Three questions to ask when managing linked infusion appointments
In certain infusion centers, and in areas of the infusion schedule where there is room to do so, linking a patient’s infusion treatment to other appointments has clear benefits. A patient who can see their oncologist right before or after their treatment saves extra travel time between those separate appointments. Getting pre-infusion labs cleared immediately also saves time, as does scheduling radiation or other treatments in an adjacent time slot. For these patients, many of whom are undergoing many tiring treatments and who are perhaps traveling long distances for care, keeping their appointments on the same day and minimizing their time in the infusion center goes beyond simply offering them convenience.
But while linking appointments may be a positive for patients, it deeply complicates infusion scheduling. In fact, the process of linking infusion appointments, predictably and in a way that minimizes wait time, is as intricate as directing connecting flights through a hub airport.
Like flights, infusion appointments depend on a complex system of supply and demand to begin and move forward on time. They involve the varied availability of nurses, chairs, and drugs, and the unpredictable lengths of other appointments. Appointments and services with oncologists, clinics, labs, pharmacies, and radiation rely on their own supply and demand patterns. This creates a set of interconnected nodes, where one service cannot begin until many other tasks in different areas have been completed, and where no appointment can begin on time unless many others do as well.
Infusion centers inevitably won’t achieve perfect on-time performance across all services in the way airlines do. To manage linked appointments, infusion center leaders must balance the needs of the patient with the reality of the center’s operations. They must minimize wait times while accommodating delays and ensuring all resources are being fully utilized, rather than sitting idle while they wait for scheduled patients who are late.
Maintaining linked appointments in the infusion center is possible, but requires thoughtful strategizing and powerful AI-based tools throughout the whole center to support. To do so effectively, start by finding answers to the following questions.
- Which infusion appointments, linked or unlinked, should be scheduled in non-peak hours?
A frequent challenge with infusion appointment scheduling, particularly with patients who have linked appointments with clinicians or other first services early in the day, is a “peaky” schedule that becomes overloaded in the midday. Such schedules are more likely to cause bottlenecks, keep nurses excessively busy during lunch time, and make accommodating add-on appointments difficult or impossible.
Moving just a few patients from these peak hours to non-peak hours goes a long way to alleviating busy midday schedules. Many linked infusion appointments will inevitably be scheduled during these times, but some can be moved, and non-linked appointments are generally viable options to shift to the less-utilized “shoulders” at the beginning and end of the day.
Patients who may be a good match for non-peak hours might include those who do not have clinic visits, or had their clinic visit the previous day; non-oncology patients, who tend to receive simpler or one-off treatments; patients coming for supportive care, such as hydration treatments; patients who have a shorter travel time to the cancer center; and patients who prefer to receive treatment before or after their workday. Schedulers can work several strategies to book patients for non-peak times who are accustomed to getting treatment midday, including offering them first pick of non-peak hours.
Adjusting scheduling to alleviate peak hours leaves more room for linked infusion appointment patients to arrive at those times. Fitting linked appointments into those hours, in a way that suits both the patient and the infusion center operations for the day, requires another consideration.
- How long is the “just right” infusion booking window?
A “booking window” is the concept of including the range of appointment times available between appointments, for instance between clinic and infusion, rather than leaving a static amount of time between them. Simply booking the infusion 30 minutes after the doctor’s visit is the wrong answer. If the booking window is too short, it might not allow enough time for patients to go between appointments or accommodate potential delays in one area without throwing off the entire day’s infusion schedule. If the window is too long, it leads to excessive wait times and may obviate the need to link appointments at all.
The key to defining the “just right” booking window is finding the feasible minimum and maximum range of time. The minimum can be based on the center’s historic patterns of how much time is realistically needed between certain appointments on a given day and time, as well as the actual amount of time between the clinical and infusion appointment being scheduled now. The maximum should allow for as much time as is possible to support flexibility in scheduling while not negatively impacting patient flow. Determining the minimum and maximum times consistently will help arrange linked appointments that function effectively within the daily infusion schedule.
- How should the infusion center optimize scheduling templates to accommodate both linked and unlinked appointments?
Moving infusion appointments to non-peak hours, and developing appropriate booking windows for linked appointments, will somewhat alleviate infusion scheduling pressures and support linked appointments being accommodated. But unpredictable factors like late-running services and unexpected patient reactions can still derail the day’s schedule. Creating the most efficient schedule, one that incorporates the many needs of every service, staff member, appointment, and patient to their optimal degree, also involves a level of math that is simply beyond the manual ability of infusion schedulers. A high powered, AI-based analytics tool to build optimal scheduling templates, which a center’s staff can customize with peak/non-peak considerations and booking windows, provides the most solid foundation for better infusion scheduling.
To learn more about supporting better infusion scheduling with analytics tools, see iQueue for Infusion Centers or visit our infusion Resource page.