A quality improvement project reduces time spent at an inflammatory bowel disease infusion center with accelerated infliximab infusion protocol
Declaration of conflict of interest: None declared.
Author contribution: All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Dr Wan Chee Ong, Dr Miao Shan Lim, Ms Elaine Chan, Dr Thomson Lim, and Mr. Teong Guan Lim. The first draft of the manuscript was written by Dr Webber Chan and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Abstract
Background and Aim
Patients with inflammatory bowel disease (IBD) requiring infliximab frequently spend hours to attend treatment. Through quality improvement (QI) methodology, we aimed to shorten the time spent in the biologics infusion center using the accelerated infusion protocol and describe patient outcomes, safety, and associated cost savings.
Methods
From September 2018 through December 2019, eligible IBD patients receiving infliximab were recruited. We implemented interventions including the accelerated infusion protocol, and modifying collection location of infliximab. Statistical process control charts were created. Patients' clinical outcome and cost savings data were analyzed using descriptive statistics and Pearson's chi-square.
Results
During the study period, a total of 60 patients with IBD receiving infliximab were recruited. A total of 315 infusions were administered—152 were under accelerated infusion protocol and 163 under standard protocol. The mean infliximab infusion time was reduced by 47%, from 2.4 h (142 ± 14 min) to 1.2 h (75 ± 10 min) (142 min vs 75 min, P < 0.001), with total time spent in the infusion center reduced by 52%, from 3.6 h (214 ± 25 min) to 1.7 h (102 ± 14 min) (214 vs 106 min, P < 0.001). Three mild infusion-related reactions (3/152 = 1.97%) were recorded. Estimated cost savings over the 16-month project period was SGD $6721.4 (nursing) and SGD $23 560 (patients). A high level of satisfaction (4.84 out of 5) with the protocol was reported.
Conclusion
Our QI project shortened the infliximab infusion time and total time spent in the infusion center, without compromising patient safety. Estimated cost savings were substantial. The protocol helps reduce work productivity loss.
Open Research
Data availability statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
