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Ironing out the problem of outpatient infusion wait times: look for process improvements first
  • Tina Sekhon,
  • Aaron Tejani
Tina Sekhon
Surrey Memorial Hospital

Corresponding Author:tina.sekhon@cw.bc.ca

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Aaron Tejani
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Abstract

Rationale, aims and objectives: Iron sucrose remains a top expenditure in Fraser Health Authority. Audit data from an iron sucrose standardized order set (SSO) pilot coupled with the addition of iron isomaltoside to formulary resulted in the implementation of a regional SSO. Survey objectives were to clarify how iron infusion referrals are triaged, determine iron infusion wait times and identify what other services can impact wait times prior to regional SSO implementation. Method: Information was collected from a web-based survey sent to outpatient unit staff at all 11 sites within the health authority Results: Survey response rate was 73%. Urgent and non-urgent referral definitions varied and included laboratory parameters, prescriber specification, consideration of procedure dates and evidence of symptoms. Urgent referrals wait times are usually within the same week and non urgent wait times varied from same week booking to up to 3 months. Outpatient units provide a multitude of services that require urgent appointment times that may require scheduling ahead of non-urgent iron infusion referrals. Outpatient clinics deal with multiple other clinical reasons other than iron infusions which contribute complicate the triage and booking process and can lead to long wait times. Wait time reduction could be the result of utilizing a SSO that displayed all the information required by clinic staff and streamlined the booking process rather than the addition of iron isomaltoside to formulary. Conclusions: With the implementation of a regional SSO the iron infusion referral process may be simplified, thereby shortening appointment wait times. It is recommended that comparable information regarding iron infusion wait times be collected after these changes in practice.