TITLE

IMPROVING CHEMOTHERAPY TURNAROUND TIME IN AN OUTPATIENT HOSPITAL-BASED INFUSION CENTER

AUTHOR(S)
Johnson, Darlene
PUB. DATE
March 2006
SOURCE
Oncology Nursing Forum;Mar2006, Vol. 33 Issue 2, p444
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Because of recent CMS rulings regarding the reimbursement of chemotherapy administration in the physician offices, an increasing number of patients are being treated in hospital-based outpatient infusion centers. This transition to the hospital setting often finds the patient routed to many different areas for registration, lab services, and chemotherapy administration. Therefore, efforts to improve on this process are necessary for promoting patient satisfaction while maintaining patient safety. The objective of this CQI project was to improve chemotherapy turnaround time in a hospital-based outpatient infusion setting. The goal was to identify areas for improvement in the overall process, while maintaining patient safety measures. A flow chart was utilized to trace the entire process from entering the hospital to actual administration of chemotherapy. Areas identified for improvement included patient scheduling, timeliness and thoroughness of physician orders, pharmacy completion of chemotherapy formulation, and timely lab services. A log sheet was utilized for documentation and data was reported quarterly to our cancer committee. A review of patient scheduling noted that 75% of patients were scheduled at 9 A.M. or earlier, therefore, guidelines were developed. 70% of patients required lab work prior to chemotherapy administration necessitating the implementation of approved lab parameters and a dual role staff position of phlebotomist and patient registrar. Delays noted in pharmacy preparation of chemotherapy resulted in the implementation of a designated oncology pharmacist and a satellite pharmacy in the infusion center. All chemotherapy orders are reviewed by pharmacy and nursing on the day prior to administration. These changes have decreased chemotherapy turnaround time from 2.5 hours to 1.5 hours and have resulted in 95% of patients and 100% of physicians expressing high levels of satisfaction with infusion center services. With proposed reimbursement changes, outpatient hospital-based infusion centers will continue to be utilized for an increasing number of patients. Nurses have the opportunity, through monitoring of processes, to make changes that will work toward improving patient care. This project has reinforced the importance of data collection and how effective process improvements can occur as a result of this.
ACCESSION #
26746828

 

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