- Nurses now check in with patients earlier and more thoroughly to detect conflicts prior to their infusion appointment.
- Fewer patients have treatment canceled after making long trips, reducing stress and disruption.
- The new approach shows how small changes in care can improve the patient experience while cutting waste.
PHILADELPHIA (May 15, 2026) — A nurse-driven quality improvement initiative at Fox Chase Cancer Center has dramatically reduced same-day chemotherapy infusion cancellations, improved patient education and experience, and generated significant cost savings. The results of the initiative were presented at the 51st Annual Oncology Nursing Society Congress.
The initiative focused on patients receiving chemotherapy at the Fox Chase-East Norriton regional campus, where many travel long distances for treatment. Historically, patients were contacted the day before infusion with a brief confirmation call. However, side effects such as nausea, vomiting, diarrhea, neuropathy, or fever were often not identified until patients arrived in person, leading to same-day treatment cancellations.
Reducing Unnecessary Travel and Disappointment for Patients
“This project really started because we felt bad having patients drive a couple of hours just to be told we couldn’t treat them that day,” said Michael Fitzpatrick, MSN, RN, Clinical Manager at Fox Chase-East Norriton and lead author on the study.
Another motivating factor was that because chemotherapy medications are custom-prepared for individual patients and delivered from the pharmacy at Fox Chase’s main campus, same-day cancellations meant the drugs were discarded, resulting in significant financial loss.
A Solution Built Into the Electronic Health Record
To address this challenge, the Fox Chase nursing team designed a standardized, medication-specific pre-infusion phone assessment embedded directly into the Epic electronic health record. The structured call guides nurses through targeted symptom and safety questions, allowing care teams to intervene earlier.
“The financial savings were important, but the real goal was improving patient care and helping patients better understand their symptoms and treatment,” said Fitzpatrick.
Key Findings:
- Same-day infusion cancellations dropped from approximately 8% to 1%
- More than $60,000 in medication waste was avoided over three months, for a projected annual savings of nearly $240,000
- Patient education and symptom awareness improved
- There were fewer unnecessary patient trips and reduced treatment-day stress
Improving Communication and Patient Confidence
Beyond financial impact, the initiative significantly enhanced patient-centered care. By asking more direct questions, nurses helped patients better understand which symptoms are expected, which are treatable, and when to call the care team. Now, patients more frequently report symptoms earlier, allowing for proactive management, dose adjustments, or rescheduling when needed.
The team continues to refine the process as new therapies are introduced and has expanded education efforts to ensure patients complete required lab work in advance of treatment, Fitzpatrick said.
The results of the initiative were presented in a podium session at the 51st Annual Oncology Nursing Society Congress, which is being held May 13-17 in San Antonio, Texas.