Workflow Optimisation Improves Timely Delivery of Systemic Anti-Cancer Therapy (SACT) in a UK Cancer Centre
According to the study, timely administration of systemic anti-cancer therapy (SACT) is essential for optimal oncological outcomes. The problem is that blood tests, the patient’s health status, the treatment plan, and medication preparation are all checked on the same day, which causes delays. Can the difference of two days significantly improve efficiency and reduce treatment delays?
Timely and precise administration of systemic anti-cancer therapy (SACT) is of great importance. However, the complexity of the process, from initial patient screening to treatment planning, often leads to unwanted delays. These delays, although seemingly minor, can have a significant impact on treatment effectiveness. They are particularly pronounced in healthcare systems with a high patient volume.
A new study, “Enhancing Systemic Anti-Cancer Therapy Delivery Through Early Screening and Workflow Optimisation: A Two-Cycle Service Evaluation in a UK Cancer Centre,” provides important insight into these challenges and offers a solution. The study authors are Abdul-Azeez Usman-Muhammed, Shahid Gilani, and Rajanee Bhana, from the Department of Oncology, University Hospital of North Midlands, United Kingdom.
We spoke with the corresponding study author, Dr Shahid Gilani, a specialist doctor in clinical oncology at the University Hospital of North Midlands.
The researchers conducted a detailed evaluation of the SACT screening process in a UK cancer centre, aiming to identify weaknesses and assess the impact of targeted improvements. The study was carried out as a two-cycle “before and after” evaluation at Ward 202, between August 2024 and January 2025. The team systematically collected data on key metrics, including the number of patients screened, screening duration, frequency of treatment delays or cancellations, provision of supportive therapy, and clinical advice provided to medical staff.
The need for clinical advice to nursing staff decreased from 8% to 6%, suggesting improved clarity and protocol efficiency
The core of the study lies in strategic interventions implemented between the two cycles, designed to simplify this complex process. Instead of performing critical checks immediately before treatment, a more organised pre-screening process was introduced two days in advance. This proactive approach enabled early identification and resolution of potential issues, reducing the risk of delays on the day of treatment. It was also ensured that all necessary supportive medications (such as antiemetics for nausea) were prescribed much earlier in the process. This eliminated the need to wait for prescriptions and reduced the likelihood of delays due to medication unavailability. Recognising the specific characteristics of different cancer types, patients with haematological/immunological malignancies were separated from those with solid tumours. This allowed workflows to be tailored to the specific needs of each group, further optimising the overall process.
The results were encouraging. The proportion of delays slightly decreased, from 3.8% to 3.5%, indicating the system’s ability to absorb a higher patient volume without a proportional increase in issues. The average screening duration increased slightly (from 2.22 to 2.30 minutes), which may be attributed to a more thorough, albeit slightly longer, pre-screening process. Importantly, the need for clinical advice to nursing staff decreased from 8% to 6%, suggesting improved clarity and protocol efficiency. The most common causes of delays remained hospital admission and completion of treatment cycles, highlighting areas for further targeted improvement. This study shows that targeted workflow optimisation can improve the timely delivery of SACT, even in highly demanding clinical environments.
This study provides a foundation for future research
Is there enough research in this area, and how can studies like this help clinical practice?
Shahid Gilani: There is a reasonable amount of research on chemotherapy delivery and oncology service efficiency, particularly within NHS systems, but relatively limited focus on the detailed operational aspects of pre-treatment SACT screening. Most existing literature addresses broader service redesign rather than the day-to-day workflow mechanics that directly affect treatment delivery. This study helps bridge that gap by providing granular, real-world data and demonstrating that targeted, low-cost interventions, such as advanced screening and improved triage, can maintain efficiency even with rising patient volumes. For clinical practice, it offers a practical and reproducible model that can support better workflow organisation, reduce variability, and enhance the safety and timeliness of treatment delivery.
What does this specifically mean for patients and their families?
Shahid Gilani: For patients and their families, the findings translate into more reliable and predictable care. Earlier and more structured screening reduces the likelihood of last-minute treatment delays or cancellations, which can otherwise cause significant stress and disruption. It also improves safety by identifying clinical issues in advance, ensuring that patients receive treatment only when appropriate. Overall, this leads to a smoother treatment experience, fewer unexpected hospital visits, and greater confidence in the care process.
How can the study provide a foundation for further research, and what is the biggest challenge?
Shahid Gilani: This study provides a foundation for future research by establishing clear, measurable operational metrics, such as screening time, delay rates, and workflow interruptions, that can be standardised across other centres. It demonstrates that service-level interventions are feasible and scalable, paving the way for larger, multi-centre studies and the potential integration of digital screening systems. The biggest challenge, however, is the lack of direct linkage to clinical outcomes and the single-centre, descriptive design. Future work will need to incorporate robust statistical analysis and correlate workflow improvements with patient outcomes such as toxicity, hospitalisation, and survival to fully validate the impact of these interventions.
Although the changes may seem minor, they help reduce delays, while clinical teams benefit from a smoother and more coordinated process of care, improving overall efficiency in busy healthcare settings.
Image courtesy of Dr Shahid Gilani, University Hospital of North Midlands.
