Planning for the sustainment of a 24/7 oncology clinic: An action and evaluation research project

Background. Usually in oncology settings patients experience multiple cycles of inpatient and outpatient care throughout their care continuum. Problematic in this cycle is the lack of options for acute symptom management especially when a patient is being seen as an outpatient. The optimum care would be a single access point for acute oncology care on demand, when they need it. One healthcare improvement that is making a difference in oncology patient's lives is making cancer care available on a 24 hours a day, 7 days a week basis.;Objective. This paper describes the new service that provides supportive care to oncology patients 24 hours a day, 7 days a week. The presentation describes the process used to develop evaluation metrics including the clinic's functions, utilization and operations.;Method. This project used an action research methodology with Lean methodology utilizing the A3 management principles. This combined approach allowed for the evolutionary drive of action research with the A3 format giving appropriate rigor for the documentation and findings of the research. A stakeholder planning event was held to gather regulatory, compliance and quality indicators identified by hospital employees. Interviews were also conducted with oncology patients to identify patient needs, opinions and ideas. The goal of evaluating these two groups was to meet both internal and external stakeholders' needs and plan for sustainment and growth of the clinic.;Findings. The patient interviews revealed two main themes that define their needs. Fear and anxiety and fatigue are the forces behind many of the patient needs and desires. Inclusion of the voice of the patient in addition to the hospital employed stakeholders in the sustainment plan of this clinic will help provide better care and patient satisfaction. Many of the metrics identified are measured by current hospital operations, quality and compliance. Patient specific metrics reflect ability to accept patients and provide services as needed. These metrics will be monitored for quality and sustainment efforts to provide for accurate assessments for purposeful changes and growth.;Implications to practice. This paper serves as a foundation to identify 24 hour oncology care on demand as an option and to provide the beginning for further research into patient needs for this type of service as well as benchmark measures for quality improvement.