| Sumario: | Significance & Background: Treatment delays and increased waiting times are very common among gastrointestinal cancer patients due to the long nature of chemotherapy protocol. The chemotherapy administration process in the day chemotherapy units involves interdependent steps starting from DCU appointment, lab tests, drug preparation, drug delivery, chemotherapy administration, and follow-up. If these steps are not efficiently coordinated, it can lead to prolonged waiting time and patient dissatisfaction. By streamlining the clinical operations and enhancing team coordination, this study aims to reduce the time to treatment among gastrointestinal patients in a specialized cancer care center. The study utilized lean six sigma quality improvement methodology to identify the workflow bottlenecks and implemented improvement strategies. Purpose: This study aimed to reduce the chemotherapy day care waiting time by identifying workflow inefficiencies as well as implementing Lean Six Sigma (LSS) interventions to improve the outcome. Interventions: The project utilized a onegroup pre- and posttest design. The DCU waiting time issues are predominantly connected with the GI cancer patient, so the sample size of 85 was exclusively taken from the GI cancer patient. Baseline data on chemotherapy waiting time and patient satisfaction were collected using the patient chart, patient satisfaction survey, and direct observation. The root cause analysis was done using the fishbone diagram to identify the contributing factors related to the long waiting time, and a series of targeted interventions were implemented to address gaps. The key interventions include streamlining the DCU appointment system, improving the turnaround time for lab results, and implementing pre-mixing of chemotherapy drugs. Additionally, the patient flow process was improved by implementing two distinct patient flow tracks: the fast track for the patient with the availability of blood results and the normal track for those requiring updated laboratory investigations. The post-intervention data were analyzed using descriptive statistics, t-tests, and process capacity indices. Results: Post intervention, the average chemotherapy initiation time decreased from 188 minutes to 128 minutes. Fast track and normal track based on the lab result readiness reduce the delays by an average of 50%. The process capability pre- and post-data shows there is an improvement from 0.76 to 0.86, indicating better overall process consistency. Discussion: Lean Six Sigma interventions significantly reduced chemotherapy waiting time by streamlining workflows, enhancing coordination, and addressing system inefficiencies. It is an excellent model for improving the care quality.
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