(66) Identifying Barriers to Timely Chemotherapy Administration, Opportunities for Improvement and Education Implementation for Improved Overall Efficiency and Satisfaction

Title: Identifying Barriers to Timely Chemotherapy Administration, Opportunities for Improvement and Education Implementation for Improved Overall Efficiency and Satisfaction

Abstract : Oncology patients are admitted from ambulatory clinics and directly from home for inpatient chemotherapy. We have identified discrepancies in the length of time it takes for chemotherapy to be initiated. We recognize that efficient start times lead to timely discharges. This also coincides with patient and family satisfaction.

Many factors contribute to the workflow of chemotherapy start times, including, but not limited to, patient arrival times, patient hydration status, provider schedules, lead time for lab results, time of chemotherapy clearance including clarifications required on chemotherapy orders and roadmaps, inpatient nursing patient acuity, pharmacy delays in making and transporting chemotherapy, antiemetic administration, and knowledge deficits in the overall process.

Our project identified the barriers to timely chemotherapy initiation. We utilized a retrospective design to collect data on patients admitted for chemotherapy over a seven month period. We subsequently administered an anonymous survey to inpatient nurses responsible for chemotherapy administration. The retrospective data and survey results highlighted opportunities for staff education and workflow optimization.

We utilized the identification of key barriers to provide staff, patient, and family education to improve patient wait times and lead to increased patient and family satisfaction. We instituted staff in-services and a post-education survey. Our goal was to both identify the barriers to delays and subsequently limit those delays to one hour from the time of a patient meeting cleared for chemotherapy parameters. The results of our initiative are leading to more efficient initiation of chemotherapy administration and increased patient, family, and staff satisfaction.
This project demonstrates that pediatric oncology APPs and staff nurses can collaborate and implement positive change to benefit their patients and families and increase overall satisfaction.