Outpatient Infusion Suite for Inpatients Improve Start Times, Length of Stay

By Leah Lawrence - Last Updated: July 14, 2022

Use of an outpatient integrated infusion suite decreased length of stay and improved the patient experience for elective chemotherapy admissions, according to a recent study.

Katie A. Karkowski, PharmD, of Dartmouth Health, Lebanon, NH, and colleagues evaluated whether an outpatient infusion suite in close proximity to the inpatient unit could be successfully integrated into the flow of elective inpatient chemotherapy admissions and would improve quality measures.

In the study, they evaluated chemotherapy start times (CST), length of stay (LOS), and revenue for the use of the outpatient infusion suite for elective inpatient chemotherapy admissions and discharges for etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab (EPOCH-R).

During the pilot phase of the study, average CST improved by about 1 hour and 45 minutes (P=.0218). The researchers said that patient encounters were streamlined by using scheduling guidelines and patients were able to be admitted earlier in the day.

The mean LOS was reduced from 4.3 midnights to 4.1 midnights (P=.0214). In terms of hours, this LOS improvement equated to a 10.3-hour decrease from 105.8 to 95.5 hours (P<.0001).

“Patients greatly appreciated the reductions in non–value-added time spent between appointments, waiting for an inpatient bed to become available, and waiting for chemotherapy to start,” the researchers wrote. “They also appreciated the significant reduction in LOS, which allowed them to spend more time at home.”

A mean quarterly revenue of $309,410 dollars was noted during the pilot that had not been previously billed.

“The initial construction cost of the new space and the daily operating costs are minimal in comparison with the new revenue captured,” the researchers wrote, adding that these improvements were sustained throughout the control phase of the study.

“It is also worth noting that the benefits observed in this study can be generalized to other regimens and not just DAEPOCH-R,” the researchers wrote. “This was demonstrated by expanding to include other rituximab-based regimens and other chemotherapy agents such as bendamustine, polatuzumab vedotinpiiq, blinatumomab, and inotuzumab ozogamicin.”


Karkowski KA, Ibrahim S, Thorley K, et al. Utilization of an outpatient integrated infusion suite to decrease length of stay, increase revenue, and improve patient experience for elective chemotherapy admissions. JCO Oncology Practice.2022;doi: 10.1200/OP.21.00914