Introduction/background information. In 1998, increasing patient volumes and workloads related to ambulatory chemotherapy began to result in delays in the outpatient clinics, laboratory, pharmacy and the chemotherapy administration areas. The various departments that were being impacted met to review the situation and propose a solution.
Program description. The team proposed that a next-day chemotherapy schedule be implemented, whereby patients would have their laboratory and physician appointment on one day and their chemotherapy administered on the next day. Originally, this was turned down by senior management, however, a year later the same issues resurfaced and the next-day chemotherapy scheduling was once again proposed and approval received to implement.
Program implementation. A timetable was created and chemotherapy administration appointments were scheduled based on the available timeslots. The goal was to have the majority of patients scheduled for chemotherapy administration on the day following their appointment with the physician. Patients who would be exceptions to the next-day scheduling system were identified and education of staff and patients regarding the change was completed. Resistance from patients and staff was encountered and managed through continued education and reinforcement regarding the reasons for the change.
Pharmacy issues/evaluation. Pharmacy conducted a follow-up timing study and the results supported that the timetable change was successful in improving pharmacy’s ability to prepare the chemotherapy for the patient’s appointment time. Pharmacy operational issues had to be worked through, however, overall the change was found to be positive.
Conclusion. The implementation of a next-day chemotherapy administration schedule has resulted in improved efficiencies for pharmacy and nursing and a decrease in waiting times for patients to receive their chemotherapy.
