| Sumario: | Significance & Background: Timely initiation of in- patient antineoplastic therapy is critical to optimize outcomes, ensure equitable care, and reduce hospital stays. Nationwide, delays prolong admissions, increase resource use and costs, and lower patient satisfaction. While no national benchmarks for admission-to-therapy start time exist, local data reflect similar challenges. At a large Midwest teaching hospital, inefficient pre-admission coordination has frequently delayed treatment for scheduled inpatient hematology-oncology patients. A review of 576 patients (2022-2024) found that 22% of patients (n=i26) were admitted without central line placement, 21% (N=120) without signed treatment orders, and 27% (N=154) without completed laboratory results, resulting in an average 6.5-hour delay from admission to infusion start. Purpose: The purpose of this quality improvement project was to reduce inpatient treatment delays by addressing pre-admission inefficiencies and leveraging a new inpatient infusion suite for timely treatment initiation. The goal was to reduce admission-to-therapy start time by 50%. Outcomes included patients being infusion-ready upon arrival to the inpatient infusion suite, minimizing delays in provider orders to expedite treatment plan verification, pharmacy preparation, antineoplastic administration, and reducing length of stay. Interventions: The intervention targets all inpatient hematology-oncology patients scheduled for antineoplastic treatment. Key strategies include: * Revising the process flow map to guide outpatient scheduling of admissions to incorporate the new inpatient infusion suite opening in November 2025. * Implementing a standardized pre-admission SmartPhrase™ for outpatient RN care coordinators. * Educating inpatient charge nurses on SmartPhrase™ documentation and communication workflow. Key performance indicators include: pre-admission completion rates (labs, orders, central line), admission-to-chemotherapy start time, order release time, length of stay, and SmartPhrase™ usage. Results: Project implementation is planned for November 2025 with completion by January 2026. The new process map and SmartPhrase™ have been developed. Data collection and analysis will continue through January 2026 to evaluate impact on admission-to-therapy start time and other efficiency metrics. Discussion: Ensuring pre-admission readiness and streamlining admissions are vital to delivering timely, equitable cancer treatment. This project focuses on removing barriers that delay therapy while also improving patient-centered care. Although implementation is underway, the initiative has already begun to reduce logistical barriers, improve patient experience, and optimize resource utilization. This model may be scalable to other institutions and serve as a framework for reducing treatment delays in inpatient cancer therapy.
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