78 Background: The Henry Ford Cancer Institute infusion center supports ~18,500 annual appointments, delivering hydration, blood products, and systemic therapies including investigational agents. On-call oncology fellows currently manage infusion-related evaluations, urgent issues, and real-time triage, while concurrently adhering to their assigned rotation. The high daily infusion volume results in frequent evaluation requests for non-urgent matters such as chronic symptom management and refill requests. To improve coordination and reduce workflow burden, we aimed to create a more patient-centered infusion model by conducting nurse-physician feedback sessions and implementing a standardized communication template to improve triage consistency, escalation practices, and care coordination. Methods: Structured meetings with nurses and covering physicians identified workflow inefficiencies and communication barriers. An initial department-wide session reviewed common concerns. Subsequently, a structured paging template was implemented, standardizing communication elements which included: urgency, patient identifiers, location, vitals, symptoms, clinical questions, timeline, and outreach attempts to primary oncologists. Effectiveness was assessed via message review pre- and post-intervention. Results: Post-intervention, message requests: Preserved volume of evaluations (4.33 ± 2.54 vs 4.31 ± 1.52/day; P = 0.942); reduced chronic refill requests (11.5% vs 3.6%, P = 0.0216); reduced urgent pages (29.2% vs 12.5%, P = 0.00158) and increased same-day reviews (30.8% vs 67.9%, P < 0.00001); improved routing to appropriate coverage (42.3% vs 79.5%, P < 0.00001); increased vital sign reporting (21.5% vs 43.8%, P = 0.0002); improved infusion completion (80.8% vs 93.8%, P = 0.003); increased inclusion of patient identifiers (92.3% vs 98.2%, P = 0.035); increased appropriate use of fellow coverage (66.2% vs 82.1%, P = 0.005). Conclusions: Message volume remained stable, reflecting comfort with the new system and consistent patient needs. This intervention appears to have improved triage quality, message clarity, routing accuracy, and infusion completion rates, supporting a more coordinated, efficient, and patient-centered care model. Additionally, fellows reported greater ability to prioritize learning and patient care within their primary rotation responsibilities, suggesting a positive impact on trainee workflow and overall wellness.
McElyea et al. (Wed,) studied this question.