Oncology Rounds

Timely care at infusion centers—how do you compare?

by Mallory Kirby and Emily Heuser

Timely treatment for cancer patients is an issue that's probably top of mind for you and your cancer program. To help you assess how your infusion center compares to the competition, we surveyed your peers on their infusion center hours of operation, throughput, and utilization in our 2019 Infusion Center Volumes, Staffing, and Operations Survey.

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Easy wins to improve chair utilization, no show rates

One of the benchmarks we collected is chair utilization. This metric has two key components—scheduled chair utilization rates and actual chair utilization rates. We defined the scheduled chair utilization rate as the number of scheduled infusion hours divided by the total available infusion hours per day. We defined the actual chair utilization rate as the number of actual infusion hours divided by the total available infusion hours per day.

Survey respondents reported a median daily scheduled chair utilization rate of 80%, compared with a median actual chair utilization rate of 70%. This aligns with our expectation that scheduled chair utilization rates would be higher than actual chair utilization rates due to a factors such as patient no shows or illness.

Learn more with our Scheduling Improvement Toolkit

Across the board, respondents reported a median 5% no show rate for infusion center patients—a number that we found surprisingly low. Even at a low rate, no shows create operational inefficiencies, frustrate your providers, and can even negatively affect patient outcomes, so it's important to understand why patients miss appointments to prevent it from happening in the future.

To help you out here, we asked more than 1,200 cancer patients across the country why they missed an appointment in our 2019 Cancer Patient Experience Survey. While not specific to infusion center appointments, 35.4% of patients who missed an appointment responded that they did not feel well—by far the most common response. Meanwhile, 19.7% of patient respondents indicated that they forgot or had the wrong treatment time, while 18.1% cited a lack of transportation to their appointment.

Read more about appointment reminders with our blog, How did Eisenhower Health cut no-show rates by more than 66%? (Hint: Text messages)

Less than half of infusion centers offer weekend hours

Many cancer programs tell us they're considering extending weekday hours or adding weekend infusion center hours as a way to maximize patient convenience and provide urgent care to patients.

Despite this, we did not see any change in infusion center hours of operation per week from the 2015 version of our survey to 2019. Respondents reported a median of 47.5 hours per week—averaging nine hours per weekday—both years.

Forty-one percent of respondents indicated that their infusion center is open at least one day during the weekend. Of those with weekend hours, 97% of infusion centers had hours of operation on both Saturday and Sunday, while only 3% were open just one weekend day. Infusion centers were open for a median of six hours on Saturdays and four hours on Sundays.

Patients wait a median of 60 minutes for their infusion to begin

Wait times and throughput can have a major impact on patient satisfaction, which may be why we continue to get so many questions on this topic. In the 2019 Infusion Center Benchmarking Survey, we asked about wait time from the moment a patient checks into the infusion center until his or her infusion begins (including time for lab draws, pharmacy mixing, and pre-med administration; excluding time for day-of medical oncology appointments).

The median patient wait time was 60 minutes in 2019, with respondents reporting a 40-minute turnaround time for blood testing and 32.5-minute turnaround time for chemo mixing. 

No matter where your data stacks up, we realize that many of our members are concerned about infusion center wait times. Increased patient volumes are likely one contributing factor to longer infusion center wait times—in 2019, respondents indicated a median of 1,289 unique annual cancer patients, compared with just 769 in 2015. This reflects the larger trend of a "silver tsunami" that’s expected to continue to increase the number of cancer patients in the United States and has major implications for infusion centers already operating at max capacity.

Read Timely Care for Oncology Patients to learn more about how to redesign your infusion center to optimize patient throughput

Managing patient wait times is just one reason to track infusion center benchmarks. Cancer program leaders are faced with increasing patient volumes and oncology staff shortages that compound the challenge of ensuring timely infusion center access and throughput. Ensuring that you're tracking the right metrics and seeing how you stack up compared with national benchmarks is the first step to ensuring timely care for cancer patients.

 

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