Publication

Abstract :

Background : In day-care chemotherapy facilities, long chemotherapy infusion wait times negatively impact patient experience. To resolve this problem, we implemented a quality improvement initiative using the - determining the problem, measuring the baseline, analysing the current situation, implementing the intervention, and controlling the improvement (DMAIC) methodology.

Methods : This study was conducted at the Department of Medical Oncology at the Amrita Institute of Medical Sciences, Kochi, from April to November 2019 in three phases. Phase 1 identified delay points from registration to the time of discharge using electronic records. Phase 2, after stakeholder input, implemented telephonic triaging (verification of laboratory results, health assessment and whether they recovered from the side effects) and pre-prepared chemotherapy orders. Phase 3 optimized scheduling - such as providing early slots for patients with chemotherapy infusion taking more than six hours, patients travelling long distances to the care centre, and vulnerable populations (older adults and children).

Results : We evaluated 1029 patients (409 males and 620 females) who underwent day-care chemotherapy. A pre- and post-comparative study across all phases revealed a significant reduction in mean waiting time. From a baseline of 3.5 hours, waiting time decreased to 2.4 hours in phase II and further to 1.6 hours in phase III, representing a 48.57% reduction.

Conclusions : Telephonic triaging and patient counselling prior to scheduled chemotherapy reduced wait times and unnecessary visits, streamlining workflow and improving patient care. This program, requiring only workflow restructuring with existing resources, offers a feasible model for other departments seeking to improve patient care and efficiency.