Addressing Workload Acuity On Oncology Unit

Project Topic:

Workload Acuity Score

Hospital, City and State:

Atrium Health Wake Forest Baptist, Winston Salem, NC

Unit:

• 3 Cancer Center

CSI Participants:

• Kayleigh Covington, BSN, RN, OCN
• Elizabeth Kepley, BSN, RN, OCN
• Lori Mason, BSN, RN, OCN
• Paige Carmack, MSN-NE, RN, OCN (Coach)

Project Goals/Objectives:

1. Increase Healthy Work Environment Assessment Tool (HWEAT) True Collaboration score from 3.7 to 4.2
2. Decrease Oldenburg Burnout Inventory (OBI) total score below 30
3. Increase nurse satisfaction assessed via a unit-specific survey 87.5%

Project Outcomes:

1. Decreased HWEAT True Collaboration score from an initial score of 3.7 to 3.24
2. Increased Oldenburg Burnout Inventory (OBI) total score above 30
3. Decreased nurse satisfaction on unit-specific survey
4. Created a dedicated column in the electronic health record for Treat On Arrival (TOA) vs physician visit before treatment

Project Overview:

In the outpatient oncology infusion clinic, pod assignments are based on chair time and patient volume. The current workflow does not accurately capture patient complexity, which often leads to disparities in nursing assignments. This imbalance raised concerns for patient safety, nurse dissatisfaction, and nurse retention.

To assist in a more accurate representation of pod assignments, an electronic workload acuity tool was created. The acuity tool captures 18 criteria (e.g. titratable drugs, home pumps, hard peripheral sticks, new treatment, etc.) that produce a workload acuity score for a patient that aids in pod schedule balancing.

This workload tool allows for the opportunity to better balance the pod assignments, allowing the charge nurse to visualize the acuity score in real time. Additionally, we now have a new column in electronic health record that specifies whether patients see the provider before coming to the treatment pod or if patients will be treated on arrival (TOA). This column is also visible in real time for the charge nurse to help balance the schedule.