Decreasing Patient Wait Time by Process Level Interventions in an Oncology Daycare Unit: A Quasi-Experimental Study

Introduction: The DMAIC approach is a five-phase improvement cycle which enables the advancement of pre-existing processes and was implemented as part of the "lean" process improvement initiative. The present study aims to improve the work efficiency of chemotherapy daycare unit (CDU) at a cancer hospital. The objectives include studying the process flow of the CDU, estimating the patient wait time (PWT) before infusion at the CDU, and implementing new measures to improve its functioning.

Methods: In this quasi-experimental study, PWT of the CDU process was assessed and its work efficiency was analyzed using other parameters of functioning. The research team implemented a planning system using "lean" methods for reducing the patient contact points in the hospital, streamlining the workflow of patient services at CDU and reducing the laboratory waiting time. The patient satisfaction survey enabled measuring the quality of care at CDU.

Results: The study methodology was "lean-DMAIC," which enabled an improvement in the activities performed by the CDU staff. The mean difference in PWT between the two groups (pre- and postintervention) was 13.93 min, which is a significant (p < 0.001) reduction (19%) in the mean PWT values. Although the patient satisfaction survey did not show significant results for the general questionnaire conducted on study subjects (95 patients each in the pre- and postintervention groups), the intervention-specific questionnaire on the cohort of 20 patients showed a significant mean difference (µ = 4.2 ± 0.3 and 4.8 ± 0.2, p < 0.001) between the pre- and postintervention groups.

Conclusion: The results of the study implicate the potential of revising the process flow for a subset of oncology patients, and its impact on the efficiency of CDU. Adopting a lean technique in the study resulted in an improvised work approach and an anticipative growth in revenue generation.