Nurse-Led Bone Marrow Biopsy Clinics Truncate Time for Testing, Treatment

The nurse-led team, which included ONS member Alecia Smalheer, OCN®, identified an opportunity (https://www.mdedge.com/fedprac/avaho/article/257702/cancer/implementation-bone-marrow-biopsy-clinic-effect-wait-times) to reduce patient wait times for bone marrow biopsy–based diagnoses and treatment initiation by establishing the dedicated clinic. They formed an interprofessional work group that included a hematology/oncology clinical nurse specialist, infusion nurse, and other representatives from nursing, pathology, pharmacy, and additional professions involved in cancer care to select a clinic location and develop a comprehensive implementation plan that included a staffing model, procedural checklist, patient education materials, and a patient scheduling ordering system. The entire process took less than four weeks.

For the current study, the researchers measured the effect (https://www.mdedge.com/fedprac/avaho/article/257702/cancer/implementation-bone-marrow-biopsy-clinic-effect-wait-times) that shifting the procedures to the clinic had on patient diagnoses and time to treatment. In the year prior to the clinic, of the 140 bone marrow biopsies performed through interventional radiology, average time from order to biopsy 23.1 days, from order to diagnosis was 27.8 days, and from order to treatment was 54.8 days. In its first 10 months of operation, the clinic performed 61 bone marrow biopsies with an average time from order to procedure of 6.8 days, from order to diagnosis of 11.4 days and from order to treatment of 27.3 days.

Overall, the clinic reduced (https://www.mdedge.com/fedprac/avaho/article/257702/cancer/implementation-bone-marrow-biopsy-clinic-effect-wait-times) time to procedure by 16.1 days, time to diagnosis by 16.2 days, and time to treatment by 33.6 days. The reductions were statistically significant for all three factors.

“Implementation of a dedicated weekly bone marrow biopsy clinic significantly reduced wait times for the procedure, diagnosis, and treatment initiation,” the researchers concluded (https://www.mdedge.com/fedprac/avaho/article/257702/cancer/implementation-bone-marrow-biopsy-clinic-effect-wait-times). “This should be considered at other VA centers to improve the care of our veterans.”