A new clinical decision pathway (CDP) developed by advanced practice provider (APP) leaders significantly improved workflow efficiency, inter-site collaboration, and patient satisfaction by enabling patients to receive infusion treatments at alternative locations within a large, multi-site cancer center network. 

This research was presented by Kathryn Mason, FNP, NP-CSC, Yale New Haven Health, New Haven Connecticut, at the 2025 Journal of the Advanced Practitioner in Oncology (JADPRO) meeting in National Harbor, Maryland.

Prior workflow fragmentation and limited flexibility forced patients to travel to the treating provider’s infusion site, even despite alternate, more convenient locations were available. To address this, an APP-driven clinical consensus group (CCG) developed a CDP, supported by institutional stakeholders, including physicians, nurses, and hospital administrators across five hospitals and 15 ambulatory centers. 

The goal was to standardize processes for patients to decouple provider visits from infusion treatments, allowing more flexibility for patients to receive therapy closer to home without compromising safety or communication.

Identification and documentation were completed as providers enter treatment details, frequency, infusion site preference, and contact information into a structured flowsheet embedded within the electronic health record (EHR). Requirements before treatment occurred as providers used “unlinked visits” 24 to 48 hours prior to infusion to review labs and confirm treatment clearance. A standardized “boarding pass” checklist was introduced to ensure all necessary pre-infusion elements (labs, clearance, orders) are complete before a patient was referred to an alternate infusion site.

Since the pathway’s launch in March 2025, it has been used 73 times by 39 providers, facilitating decoupled care for 44 patients. Early feedback from APPs and RNs cited improved inter-site communication and patient-centered scheduling flexibility.

The researchers concluded, “The tools incorporated into this pathway have the potential to increase chair availability and workflow efficiency by guiding providers towards unlinked visits that require clearance to treat, orders signed, and labs resulted prior to treatment.”

They added, “Utilizing this all-encompassing pathway provides the source that will ultimately lead to improved workflow, increased documentation, better communication between sites and increased patient satisfaction."

Source:

Mason K, Davies M. Expanding Access to Oncology Infusion Centers Through a Clinical Decision Pathway. Presented at the 2025 Journal of the Advanced Practitioner in Oncology Meeting. October 23-26, 2025; National Harbor, Maryland. Abstract JL1323C.