• Copyright © 2012 by American Society of Clinical Oncology

Improving Wait Time for Chemotherapy in an Outpatient Clinic at a Comprehensive Cancer Center

1. Michael A. Kallen, PhD, MPH,
2. James A. Terrell, MS,
3. Paula Lewis-Patterson, RN and
4. Jessica P. Hwang, MD, MPH⇓

+ Author Affiliations

1. The University of Texas MD Anderson Cancer Center, Houston, TX

1. Corresponding author: Jessica P. Hwang, MD, MPH, 1515 Holcombe Blvd, Unit 1465, Houston, TX 77030; e-mail: jphwang@mdanderson.org.

Abstract

Purpose: We conducted our study at the Ambulatory Treatment Center (ATC) of the MD Anderson Cancer Center, a network of six outpatient treatment units for patients receiving infusion therapies. Excessive patient wait time for chemotherapy was a primary source of ATC patient dissatisfaction. ATC employees expressed frustration, because often, patients arrived physically on time but were not treatment ready. Additionally, ATC staff emphasized challenges associated with obtaining finalized treatment orders for prescheduled appointments (ie, placeholder appointments without associated physician treatment orders). We aimed to decrease mean patient wait time from check-in to treatment in one ATC unit by 25%.

Methods: We studied appointment cycle time in the ATC Green Unit, stratifying appointments by type (ie, prescheduled [no finalized treatment orders] and scheduled [finalized treatment orders]). We obtained mean wait times at baseline (control) and again after our intervention period. We conducted interviews and observations in ATC Green, from which we developed a three-part plan to reduce wait time: increase process efficiency within ATC Green, enhance communications with MD Anderson clinics and centers, and incorporate information technology applications.

Results: After our intervention, we observed a 15% decrease in wait time for patients with prescheduled appointments and a 29% decrease for those with scheduled appointments. Overall, there was a 26.8% reduction in mean patient wait time relative to baseline (control).

Conclusion: We observed a significantly decreased mean patient wait time after implementing our intervention. This decrease may improve patient satisfaction, relieve employee frustration with appointment scheduling, and create opportunities for increasing institutional revenue.

• Accepted August 3, 2011.

Improving Wait Time for Chemotherapy in an Outpatient Clinic at a Comprehensive Cancer Center