Improving Oncology Inpatient Access through Reduction of Intra-Unit Transfer Times

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Hospital admissions continue to be on the rise, forcing hospitals to address capacity issues. Staff within n 800-bed academic Magnet® hospital with high intra-unit transfer volumes, inclusive of a 20-bed medical-surgical hematology/oncology unit, noted opportunities to impact patient flow through improvements in intra-unit transfer times. In particular, there was no standard work associated with these transfers. Evidence has shown that standard work improves efficiencies. This poster details the standard work algorithm for intra-unit transfers, as well as strategies for success and tactics to address barriers encountered. An interprofessional team was formed, consisting of representatives from medical-surgical and critical care units, bed management and patient transport; a coach skilled in lean methodology assured evidence associated with standard work and patient flow was reviewed, considered and incorporated into solutions. Intra-unit transfer time is defined as “the time it takes from when a patient is assigned a clean bed on another unit until that patient occupies that bed.” A standard work algorithm was developed, including specific actions, time frames and responsible persons, and implemented during December, 2015. During the six months pre-interventions, hospital-wide monthly transfer times ranged from 86 to 107 minutes. The range post-interventions, January 2016 through the present, is 61 to 71 minutes. The hematology/oncology unit average unit intra-unit transfer pull time for fiscal year (FY) 16 (pre-standard work) was 68.3 minutes and for FY17 (post-standard work) was 57.1 minutes. Success is attributed to development of the standard work algorithm and accountability through inclusion of an incentivized goal for management and clinical nurses to decrease intra-unit transfer time, evaluated at the time of annual performance appraisal. Presentation content is applicable to oncology nurses in any acute health care setting that has opportunities to improve capacity through efficient intra-unit transfers, thus enhancing the oncology patient experience.


Clinical Practice Poster Session.


Patient Care Services / Nursing, Patient Care Services / Nursing Faculty

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