title: Outpatient chemotherapy administration: decreasing wait times for patients and families.
abstract: Increasingly, there is a trend to deliver chemotherapy, where possible, in the outpatient ambulatory setting. In the few studies that have explored the setting of cancer care, long wait times are frequently linked to dissatisfaction. Several factors contribute to lengthy waiting times for patients and their families: long registration processes, lag times associated with obtaining laboratory results, time required for patient assessments and preparation of chemotherapeutic agents, adequacy of nursing resources, and physical space constraints in relation to patient volumes. With the goal of improving care delivery in the outpatient clinic, a fast-tracking system was established. Program planning included establishing patient eligibility criteria, protocol and treatment appropriateness, interdepartmental collaboration, development of a communication plan for families and staff, negotiation of physical space, and allocation of human resources. This was instituted by re-allocating existing resources and establishing an autonomous nurse-managed chemotherapy clinic. This fast-tracking program has enabled us to use our existing resources with greater efficiency and improve patient care from safety and quality-of-life perspectives for those included in the program.
authors.affiliation: Division of Haematology/Oncology, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada, M5G 1X8. eleanor.hendershot@sickkids.ca
authors.forename: Eleanor
authors.initials: E
authors.lastname: Hendershot
authors.forename: Cory
authors.initials: C
authors.lastname: Murphy
authors.forename: Sandra
authors.initials: S
authors.lastname: Doyle
authors.forename: Judy
authors.initials: J
authors.lastname: Van-Clieaf
authors.forename: Jane
authors.initials: J
authors.lastname: Lowry
authors.forename: Lisa
authors.initials: L
authors.lastname: Honeyford
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001294:Attitude to Health; D002648:Child; D005190:Family / Q000523:psychology; D006776:Hospitals, Pediatric; D006801:Humans; D008019:Life Style; D024802:Nurse's Role; D015403:Nursing Evaluation Research; D009859:Oncology Nursing / Q000458:organization & administration*; D009864:Ontario; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D010347:Patient Care Planning; D010348:Patient Care Team / Q000458:organization & administration; D018579:Patient Selection; D010371:Pediatric Nursing / Q000458:organization & administration*; D010865:Pilot Projects; D017009:Professional Autonomy; D016730:Program Development; D015397:Program Evaluation; D011787:Quality of Health Care / Q000592:standards; D017748:Time Management / Q000458:organization & administration*; D014850:Waiting Lists
chemical_list: D000970:Antineoplastic Agents