City of Hope patient-care staff recently put in place several changes expected to improve patients’ experiences in clinic appointments and blood draws. The changes are part of City of Hope’s Accelerating Care Excellence (ACE) program.
Staff teams participated in two week-long “rapid improvement events.” On Dec. 4, the teams reported their achievements on projects in the Geri & Richard Brawerman Ambulatory Care Center’s 2B surgical clinic and the medical center’s phlebotomy area.
 Kathie Schell, left, and Ruth Nolen report on the phlebotomy team’s improvement process. (Photo by p.cunningham) |
Clinic appointments
Because many patients experience delays during their clinic appointments, ACE participants examined patient flow in the 2B surgical clinic. The ACE team, which is composed of patient-care and administrative staff, identified several important issues through observation and discussions with employees and patients.
“The areas we felt we could effectively address through this exercise included efficient use of a limited number of exam rooms, the movement of patients for different aspects of their visit and communications about work flow,” said Robert Lee, registration representative in radiology and team leader for the 2B surgical clinic review.
The team implemented eight experiments, including placing colored flags on exam room doors to indicate rooms’ availability and additional computer monitors for nurses to review all necessary patient information.
The team is continuing to develop improvements such as establishing a flexible and efficient system of scheduling exam rooms.
ACE team members recognized that certain areas of improvement will require time to implement.
“Change can be difficult for all of us, and we can sometimes be resistant because we are accustomed to our work habits and routines,” said Virginia Opipare, chief operating officer.
Phlebotomy
When the ACE team first observed the phlebotomy area, they counted 24 patients waiting for blood draws during peak hours, according to Ruth Nolen, quality improvement specialist in Quality Risk and Resource Management Department, who led the phlebotomy review.
The chief issues slowing patient flow included vials and supplies being centrally stored instead of each station being stocked, patients who arrived outside of their scheduled appointment times and incomplete test orders.
The team implemented some simple improvements such as putting up signs regarding sample and specimen submission and instituting a waiting list for patients who show up outside their scheduled appointments.
The steps made a difference.
“We were able to see some substantial improvements in decreasing the number of patients waiting to six during a peak time through immediate changes that were easily adopted,” said Nolen.
The next two rapid improvement events are scheduled for Jan. 4 to 8. One team will address the topic of the initial patient call to City of Hope, and the other will observe patient and work flows in the Brawerman 3B Medical Oncology clinic.
For more information, visit www.coh.org/ACE. Questions about ACE also may be addressed to Tricia Kassab, vice president of quality and patient safety, at tkassab@coh.org.
