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Quality & Safety

Laboratory Process Improvement: A Quality Initiative in an Outpatient Oncology Clinic

Megann Wojciechowski
Mary F. Rodts
CJON 2020, 24(5), 571-574 DOI: 10.1188/20.CJON.571-574

The goal of achieving maximum productivity through process redesign and teamwork in oncology laboratory (lab) operations can be challenging in cancer care organizations. At an urban cancer center, missing lab orders occurred frequently and led to increases in lab errors, turnaround time, and patient wait times. Patient and staff satisfaction metrics were also affected, resulting in suboptimal scores. A nurse-driven practice change project was initiated after a thorough assessment in two clinic sites. The application of targeted lean methodology to redesign lab processes and workflows, in addition to engaging multiple stakeholders, was implemented to support a culture of continuous quality improvement.


  • Missing lab orders in the outpatient oncology population causes delays in results, inefficient care delivery, and suboptimal patient and staff satisfaction.
  • Working within patient-centered systems, oncology nurses can integrate teamwork and collaboration by engaging stakeholders to improve operational and organizational outcomes. 
  • Applying the principles of lean methodology can stimulate oncology nurses to lead the redesign of lab processes that optimize productivity, quality, safety, and responsive patient care.

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