How leading health systems use data to streamline operations
Patients arriving for infusions don’t want to spend more time than necessary getting treatment and staff members prefer a steady stream of work rather than a mid-day rush. With each patient needing a different infusion time, scheduling can be difficult and imprecise. During a Dec. 16 webinar, Mohan Giridharadas, founder and CEO of LeanTaaS, Jamie Bachman, chief administrative officer for oncology at Johns Hopkins Medicine, and Debbie Fernandez, director of the quality and oncology service line at University of Kansas Health System, shared common infusion center challenges and solutions to streamline operations, which can be applied to other clinical practices across health systems beyond infusion centers.
1 Common challenges plague infusion centers and other clinical offices
Infusion centers, like other clinical practices, usually face three challenges daily: long patient wait times for appointments, especially mid-day; a mountain-shaped appointment profile; and nurses often missing lunch breaks. The capacity and demand mismatch leads to high overtime costs, staff and chair over or underutilization and low team morale. Like freeways at rush hour, peak appointment periods can cause backups at every step.
2 Analytics-driven predictive algorithms can help with scheduling
To convert the utilization profile from a mountain to a plateau, clinical practices must be able to predict daily patient volume accurately. This is difficult because physicians have different practice patterns and patients have different needs. Physicians may also estimate longer or shorter appointment times than are actually needed. When building a scheduling model, analytics can inform how to arrange appointments to account for constraints like nursing shifts, pharmacy hours and physician schedules. The model can then match the nursing workload and staff with patient needs, unlocking additional capacity.
3 Visibility to scheduling system is key
Providing all stakeholders with visibility and accessibility to the scheduling system leads to better outcomes for patients and staff. Frontline teams can plan daily schedules better by knowing when they need staff reinforcements and when physicians can round. Pharmacists can also plan in advance to premix some medications.
4 Implementing a new scheduling system requires a team approach
A new scheduling system requires multiple team members including nurses, administrative leaders, IT staff, billers and schedulers. The planning and implementation process can happen over web conferencing. Training can also be virtual, with onboarding webinars for staff members. Referring doctors and patients should also be informed of the changes through email and posted information. This alerts patients that their usual appointment times may slightly change, but the result will be shorter waits.
5 Metrics help understand performance
Data is important for staff members to understand and quantify challenges and measure improvements. When Johns Hopkins implemented the iQueue infusion center scheduling system, it decreased drug preparation wait time by 13 to 32 percent, depending on the center. Schedulers created nursing assignments in a quarter of the time than they did before. And at the University of Kansas Cancer Center, patient volume increased by 19 percent after implementing iQueue, essentially adding a day of patients each week without adding new chairs.