Improving the Clinical Research Unit: A Ray of Hope for ‘Challenging’ Units

A poster presented during the Oncology Nursing Society (ONS) Congress shared one center’s success in improving patient and staff satisfaction by revamping their Clinical Research Unit (CRU).

In 2016 the CRU at City of Hope Cancer Center in Duarte, California, which is an outpatient research treatment center where patients enrolled in first-in-human phase III trials undergo treatment, had a host of issues, including:

  • low patient satisfaction (the “likelihood to recommend” was never more than 30%)
  • disengaged/unhappy staff
  • long patient wait times
  • crowded space
  • staff shortage

Some goals for the new CRU to improve patient satisfaction were to improve transparency, reduce wait times, improve scheduling, involve patients in decision making, and more. To improve staff engagement, some goals included building a team, providing support, listening to concerns, and more.

In 2018, a new, remodeled Briskin Center for Clinical Research (BCCR) was unveiled; at the same time, volume increased by about 16% each year. This only made it even more pressing to improve patient satisfaction and have more engaged staff members.

There were only six staff members remaining: two full-time nurses, three per diem nurses, and one nursing assistant, so the center’s senior director (SD) was tasked with increasing the staff. The SD worked in conjunction with the recruiter to tailor job descriptions to ensure candidates were qualified to manage patients in the early therapeutic studies. BCCR hours were increased to allow nurses to work 12-hour shifts, which helped drive up interest.

The new unit focused on a modified patient-centric model that allowed feedback on a variety of factors, including bed/chair choices, food options, valet parking, and more.

“Leadership wanted the environment to be less clinical because the patients often had 10- to 12-hour appointments with observation time, and they didn’t want them to feel they were in the hospital, although technically they were in a safe outpatient unit setting,” said Pamela Herena, MSN, RN, OCN, who presented the poster.

Efficient working space for the nurses was created, with computers, supplies, and printers close to the treatment stations. Nurses also had the space to collaborate freely, Herena added.

“We moved into the new unit November of 2018, which was near the beginning of our fiscal year 2019. And by the end of the FY, our patient likelihood to recommend percentage was at 99%, and we surpassed our target,” Herena revealed. “The staff satisfaction survey continued to increase as well.”

“I wanted to share this experience to give hope to anyone who has a challenging unit and just doesn’t know where to start. We are oncology nurses, and I like to believe that inside each nurse is an innovator, wealth of knowledge, and love for patients that connect us all,” Herena concluded.