Novant Health and Presbyterian Medical Center, part of a large not-for-profit healthcare system in North Carolina, South Carolina, and Georgia, opened a new, larger chemotherapy and infusion center in 2020. Novant Health Nurse managers Lisa Rioux, RN, BSN, OCN, CRNI and Susan Perella, RN, OCN were part of the implementation team responsible for its successful operation. After opening the new Center, they launched LeanTaaS’ iQueue for Infusion Centers, technology that uses predictive analytics to improve infusion center scheduling. Rioux and Perella recently talked about their journey and preparation of going from a 32 to an 80 bay infusion center. Here they share the innovations and best practices that allowed them to decrease wait time, improve patient satisfaction, and accommodate breaks for nursing staff.
Novant experienced many of the same challenges all infusion centers face. Appointments tended to be clustered in the middle of the day, nurses struggled to take breaks, and immunocompromised patients sat in waiting rooms as infusion chairs were often not available during peak times. Same-day add-on appointments from oncologists were often requested. Epic templates didn’t allow nurses and managers to predict future demands and reduce the strain by “flattening” the schedules throughout the day.
Novant’s bottlenecks and pain points urgently needed to be addressed. Rioux explained, “Moving into our new space three times the size, we needed to make some type of a change. We were going to have bigger problems on a larger scale if we didn’t fix it then.” They implemented iQueue for Infusion Centers to directly address the scheduling challenges.
Outcomes have included a 41% decrease in wait times and a 10% decrease in the average drug wait time. Here are the top takeaways from Novant’s experience:
Innovations & Best Practices for Infusion Center Scheduling
#1 Keep patient flow moving with a small waiting room Now immunocompromised patients are not forced to all sit together in the same space – especially important during the pandemic when social distancing is critical,
#2 Update your duration crosswalk and make it simpler to follow. Perella said, “we learned to be very adaptable and flexible, especially during COVID. Last year, we were doing monoclonal infusions for COVID-positive patients. iQueue was instrumental in helping us with that and changing that on a weekly basis. It really helped the flow over there, allowing them to be flexible and accommodate those patients. It created a more spread-out time for nurses to go to lunch, which wasn’t happening before.”
#3 Level load assignments using the nursing allocation tool. As Perella also explained, “we plug names in and iQueue runs it for you. It gives you a great baseline to level load the assignment so nurses aren’t overwhelmed. That also gives us the availability when we have add-on calls for same-day appointments. We can see where there are gaps,” Perella said.
#4 Use data for daily huddles and leadership meetings. iQueue data is invaluable for sharing future days’ volumes, mix of patients, and predicted chair time. Rioux said, “I could get a quick glance at the future days’ volumes, and the mix of patients that are coming, based on their predicted chair time. I could adjust staffing, and pull a nurse off Sunday and schedule them to work Thursday when I knew that was a higher workload for that day. The diagnostics reports are also really good tools to use during our leadership meetings, so we can inform them how our chairs, chair utilization, and our volumes are going in our department.”
#5 Obtain provider and patient buy-in. When a provider office calls asking to send over a patient for a particular day or time, LeanTaaS helps them make those decisions. Rioux added, “We also sent out a letter to our patients, informing them of our new process and to be patient with us. Nurses and schedulers all received that scripting on helping us stay on track with our templates so that we wouldn’t sabotage it immediately when we went live with iQueue.”
Rioux concluded, “We still have work to be done, and we still have goals that we’re trying to accomplish. We continue to track our data. We can make adjustments based on that data, looking at the number of add ons and cancellations and no-shows and why is that happening. Maybe we need to dig a little bit deeper to find out why. We can identify what processes need to happen to get us back on track.”
For a deeper dive on Novant’s implementation of iQueue for Infusion Centers, read the further blog or view the webinar here. For more information on best practices in infusion center scheduling, download a free ebook.
