• Mayo Clinic Cancer Center adjusts chemotherapy schedules to accommodate more patients

Close up of IV drip for patient and Infusion pump in hospital.

PHOENIX — Researchers at Mayo Clinic Cancer Center have developed, tested and implemented new system that schedules outpatient chemotherapy appointments throughout the day, thus preventing crowded outpatient infusion facilities in the middle of the day. A summary of the researchers' findings is published in JCO Oncology Practice.

"Most people are not aware of the near-universal phenomenon at infusion centers across the country, where the bulk of chemotherapy infusions happen between 10 a.m. and 2 p.m. daily," says Alan Bryce, M.D. Dr. Bryce is an oncologist at Mayo Clinic Cancer Center in Phoenix, which is one of the sites across Mayo Clinic Cancer Center that tested the scheduling system.

Kris Altman, a nurse manager in charge of the chemotherapy unit at Mayo Clinic Cancer Center in Phoenix says that traditional scheduling leads to an excess of appointments that occur between 10 a.m. and 2 p.m. "The goal of spreading outpatient chemotherapy appointments throughout the day is to improve patient safety by avoiding periods of time where patient volumes exceed staffing levels — and also to avoid the subsequent pressure on nurses to skip or minimize breaks to manage patient volumes at those peak times."

Altman says chemotherapy infusion appointments should begin early in the day, stay level and then drop off quickly at the end of the day. "This schedule allows the nursing team to maintain optimal and efficient staffing, and it decreases patient waiting times and unanticipated delays," says Altman.

Dr. Bryce says the scheduling system is "a thing of beauty, and the direct result of managerial excellence, professionalism, and intentional effort from our nursing and scheduling teams." He says it requires discipline on the part of the teams to adhere to the plan and not make exceptions for any of the reasons that consistently arise. "Without that discipline, the outcomes would be less ideal for patients and staff alike," says Dr. Bryce.

"We have implemented this system at Mayo Clinic in Minnesota, and it was the first time I have ever seen a project successfully show exactly what the model predicted could be done," says Robert McWilliams, M.D., an oncologist at Mayo Clinic in Minnesota. "This is a true example of a win both for patients and the people who care for them."

This research was supported by the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery.

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