Their mission: to get City of Hope patients through registration and to their appointments as quickly as possible. Their challenge: long waits and crowded patient areas.
|Tricia Kassab applauds Kathleen Dorsey, who received an award. (Photo by p.cunningham)|
One year ago, nine intrepid employees formed the institution’s first “rapid improvement team” to improve patient services. As part of City of Hope’s Accelerating Care Excellence (ACE) program, they had one week to figure out inefficiencies in the patient registration area and create a plan to enhance the patient experience.
Their successes — still sustained 12 months later — inaugurated a highly successful program that continually seeks ways to provide the highest quality of patient care possible. The program’s subsequent projects stretched from surgical clinics to phlebotomy labs, raising patient satisfaction along the way.
“I have to be on time to my appointments now,” said Kommah McDowell, a breast cancer survivor and City of Hope patient who has participated in ACE events. “Before, I was waiting, and now I come in, have my appointments and go home.”
McDowell spoke at an ACE celebration event Oct. 29 in Cooper Auditorium to mark the first anniversary of the program and recognize the accomplishments of participating City of Hope staff in the 29 ACE events undertaken over the course of the year.
“City of Hope has a well-deserved reputation for compassionate care and it takes considerable work to achieve that,” said Virginia A. Opipare, executive vice president and chief operating officer. “I am very proud and grateful to everyone who has taken the time to participate in ACE events that make such a difference.”
During the ACE celebration, several staff members received awards for exceptional achievements in ACE events. Employees were recognized for going beyond the call of duty and widening the scope of improvements for an event, for the most noticeable and sustained improvements to an area, for participation in the most ACE events and for compassionate care.
Beyond the Scope Award – Expanding improvements beyond event
- Terry Closson and Rosamaria Gonsalez-Cobery, New Patient Services
Leap and Bounds Award – Largest Press Ganey survey improvements
- Outpatient registration group (Lucy Vizcarrondo, Wendy Arteaga, Wendy Contreras, Valerie Fabacher, Monique Gallo, Maila Garrido, Angela Inman, Danielle Nelson, Marlene Valadez, Lisa Zamora and Betty Armenta)
Most Valuable Player Award – Staff member who participated in the most events
- Kathleen Dorsey, R.N., B.S.N., clinical nurse manager
Most Valuable Physician Award – Physician who participated in the most events
- Karen Chang, M.D., chief and professor of clinical pathology
Compassionate Heart Award – iCare service excellence
City of Hope’s Got Talent – Most entertaining team report on ACE event
- ACE team evaluating improvements to lab test orders (Dale Adams, Pharm.D., Amanda Arceo, Ben Calnon, Karen Chang, M.D., William Goicochea, Gus Hahn, Galene Reese, Doug Stahl, Ph.D., Sharon Steingass, R.N., M.S.N., A.O.C.N., and Dahni Tsuboi, J.D.)
Tricia Kassab, R.N., vice president of quality and patient safety, also highlighted the efforts of other departments that supported ACE event teams during their weeklong ventures. These departments — facilities, environmental services, City of Hope information services, organizational development and information technology services — handled requests that ranged from creating new electronic forms to renovating a vital signs room into an exam room.
According to Alexandra Levine, M.D., M.A.C.P., chief medical officer of City of Hope, ACE has shown the value of employees’ perspective and commitment. “Every one of us is important,” she said. “All of us are vital, and we all needed to identify opportunities for improvement and find those solutions.”
The ACE program will expand its scope entering 2011. The first rapid improvement events addressed outpatient care areas including general oncologic surgery and infusion, but future ACE teams also will tackle issues and opportunities in electronic medical records and clinical research.
Patients may not see the employee teams at work, but they have seen the difference they make. “Thank you for what you’re doing,” said McDowell. “As a patient, I want to let you know that we feel it. It works.”
ACE achievements during the year
Since November 2009, City of Hope has conducted 29 ACE events that involved more than 174 staff and 42 physicians across 90 different areas. Among the highlights:
- It now takes only 30 minutes for new patients to get an appointment scheduled with a surgeon during their first call. Before the improvement event, patients typically waited several days to book their first appointment.
- New patients can easily download consent forms from City of Hope’s website to grant permission for staff to collect medical records on their behalf.
- The blood-draw area has sustained improvements for more than 90 days, with increased productivity and few patients waiting at any given time.
- Instead of asking new patients to collect all of their own medical records in advance of their initial clinic appointment, City of Hope staff members now collect the records on behalf of all new patients.
- Patients scheduled to undergo surgery with general anesthesia must be evaluated in the Pre-anesthesia Testing Center prior to surgery to avoid treatment delays. The number of patients visiting the center rose from nine per day in February to more than 22 per day in April, a greater than 140 percent improvement, and the number of delays was down from 15 percent to 2 percent in the same time period.
- Patients now complete their appointments in the pre-anesthesia center within one hour, an improvement of more than 40 minutes.
- Decreased patient wait times in several key areas led to higher Press Ganey patient satisfaction scores (comparing scores from July through September 2009 to those from July through September of this year). After the patient registration process was improved in late 2009, patients were registered more efficiently. As a result, patient satisfaction mean scores rose from 82.4 to 91.2. Clinical leaders are especially pleased with the 8.8-point increase because even an improvement of a tenth of a point is considered excellent. In addition, by streamlining how patients go through phlebotomy, related satisfaction scores increased from 85.0 to 91.2.
- Overall, Press Ganey patient satisfaction scores increased from 86.3 to 90.2 over the same time period.