Patient-, care partner–, and clinician- proposed solutions to address the time toxicity of oncology care.

370 Background: As the concept of time toxicity has gained traction, work has largely focused on mapping and measuring time burdens. This qualitative study sought to elicit perspectives from people with lived or professional experience with cancer on strategies to decrease the time burden of oncology care. Methods: We conducted semi-structured interviews with 47 participants (16 patients with advanced gastrointestinal cancer, 15 informal care partners, and 16 oncology clinicians with diverse roles) from one academic cancer center in Minneapolis, Minnesota. Interviews were conducted between 2/2023-10/2023 and transcribed and analyzed using a hybrid approach. Results: We identified 24 subthemes that we grouped into 5 themes (Table 1): (1) Personalized ambulatory care scheduling taking into account patient/ care partner needs and preferences; (2) Support for administrative and logistical tasks; (3) Home-based care when safe and feasible; (4) Clear and compassionate communication about time burdens; and (5) Innovations in care design and care delivery. Conclusions: Findings from this study will aid the oncology community in considering and designing interventions to decrease the time burdens of cancer care. Implementing individualized, person-centered solutions will require interventions at the patient, provider, health system, and policy levels. Themes, subthemes, and quotations. Theme Subthemes Illustrative quotes Personalized scheduling of ambulatory care Site of care close to home, personalized scheduling, cluster scheduling, cluster scheduling is not always preferred, designated schedulers, ensuring care is necessary "I was going over to [the university hospital] and then they got things set up at [community site] which is just five minutes from me, which made it much more convenient." (Patient) Support for administrative and logistical tasks Support with medical bills, insurance, and paperwork, adequate staffing for support "The bureaucracies of insurance and all of the time that it takes to get people what they need, is a huge stressor for not only patients and families, but also for the staff that have to do it." (Clinician) Home-based care Telemedicine, other home-based services, policy support “My goodness. Not having to come in [and be able to get the pump disconnected at home] was excellent.” (Care partner) Communication regarding time burdens Desire for information and guidance, setting honest expectations, using objective measures of time, using time burdens as a factor in decision-making “I really hate it when the doctor says "it’ll be quick" and then the receptionist books a 3-hour infusion, and then it takes 5 hours.” (Care Partner) Care innovation Shorter courses, oral, less frequent, and faster treatments, digital communication "I was scheduled to have chemo for six months and after this trial, they showed that you could have chemo for three months." (Patient)