ABSTRACT
Oncology Nursing Practice The current supportive care team shortages have led to immeasurable negative impacts on the healthcare workforce, compounded by the existing workforce instability generated by the COVID-19 pandemic. To address increasing volume and complexity of patients coming to the ambulatory setting for oncology care amidst the current workforce challenges, it became imperative to re-design the roles and workflows for the ambulatory oncology support team. The Cancer Service Line (CSL) operations leadership team worked with Hospital, Ambulatory, and Laboratory leadership addressing workforce challenges to improve patient flow and satisfaction. The goals of this project were to improve integration, clinical oversight, and care coordination through a phased two-part initiative: 1) Transition Phlebotomists" working in the Cancer Center to align under CSL leadership, and 2) Increase resources and efficiency within Clinic and Lab by cross-training CSL Clinic CSAs and Lab Phlebotomy staff, creating a "one-stop shop" concept, where patients have pre-visit labs and vital signs captured in one location by one staff member. This project aims to improve both patient and provider experience through reduced delays, improved patient flow, and enhanced efficiency. CSL clinical support team expanded to include more role diversity to address the growing numbers of oncology patients amidst the current workforce shortages. Nurse Leaders assembled teams of Registered Nurses, Certified Medical Assistants, Certified Nursing Assistants, Phlebotomists, Licensed Practical Nurses, and Clinical Coordinators. All members of the clinical support team underwent extensive training to cross functional skillsets within the appropriate scope of practice. The cross-functional team received comprehensive didactic training, hands-on training, and competency validation. A new Cancer Center Intake workflow was created to improve patient flow and clinic efficiency. Patients now have their vital signs, intake questionnaires, and phlebotomy services in one location by one staff member, creating a "one-stop shop" for our patient's pre-visit intake needs. The care team redesign and new Intake workflow are being evaluated through the following metrics: patient satisfaction, improved patient flow, provider satisfaction with intake efficiency, increased "economies of scale" through better staffing coverage models, and staff satisfaction and retention through advancement and utilization of new skills. Early results indicate that the care team re-design and Intake workflow has consolidated pre-visit patient stops, streamlined patient flow, and increased efficiency. This low cost, high reward initiative may offer value in supporting oncology care team members through current and future workforce challenges.