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The oncology patient journey is often blighted by prolonged wait times. Prolonged wait times negatively impacts treatment outcomes and patient satisfaction. Innovative solutions that streamline the admission process and enhance the overall patient experience are essential. Technological groundbreaking strategies within the electronic medical record (EMR) have revolutionized real-time communication between health care providers and the patient flow team regarding patient disposition. This approach leveraged secure chat as a mechanism to promote seamless communication of critical patient information between a health system's emergency department (ED) in a community hospital and an oncology specialty hospital. This communication method affords and expedited admissions process and elevates the care coordination for oncology patients, while incorporating the goal of decreasing the admission decision to accept time of 30 minutes or less. Clinical stakeholders, comprising of an ED clinician, inpatient medical hospitalist, and patient flow team, created a secure chat group. Once the decision to admit was made, a request is placed through the ternplated secure chat feature. The patient flow team member then acknowledges the request, while the accepting hospitalist reviews the request, and asks any pertinent questions to move forward with an acceptance or denial of admission. Next, patient flow asks any additional pertinent questions and after the patient is accepted for admission, the flow team follows through with appropriate bed assignment. Analysis of the admission wait times prior to implementation of the secure chat group and post-implementation demonstrate an increase in number of patients, from 64% to 70%, that have an accepted admission within the 30 minutes from initiating the request. Currently, the process is solely used with medical oncology admissions. Future expansion will include any admission across all emergency departments within the health system requiring oncology specialty care, regardless of service. Qualitative feedback can be collected via interviews with the clinicians and patient flow team, as well as patients assessing this vast positive impact in the oncology patient journey. Multiple phone calls and connecting physicians resulted in admission acceptance delays. Integrating secure chat has pioneered an expedited communication and streamlined process for the unplanned, urgent oncology admission, coupled with a safer manner to do so. By leveraging technology, we have enhanced the patient experience, reduced wait times and facilitated clearer and more concise communication between health care teams.

Fluctuating patient needs, coupled with an ever-present nursing shortage, galvanize nurse leaders with ative model challenges and budget variances, necessitate prompt evaluation to adapt to the organizational staffing needs. An innovative tool, created to conduct real-time variance analysis, has empowered frontline leaders with an ability to analyze as well as adjust the staffing matrix. The development of a staffing analysis workbook to capture current staffing plans, census data, and targeted nursing hours per patient days (HPPD) was designed to assess staffing decisions, incorporate nursing skill mix, patient acuity, and shift from the traditional 12-hour staffing paradigm. Assessing staffing in four-hour increments optimizes resource allocation thus adapting to patient throughput throughout the day and reduces unnecessary labor costs due to overstaffing during lower census periods. A comprehensive staffing analysis workbook afforded live input of staffing, census, and acuity data in four-hour intervals. The workbook was equipped with preset values for targeted RN HPPD and total HPPDs, facilitated the calculation of actual HPPDs, and initiated variance analyses. Color-coded indicators simplified budget assessments, aiding supervisors in decision-making during off peak hours pertaining to staff deployment. An enhanced ability to assess, evaluate, and promptly alter staffing decisions was established. Daily variances in staffing and budget discrepancies were reduced, contributing to improved fiscal accountability. Trends in hourly, daily, and weekly census were identified while considering patient acuity and promoting greater resource allocation and efficiency. Sharing with the finance team provided valuable insights into the fiscal impact of staffing decisions. This tool improved overall staffing practices and strengthened the relationship between nursing leadership and the finance team. Through a collaborative approach, a deeper understanding of the interplay between clinical and financial factors was fostered, resulting in informed and strategic decisions. The collaboration culminated into a biweekly meeting with the CFO to review positions, based on accurate assessment of operational needs. The initiative revolutionized the analysis of nursing staffing by transcending from the 12-hour staffing model to real-time assessments in four-hour increments. Improved utilization of resources was ensured through assessing the appropriate number of staff that is available at critical times. By enriching the financial acumen of frontline nursing leaders, a culture of fiscal accountability was formed, bolstering the partnership between nursing leadership and finance. The strengthened professional relationship exemplifies optimal changes across healthcare organizations.