Improving access to infusion services: Results of an operational sprint.

person Michelle Wilson Miami Cancer Institute, Miami, FL info_outline Michelle Wilson, Paula Fonte-Smith, Jonathan Kalish, Alexander George, Dina Bernie Dumercy McHenry, Maria Suarez, Vicki Caraway, Mark Davis

Authors person Michelle Wilson Miami Cancer Institute, Miami, FL info_outline Michelle Wilson, Paula Fonte-Smith, Jonathan Kalish, Alexander George, Dina Bernie Dumercy McHenry, Maria Suarez, Vicki Caraway, Mark Davis Organizations Miami Cancer Institute, Miami, FL, Miami Cancer Institute - Baptist Health South Florida, Miami, FL, Miami Cancer Institute, Hollywood, FL, Miami Cancer Institute, Baptist Health South Florida, Miami, FL Abstract Disclosures Research Funding No funding sources reported Background: As a large clinical academic cancer center growing from 40,772 unique patients in 2021 to 44,416 patients in 2022, access for patients to begin therapy in the infusion suite was delayed by 3.2 days. In addition to delays in care the center experienced decreased patient satisfaction related to timeliness of scheduling and an inflexible scheduling template that did not allow for the maximization of chair assets. An infusion sprint was launched to address the challenges with the main goal of providing a seamless patient experience while ensuring that all 60 chair assets were maximally utilized. The multi-disciplinary team sought to accomplish this through a disciplined evaluation and intervention program with the goals of increasing access, improving patient satisfaction and growing operating income. Methods: In February 2022, a multi-disciplinary team was assembled to develop and implement a plan to increase access to the infusion suite over a period of 6 months. The team utilized LEAN-Six Sigma principles to characterize current state, desired future state and tactical interventions with metrics. Access data, available infusion appointments and activities occurring in chairs were analyzed with the goal of maximizing utilization. This was accomplished through the development of an active asset management methodology that compared available infusion appointment hours in the schedule to the actual completed hours which allowed the center to determine the growth opportunity within the current chair count. Financial performance was reviewed, and a pilot of an AI-based scheduling platform was launched. Results: Data collected in December 2022 showed that the pilot increased average daily chemotherapy infusion patient volume by 10% and overall volume by 11% over prior fiscal year from October 2021 to September 2022. Daily scheduling escalations manually resolved by leadership decreased 54% between May 2022 and September 2022. Newly created chair utilization methodology showed increased utilization from 62% to 82% in 7 months and patient satisfaction increased from 76.97% to 81.18% for “Timeliness of Scheduling.” These initiatives also resulted in an 18% increase in infusion/pharmacy income from operations from October 2021 to September 2022. All of this was accomplished without adding staff to the workforce or chairs to the infusion suite. Conclusions: A focused, intentional, multi-disciplinary infusion sprint conducted over 6 months resulted in increases of patient access, increased patient satisfaction and revenue. External validity is limited by its one site design with future investigation planned at other sites within the cancer care network to determine if results can be reproduced.