Objective To investigate the efficacy of PEDALS-model-driven ambulatory-chemotherapy workflow optimization in reducing non-therapeutic waiting time and simplifying procedures, and to assess its impacts on chemotherapy service efficiency and core surgical indicators brought by pathway adjustment. Methods We identified workflow bottlenecks through on-site observation, whole-process time tracking, and interviews with patients and staff. An optimization plan was designed and implemented based on the six components of the PEDALS model. The total whole-process in-hospital time was compared between the pre-optimization period (June-December 2023) and post-optimization period (June-December 2025) to evaluate the effect of process optimization. Changes in surgical case volume and drug-cost ratio in surgical wards from 2021 to 2025 were also analyzed to assess the effect of pathway adjustment on resource allocation. Results A total of 122 patients were included, with 61 patients before and after optimization. Before optimization, the patient satisfaction was 96%; after optimization, the patient satisfaction was 100%. After optimization, the total duration from consultation to settlement for patients in all departments decreased from 332.5?min to 266.8?min, the outpatient waiting time was shortened from 18.7?min to 5.6?min, and the settlement duration dropped from 26.2?min to 8.8?min. Following the pathway adjustment, the surgical case proportion in surgical wards rose from 20% to 92%, whereas the drug-cost ratio decreased from 75% to 9%. Conclusions The PEDALS-guided process optimization shortened patient waiting times and improved the efficiency of daytime chemotherapy. The pathway change (shifting chemotherapy patients from surgical wards to outpatient care) freed up bed capacity and improved the surgical case mix. Together, these two stages offer a practical reference for daytime chemotherapy management in public hospitals.