiting time for daycare infusion therapy thereby enhancing patient experience.
Methods: The Define, Measure, Analyze, Improve, and Control (DMAIC) methodology was implemented, and its impact on reducing waiting times was evaluated. The objective is to ensure that more than 85% of patients enter the daycare infusion unit within an hour of their appointment time in 6 months. The baseline data for patient waiting times was measured for a period of 2 months, and the average waiting time was determined. Potential causes contributing to prolonged waiting times were identified through time-motion analysis, with a fishbone diagram categorizing potential causes and a Pareto chart prioritizing them. Plan, Do, Study, and Act (PDSA) cycles were conducted for implementing the changes and a new process flow mapped.
Results: Baseline data showed 32% average adherence to the defined Turn Around Time (TAT) of one hour, with average waiting time of 108 minutes. Forty causes were identified for increased waiting time, of which eight were key. Adherence to waiting time TAT improved from 32% to 89% and average waiting time decreased by 59 minutes from 108 minutes, increasing patient satisfaction index by 7.5%. The balancing measures include an increase in operational efficiency and throughput of the unit and the inventory levels of oncology medicine were decreased, leading to a 50% reduction in inventory value, while medication error declined by 0.62%, improving patient safety.
Conclusion: The project gained tangible and intangible benefits impacting staff, patients, and relatives, while improving operational efficiency. This study, with its scientific and systematic approach, enhanced patient satisfaction, patient safety, and better utilization of resources.
Reference:
Mamballikalam G, Davis D, Sabrish KG. Process reengineering using DMAIC framework for reduction of waiting time in daycare infusion therapy for better patient experience. Int J Qual Health Care. 2023 Dec 29:mzad111. doi: 10.1093/intqhc/mzad111. Epub ahead of print. PMID: 38156362.