Nurses, leaders, and staff responsible for infusion center scheduling often feel like they are trapped in a never-ending game of Tetris, and they are far from alone. A five-year survey of the leadership teams of 500+ infusion centers all over the US showed similar ongoing concerns as they try to cobble together daily schedules for their infusion chairs.
Following five simple steps, however, will go a long way to addressing infusion center scheduling problems using a mathematically-driven solution.
1. Build an optimal template to guide infusion schedulers
Common infusion center scheduling practices of “first come, first scheduled” or offering slots based on a calendar don’t work. Neither do approaches that attempt to “schedule to a chair” for each patient based on their appointment time or “schedule to a nurse” by assigning each patient to a specific nurse. All these approaches are prone to causing bottlenecks that derail an infusion center’s entire day. They also lead to a “peaky” schedule, overbooked with patients’ generally preferred midday appointments and also leave little room for inevitable add-on appointments.
Instead, it’s possible to build an optimal infusion scheduling template based on the specifics of each facility’s operations. This can be engineered to guide schedulers to intelligently sequence the start times of various appointments, based on their respective durations.
The template tells infusion schedulers how many appointments of each duration should ideally be started at each time slot throughout each day of the week. The objective is to create a smooth ramp-up to attain full utilization of the chairs by mid-morning, keep the chair occupancy flat, and then smoothly ramp down at the end of the day.
Read how Nebraska Medicine’s Buffett Cancer Center used optimal infusion schedule templates to grow patient volumes while keeping patient wait times under 10 minutes.
2. Make data-driven infusion scheduling decisions for each day’s reality
Regardless of how accurate the optimized templates may be, each day presents a new reality for infusion scheduling—the volume of patients may be different from the predicted volume, the actual mix of treatment durations may not perfectly match the expected mix, or a scheduler may have been forced to accommodate an urgent add-on outside the slots recommended by the template.
To provide up-to-date guidance, a profile of the way today is likely to unfold in the infusion center can be automatically generated at the start of each day, or the prior day or week. This profile can point out times when infusion chair capacity may be tight, as well as windows of time where add-on patients would best be scheduled. It also gives the nursing leadership insight into whether the day will run smoothly and end on time, and what action to take if it looks like the day will not.
Read how Michigan Medicine’s Rogel Cancer Center used historical data to proactively adapt daily infusion schedules to likely changes.
3. Groom the infusion schedule for the upcoming days and weeks
While numerous “day of” decisions are important to get right, only so much optimizing can be done at that last minute. It’s crucial for nurses and schedulers to be able to look ahead several days or weeks and “groom the schedule” by making small adjustments that are easy to make now but will be harder to implement later. Examples include rescheduling a small number of patients, modifying a nurse’s shift schedule, or restricting additional appointments being made within a specific time window.
Similarly, a “huddle calendar” can be generated to show alert flags on specific days, and give guidance on the highest-leverage grooming actions that can be taken days in advance.
Read how Seattle Cancer Care Alliance successfully implemented groomed weekly infusion schedules to alleviate historic bottlenecks.
4. Solve upstream scheduling issues to the fullest extent possible
In cases where specific providers may be inadvertently creating bottlenecks by sending too many patients to the infusion center in too short a time, it may be helpful to capture data demonstrating this and share it with the provider. This may persuade the provider to consider “de-clustering” their routine follow-up appointments with infusion patients so that all of those patients don’t come in for infusions at the same time of day, and that unlinked appointments are available at the “shoulders” at the beginning and end of the day’s schedule.
Read how Texas Oncology Centers tracked consistent midday “peaks” to take action and level-load infusion schedules.
5. Build a learning loop to promote effective infusion center scheduling on an ongoing basis
Infusion centers are not static; their operational realities change frequently. A template that is optimal today may not be optimal tomorrow, let alone six months later.
It’s essential to track the operational changes that matter and to have a systematic, continuous method of mining your data to compare actual performance to predicted performance. This way infusion schedulers and managers can identify discrepancies between the two and accurately classify them as either one-off variations or systemic issues resulting from a change in the underlying operational facts.
Infusion centers all over the country are discovering the power of sophisticated mathematics, supported by AI-based analytics tools, to streamline their operations and vastly improve the patient and staff experience.
A mathematically-driven solution makes it possible to beat the infusion center scheduling game. iQueue for Infusion Centers, in working with top cancer centers throughout the country, has developed and perfected the use of AI to facilitate scheduling, reduce average waiting times, drive higher patient volumes, lower overtime pay, and increase nurse satisfaction and patient experience scores.
Want to learn more? Check out our ebook on winning the game of infusion scheduling Tetris.