title: Delivering Patient Value by Using Process Improvement Tools to Decrease Patient Wait Time in an Outpatient Oncology Infusion Unit.
abstract: OBJECTIVE
  This study aimed to streamline workflow from arrival to premedication by decreasing patient wait time to increase value in a high-volume academic outpatient oncology infusion unit. The streamlining process involved identifying and prioritizing patients for treatment by driving out waste in patient flow.
  
  
  METHODS
  The plan-do-check-act (PDCA) method and Lean Methodology were used in completing a project to streamline a defined subset of patient experiences within an outpatient oncology infusion unit in an academic comprehensive cancer center. Wait time for patients whose labs were completed before treatment day and within normal limits and whose orders were signed the day before treatment was collected manually for a period of 5 months and tracked via value stream and control charts.
  
  
  RESULTS
  Postimplementation, patients experienced a decrease of 17 minutes in mean patient arrival to premedication start time (preimplementation 77 minutes, postimplementation 60 minutes). Additionally, a value stream analysis demonstrated that in the new process, patient touch points were decreased by two, and value-added time was increased by 17%.
  
  
  CONCLUSIONS
  By using the systematic PDCA tool, the team was able to identify opportunities to reduce waste in the system and streamline patient care. The results demonstrated a significant improvement in reducing patient wait time from arrival to premedication start time and increasing percentage of total value added during a patient's treatment cycle.
authors.affiliation: University of Miami Health System; and Sylvester Comprehensive Cancer Center, Miami, FL.
authors.forename: Lauren N
authors.initials: LN
authors.lastname: Gjolaj
authors.affiliation: University of Miami Health System; and Sylvester Comprehensive Cancer Center, Miami, FL g.gari1@med.miami.edu.
authors.forename: Gloria G
authors.initials: GG
authors.lastname: Campos
authors.affiliation: University of Miami Health System; and Sylvester Comprehensive Cancer Center, Miami, FL.
authors.forename: Angela I
authors.initials: AI
authors.lastname: Olier-Pino
authors.affiliation: University of Miami Health System; and Sylvester Comprehensive Cancer Center, Miami, FL.
authors.forename: Gustavo L
authors.initials: GL
authors.lastname: Fernandez
mesh_terms: D006801:Humans; D008495:Medical Oncology; D008962:Models, Theoretical; D010044:Outpatient Clinics, Hospital; D010045:Outpatients; D058996:Quality Improvement; D011787:Quality of Health Care