Nurses, Researchers Create Innovative Solutions to Ambulatory Care Challenges in ONS Hackathon

“It is very typical for a hospital system to say, ‘We’re going to buy this product and install it in this area.’ And nurses will be the ones to use it, but they have no role in selecting or testing the product to see if it’s appropriate for their use. Inevitably, the product doesn’t match their workflow,” Michele Galioto, DNP, RN, CNS, executive director for the ONS Center for Innovation, said. “Here, nurses have the opportunity to flex their innovative muscles and have a say in how something may be developed and what solutions may be appropriate.”

Hackathon is a team-based competition designed to identify methods to address challenging issues in the delivery of quality cancer care. The winning team (see sidebar) identified a universal problem (https://onf.ons.org/onf/47/4/causes-and-consequences-chemotherapy-delays-ambulatory-oncology-practices-multisite) across various practice settings that created delays in care, dissatisfaction, and waste of nursing resources in ambulatory care: unsigned or missing provider orders and patient consent forms. In their pitch, team members proposed that in ideal infusion center operations, every patient is ready to be infused when they arrive for their appointments. Other barriers included uncompleted or unordered labs, same-day provider appointments, and missing prior authorizations.

The team determined that the cause was inefficiency in gathering pertinent information from patient charts. Providers, nurse leaders, and infusion center staff would benefit if they had a dashboard that could display needed information based on priority to do their work in an easily digestible manner.

And so came the idea for Ready, Set, Go! Your Total Infusion Dashboard Solution, an infusion dashboard for three different user groups: physicians, nurse leaders, and infusion center staff. Each dashboard displays important variables based on priority in the ambulatory care setting. The system reduces wait time for patients to begin infusions, which improves workflows, standardizes the order process, decreases provider interruptions, and ultimately eliminates preventable unsigned orders.

Team members said that Hackathon’s collaboration was a particularly valuable part of the experience.

“It was amazing to see how each member of the team strives to provide excellent cancer care to our patients,” Stirling said. “I was reassured that the challenges I experienced working in outpatient oncology care were not unique to my setting and how different strategies were employed to address these challenges.”

“I would love to make this project a reality in my own center and will take steps to make that happen,” Catches said. "Participating in Hackathon gave me further confidence in my growing expertise of staffing a multifaceted cancer center.”

Stirling said that the team will submit the project as an abstract for the 47th Annual ONS Congress^TM in April 2022.

ONS’s June 2021 Hackathon was held virtually over four weeks, and the Center for Innovation built the teams of ONS members from across the country based on a variety of demographics. For this event’s challenge, participants were asked to create a tool to prioritize patients in ambulatory infusion settings based on variables and treatments. Participants were paired with their team members and had access to additional resources and mentors during their creative process before pitching their solutions to a panel of three judges.

Judge Alex Fauer, PhD, RN, OCN®, postdoctoral fellow with the University of California, Los Angeles, said that Hackathon was an exciting opportunity to hear nurses across the country analyze problems and develop solutions crafted from their own professional experiences.

“As a nurse in an academic environment, I often hear about the disconnect from research to clinical practice,” Fauer said. “This Hackathon was so important for today’s cancer care because it focused on evidence-based strategies with rapid-cycle testing. It used interprofessional perspectives drawing from systems theory, business, and statistics.”

Mentor and keynote speaker Anne Ireland, DNP, RN, AOCN®, CENP, oncology clinical specialist with ONS, said she felt inspired to hear each team share their concepts and deliver on their commitment to drive change.

“Participating in Hackathon was an exciting opportunity to explore new and innovative approaches to improve clinical care delivery in a wide variety of settings,” Ireland said. “All nurses have a leading role in further study of ways to improve and enhance high-quality cancer care.”

Galioto said to watch for ONS email updates to learn more about ONS’s next Hackathon.