Optimizing Outpatient Cancer Infusion Center Throughput Using a Systems-Based Approach

Abstract

Over the last 30 years, outpatient infusion centers have been constructed across the United States to meet rising demand for cancer care. While outpatient care is now commonplace, these clinics still struggle to achieve patient throughput levels that match demand for their services. Our study examined the infusion workflow at a central Virginia infusion center whose patient throughput rate in fiscal year 2022 fell in the second quartile of infusion centers nationwide. We collated qualitative stakeholder interviews and in-person observations with the center’s quantitative patient appointment data, to conduct a holistic analysis. Next, we evaluated current throughput levels with process mapping and descriptive statistics. Finally, we used statistical analysis to propose a strategy for future throughput improvement that included a data-based pilot test. Our analysis confirmed a need for process improvement at the infusion center. We found that patient idle times, drug types, and staffing appeared to be the key factors impacting throughput. Additionally, our results showed that appointment buffer times and drug pre-mixing were the most leverageable factors on patient throughput. Next steps should focus on enhancing our predictive modeling and implementing our proposed throughput improvement solutions.