Defense Date

7-17-2025

Graduation Date

Summer 8-8-2025

Submission Type

Dissertation/Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Doctor of Nursing Practice (DNP) Program

School

School of Nursing

Faculty Mentor

Manjulata Evatt

Keywords

Oncology access, expedited appointments, structured workflow, healthcare team vitality, care coordination, scheduling efficiency, outpatient oncology

Abstract

Background and Significance: Delays in oncology appointment scheduling can negatively impact timely cancer treatment, care coordination, and patient outcomes. Inefficiencies often stem from inconsistent workflows, communication breakdowns, and limited visibility into provider availability, contributing to scheduling inaccuracies, and treatment delays (Fletcher et al., 2023; Johnson et al., 2020). Purpose: This quality improvement project aimed to implement and evaluate a structured workflow for expedited oncology appointment scheduling in an outpatient setting to improve scheduling accuracy, care coordination, and healthcare team vitality. Intervention and Implementation Plan: Guided by the Institute for Healthcare Improvement (IHI) Model for Improvement and the Johns Hopkins Evidence-Based Practice (JH-EBP) Model, the intervention was developed and refined through iterative Plan-Do-Study-Act (PDSA) cycles. Oncology access navigators and scheduling staff received targeted training and visual tools to support implementation. Data were collected pre- and post-intervention using the Healthcare Team Vitality Instrument (HTVI) and appointment tracking tools. Results and Implications: Results demonstrated improvements in perceived adequacy of resources (mean score increase from 2.88 to 4.66; p = .00017), interdepartmental communication (3.11 to 4.49; p = .00587), and scheduling accuracy within the Breast oncology team (from 33.3% to 78.6%), with a reduction in average delay days from 20 to 11. HTVI scores also indicated significant gains in psychological safety and role satisfaction. These findings suggest that implementing a structured workflow enhances both operational efficiency and staff engagement. Implications for nursing practice include promoting interdisciplinary collaboration, increasing timely access to oncology care, and supporting sustainable workflow redesign aligned with national quality improvement standards.

Language

English

Included in

Nursing Commons

COinS