Interventional Radiology (IR) Clinic Nurse-Led Procedural Teaching Program

This project’s purpose was to improve patient access and decrease wait time for outpatient interventional radiology (IR) procedures. This was an opportunity for nursing to work more autonomously and allow advance practice providers (APP) to see more complex patients, thereby improving the timeliness in care, patient outcomes and retention of cancer patients. The registered nurse (RN)-led teaching program was developed to provide education and prepare patients for procedures leveraging APPs for clinical escalation as needed, with the goal to decrease wait time for procedures related to clinic provider availability.

Delays in cancer diagnosis can lead to devastating consequences. Patient access to cancer care can be a limiting factor, and time to diagnosis is critical in treatment planning. Many patients can miss a critical time window during which cancer treatment may have been most effective. At a National Cancer Institute (NCI)-designated cancer center, a multidisciplinary task force was convened to create and implement a new nurse led patient pre-procedure education program workflow with the goal to decrease wait time for procedures.

Members of this multidisciplinary task force included nursing leadership, physicians, APP leadership, nurses, administrators, and radiology assistants. Weekly meetings were held to identify gaps, streamline processes, and create algorithms and workflows for the respective team members. A centralized scheduling template was created to promote flexibility and collaboration between IR clinic nurses. The role of the RN was to evaluate eligibility criteria, review patients’ comorbidities and medications, educate patients on procedures, review risk/benefits, and coordinate required outpatient visits. A pilot program was conducted in one area to evaluate its effectiveness and feasibility. After the pilot, improvements were identified and implemented. Once finalized, nursing-led teaching program was expanded to all IR clinic nurses across the cancer center.

Metrics identified included wait time to procedure, clinical escalation needs, procedure type, successful teaching completed, and reasons for unsuccessful teachings. Data showed from May 2023 prior to going live the average wait time to biopsy was 45 days. Post-implementation to October 2023 wait time was reduced to nine days. During the first three months, 386 RN teachings were scheduled and 87% were completed successfully. Data is continuing to be collected and evaluated.

The program achieved the goal of reducing wait times to procedure, biopsy, and diagnosis. It showed the ability to create efficient workflows in the outpatient scheduling system and demonstrated the impact of nursing collaboration towards patients gaining access to cancer care timely and safely. The workflow required collaboration among the multidisciplinary team and stakeholders which employs an evidence-based approach to optimize coordination of care. Future programs or similar approaches could be utilized at other institutions to maximize access for patients and diagnosis of cancer.