At the LeanTaaS 2022 Summer Transform Hospital Operations Summit, SSM Health Director of Clinical Services Melanie Maze and Administrator of Oncology Outpatient Operations Shannon Veltrop discussed their infusion centers’ agility and resilience in navigating operational shockwaves and continuing to implement and achieve results with analytics during the disruptions of the pandemic. See their full session here or explore more success stories of AI in cancer centers here.
About SSM Health
SSM Health is a Catholic Midwest-based not-for-profit health system with care delivery sites in Illinois, Missouri, Oklahoma, and Wisconsin. The system, headquartered in St. Louis, encompasses both academic and community care offerings as well as its own health plan. SSM Health’s physician services in St. Louis are doubling in size in 2022, with the integration of the SLUCare Physician Group.
In 2021, SSM Health Cancer Care served in total about 3,000 patients across almost 39,000 visits throughout six community infusion rooms. Maze currently oversees three Cancer Care locations, who provide medical oncology, radiation oncology, and infusion services.
Initial SSM Health infusion challenges: when AI is needed to address capacity problems
Several years ago, SSM Health was introduced to iQueue for Infusion Centers at an industry conference, and while interested in the product, did not think they needed it. While SSM Health infusion centers were experiencing ongoing issues with patient access and scheduling appointments in a timely way, they always managed to place every patient who needed an appointment eventually. All infusion personnel understood that chemo patients would arrive in the morning, be linked into physician appointments whenever those are available, and have other appointments placed where possible throughout the day. With this process in place, infusion nurses and scheduling staff did not seem to need any further support building optimal schedules or patient paths that maximized capacity.
Later, around 2019, SSM Health began to feel the financial pressures impacting the healthcare industry as a whole. They were not able to hire additional staff, and retaining existing staff became more of a challenge.
Maintaining the staff we had was getting harder. We would work our infusion nurses especially hard in the mornings, work them through lunch and then try to get them out the door as fast as possible when patient volumes dropped in the later afternoon to protect our productivity metric. -Veltrop
Nurses were…sometimes not getting a break until late afternoon. The pharmacy could not keep up with the volume in the morning, causing an even bigger bottleneck of wait time for chairs. By late afternoon, everyone was gone. The tumbleweeds were rolling through the infusion room and we were pressuring the staff to finish up and clock out. -Maze
At this time, SSM Health re-examined the opportunity to adopt iQueue, to leverage the solution’s AI and analytics capabilities to help even out daily schedules, stagger nursing shifts, and help unclog the pharmacy backups. Doing so could expand infusion capacity enough to decrease patient wait times while maintaining current volumes and not requiring expansion of space or chairs.
Going live with iQueue for Infusion Centers: analytics prove out results
SSM Health went live with iQueue in May 2019 at its busiest center, the Lake St. Louis location, which sees an average of 30-50 patients per day. At the time the center took about 40 daily patients across its 17 infusion chairs, and was expanding the size of its room and looking to add two chairs and possibly one nurse as they were implementing iQueue. This first phase of deploying analytics to manage infusion capacity achieved the following results:
- 18% increase in patient volumes
- 44% decrease in wait times for chair access at the scheduled appointment time
- 25% decrease in wait times for drugs from pharmacy
Given these improvements, the center no longer had to add chairs or staff as originally planned. The daily experience of nurses, staff, and patients noticeably improved.
Due to the morning rush, sometimes nurses were waiting to chart notes and enter charges instead of in-time charting, which can cause documentation and charging errors. We were able to utilize afternoon hours more efficiently, allowing staff break and lunch times and allowing pharmacy to work at a more efficient pace…nurses now chart on time, completing all their documentation by patient discharge and are ready for the next patient at the scheduled appointment time, patients were no longer waiting for chairs causing overcrowding in the lobby and spent less time in the clinic. -Maze
Infusion capacity disrupted – briefly – by COVID safety measures
At the start of 2020, the iQueue implementation was continuing successfully, and SSM Health planned to expand iQueue to additional locations. Then the COVID-19 pandemic began requiring rapid adjustments in capacity to enact safety measures.
Who knew the magic distance of six feet could wreak such havoc in our infusion rooms that had been strategically managed to accommodate as many chairs as we needed? We got the tape measures out, spaced out the chairs, and found we needed to eliminate about 11% of our chairs across our St Louis community sites to allow for safer social distancing. -Veltrop
The abrupt reshuffling of capacity seemed at first like an insurmountable task, but by working with iQueue partners on their scheduling templates, the SSM Health infusion team was able to largely maintain patient volumes, protecting about 8% of their contribution margin, which totaled several million dollars.
Later a construction project at one site, coincidentally occurring in the middle of one of the worst COVID surges, further constrained space in both the lobby and infusion room. SSM Health was able to use the analytics tools offered by iQueue to modify their scheduling templates and safely accommodate patients at another site about ten miles away. This pivot allowed patients to keep their treatments on schedule while staff and nurses could continue working regular operating hours. It also ensured the construction project was finished on time, preventing added costs of delays. When the project was finished, the SSM Health team used iQueue to easily bring patients back to their regular site.
Further uses for analytics in infusion centers: SSM Health deploying iQueue now and in the future
Over the time spent using iQueue in its community settings, SSM Health has developed several new best practices to support daily operations. Since iQueue provides nurses with visibility into the optimal capacity arrangement for a given day, incorporating the mix of patients and the length and type of their appointments, they have been able to adopt a Nursing Lead scheduling process. Lead Nurses in the infusion room schedule both physician and infusion appointments. This allows them to spread linked appointments throughout the day and avoid overloading the mornings, which promotes staggered start times for infusion nurses.
Given iQueue’s proven success so far, SSM Health has also adopted the solution as its standard for cancer care infusion rooms and plans to continue implementing it throughout the system. SSM Health’s partnership with LeanTaaS allows for easy addition of sites, and early implementation outside of the St. Louis region in one of our Wisconsin sites is showing promising results.
For the full story of SSM’s use of analytics and AI in its cancer centers, view the full session.
