Utilizing the Time Stamp Research Tool – A Case Study: Part 1
As a research administrator in an oncology research setting at TriHealth in Cincinnati, Ohio, the use of resources for clinical trials at a time of scarce talent and expounding growth has challenged us to look at current processes and procedures to determine the best use of Clinical Research Coordinator’s (CRC) time and whether the process meets the end-goal. One of the low hanging fruits to review and conduct a study at my institution is the process of transporting IP (research drug) from our main research pharmacy site to several of our infusion center locations within the Greater Cincinnati area. Based on the study, the patient-subject’s schedule and the availability of the IP, a CRC would need to call in an order for the pharmacist at base to prepare, compound if necessary, and evaluate it to be released for pick-up and physically transported to where the patient-subject is located.
We utilized the ‘Time Study’ tool to discover the average time it takes to transport the IP from base to the patient-subject, the impact of time and the indirect cost associated with a CRC’s time/effort in transporting. A team of CRC’s and myself started by determining the average drive-time and average miles from base to each infusion center which ranged from zero to thirty-five minutes (on a good day considering traffic). The average distance for a one-way trip ranged from zero to twenty-six miles to deliver IP. At the time of reviewing the data, we were only able to obtain and solidify for 9 ½ months in which we found the following:
Our data showed the CRC team consisted of nine FTE’s, covering any appointment needing IP transfer to six different infusion locations, and their salaries ranged greatly based on their title. We found FTE minutes totaled 80,822 minutes (or 1,347 hours) which equaled $45,403.32 (average CRC team hourly FTE rate). Also, within the same period, mileage reimbursement totaled for a one-way trip was calculated to be $2,304. Based on these calculations, the personnel cost, if continued, would average $4,779 a month or $57,352 (without including the cost of benefits). The conclusion drawn from a fiscal management perspective is that it has exceeded the average personnel cost that is currently on the payroll (a Clinical Research Coordinator’s average annual salary is $54,230, a Clinical Research Assistant’s average annual salary is $41,906, and a Non-exempt Pharmacy Tech’s average annual salary is $44,641).
However, part of the drive for this project was to evaluate not only the fiscal impacts of IP transfer but to determine whether this process was meeting the end-goal (the patient impact in terms of patient care and/or satisfaction). Based on our data collection it took an average of four hours and twenty-eight minutes per IP transfer (from the time of the patient appointment to when the pharmacy had the IP available for transport to eventually when the drop-off occurred for patient use). We spent so much time on IP transfer that it seems we are likely missing the key components for our patients which is to be efficient and minimize the time our patient has to endure waiting (after their normal clinical appointment) to have the IP delivered to their appointment location and for it to be administered. Reviewing the data, the team came to the conclusion that the current process likely creates a time drain from our patient centered tasks since the CRCs are not truly performing tasks that they were originally hired for which is to enroll, engage and conduct studies with our patient-subject. Our next step after conducting this study is to develop recommendations and to test them out to see which one allows us to be more efficient and help us reach our goal in providing patient satisfaction. That part will be explained in another article, so stay tuned!
Contributors: Adams, A.; Bibee, H.; O’Connor, M.; Powers, S.; Bone, K.;
Golden, L.; The Effects of Working Time on Productivity and Firm Performance, Research Synthesis Paper (https://www.researchgate.net/publication/256035039_The_Effects_of_Working_Time_on_Productivity_and_Firm_Performance_Research_Synthesis_Paper)
Baskin, K.; For American Workers, Time Really Is Money (https://mitsloan.mit.edu/ideas-made-to-matter/american-workers-time-really-money)
Holpp, L.; Preparing To Measure Process Work With a Time Study (https://www.isixsigma.com/methodology/business-process-management-bpm/preparing-measure-process-work-time-study/)
Authored by Jason Claes, Oncology Clinical Research Manager
TriHealth Cancer Institute