Cancer Clinic Redesign: Opportunities for Resource Optimization

Ambulatory cancer centers face fluctuating patient demand and deploy specialized personnel who have variable availability. This undermines operational stability through misalignment of re-sources to patient needs, resulting in overscheduled clinics, high rebooking rates, budget deficits, and wait times exceeding provincial targets. We describe how deploying a Learning Health System framework led to operational improvements within the entire ambulatory center. Known methods of value stream mapping, operations research and statistical process control were applied to achieve organizational high performance that is data-informed, agile and adaptive. Caseload management by disease site emerged as an essential construct that incorporates disease site teams into adaptive, reliable care units, clinically and operationally. This supported clus-tering interdisciplinary teams around groups of patients with similar attributes, while allowing for quarterly recalibration. Systematic efforts were made in the negotiation required to im-plement changes that impacted physicians, nurses, clerks, and administrators. Feedback mecha-nisms were created with learnings curated and disseminated by a core team. The change aligned financial expenditures to the regional demand for specialized services and smoothed clinical operations across 5 weekdays and 2 centers. The impact was predictable, optimized expenditures, increased efficiencies across human and physical resource deployment and improved disease site collaboration in patient care.