*Purpose: An increase in transplants performed at the medical center in comparison to the limited availability of outpatient infusion chairs and home infusion companies compelled the team to create a specialized infusion center for the needs of our high-risk transplant patients. In 2014, the infusion center began as a two-chair unit with one nurse. From 2015 to 2018, strategies were put in place to streamline the medication process, from ordering to administration, to prevent delays and inefficiency. An increase in the number of patients needing infusions led to a delay of several days to weeks for seat availability.

*Methods: Implemented strategies created a systematic approach from scheduling, obtaining financial authorization, and improving the medication delivery system. Without the ability to expand the work area, the extension of the operational time, additional nurses and schedulers supported the increasing volume. Block timing with longer infusions scheduled first then shorter infusions scheduled in between led to more efficient use of the schedule. Quality was maintained by implementing an alphabet split to ensure accountability from all teams. Innovations included the pharmacist utilizing therapy plans to order medications, triggering a referral which was sent to finance specialists to obtain authorizations in a timely manner. All pertinent information was therefore available on one system. Infusion nurses called the patients prior to their visit to prevent cancellations and medication wastage. A weekly meeting with the team facilitated communication, cooperation and maintained a steady workflow.

*Results: The implementation of time saving strategies and ongoing improvements propelled the team to accommodate the demanding needs of the transplant population. A team of physicians, nurses, pharmacists, finance specialists, and schedulers working cohesively has increased the infusion numbers from 287 in 2014 to 1986 infusions in 2018.

*Conclusions: Significant growth was measured in the infusion center since the initial opening in 2014. In response to the dramatic increase in patient volume and therapies available for transplant patients, the implementation of a dynamic hands-on workflow where all members of the team work in a timely manner to provide allograft saving treatments. From teamwork to direct patient care, the hope is that this single-center experience may provide insight to the development of future ambulatory infusion centers.

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