The implementation of a nurse led SACT clinic to reduce waiting times for patients with soft tissue sarcoma attending for systemic anti-cancer treatment (SACT). A service improvement project

Introduction: The principal aim of the project was to reduce the amount of time spent in hospital when attending for Day Case SACT treatment for soft tissue sarcoma. Additional aims included measuring patient satisfaction and assessing efficiency of the new service. Methods: The project was run following the Lean Six Sigma DMAIC framework; defining and measuring the problem of patients spending longer than necessary in hospital during day case appointments, with patient diaries and mapping current clinic flow. Points in the pathway were identified for improvement and optimum time was calculated. A new process map was then developed, and patient satisfaction questionnaires completed. One year review looked at reduction of time in clinic, efficiency of the nurse led service and patient satisfaction. Results Total time in hospital was reduced from 8 hours 31 minutes on average, to 3 hours 57 minutes. This is a reduction of 4 hours 34 minutes (53.6%). If treatment was authorized the day beforehand, time in hospital was reduced further, to 3 hours 18 minutes, reducing pre project time in hospital by 61.3% Patient questionnaires were completed by 12 patients and showed high rates of satisfaction. The majority of answers were scored (out of 5) 5 excellent, or 4 very good. Conclusion: The implementation of a nurse led SACT clinic led to a significant reduction in the amount of time patients spent in hospital on the day of their treatment. The nurse led service was successful in delivering SACT more efficiently and patients were highly satisfied.