City of Hope’s Accelerating Care Excellence (ACE) program recently addressed three areas in which clear and understandable communication is vital to providing quality patient care. ACE teams examined chemotherapy education, financial counseling and clinical trials databases.
|ACE team members perform a skit about clinical trials management. (Photo by p.cunningham)|
All three teams reported their successes May 27.
Cancer patients have to absorb a lot of information quickly — from understanding their diagnosis to choosing a course of therapy. They often feel unprepared for the complexity of their treatment.
A team of physicians, nurses, employees and patients met through ACE to improve how patients and family members learn about chemotherapy.
“Patients let us know that they sometimes feel overwhelmed by all of the medical information they need to learn. They did not know what chemotherapy actually entailed and the common side effects they could experience,” said Bow Criddle, R.N., clinical nurse manager in City of Hope Helford Clinical Research Hospital and team leader focused on chemotherapy education. “We developed a new process to assist nurses in providing consistent education prior to the first treatment, and additional resources for patients to manage side effects from treatment.”
Among the team’s accomplishments:
- Team members developed a standardized curriculum for patients receiving chemotherapy for the first time.
- They created a simple assessment tool to make patients more aware of possible side effects and to manage those health concerns.
- They integrated patient services from the Sheri & Les Biller Patient and Family Resource Center into chemotherapy education.
Nurses and patients have responded well to the improved chemotherapy education, especially to resources available from the Biller Patient and Family Resource Center.
One ACE team addressed patients’ financial eligibility and responsibility and benefits during the initial registration process, aiming to eliminate patients’ uncertainty and potential emotional distress.
“Our goal was to resolve any issues and approvals in the first call so that patients never feel like they might not be taken care of,” said Robert Lee, clerical supervisor in the Department of Diagnostic Radiology and financial counseling team leader. “We were able to provide patients an appointment and financial counseling about their insurance coverage and responsibilities in the same call. When validation took longer, we were able to clearly communicate that with patients, with specifics on follow up.”
The ACE team made several improvements to the process:
- All patients will receive financial counseling about their insurance coverage and financial responsibilities during their first call to New Patient Services.
- A counselor from Financial Support Services now works in the New Patient Services office.
- A registered nurse in New Patient Services now ensures patients speak directly to a financial counselor.
Clinical trials management
Computer database and software programs can help departments efficiently manage vast amounts of information, but different computer programs need to interact well with each other for information to flow to various departments efficiently. Sometimes programs speak different languages, creating information barriers.
Clinical researchers at City of Hope currently use different electronic systems to manage the extensive clinical trials portfolio. One system is dedicated to patient medical records, another to routing clinical trial information to regulatory committees and a third to patient billing. Staff members had to consult each system separately for information they needed, and sometimes updates in one system were not immediately reflected in other systems. An ACE team tackled the problem.
“The team worked to develop a way to integrate all of the information together so there is one source of up-to-date information,” said Marie Jackson, project director in City of Hope’s Clinical Research Operations Department and team leader for clinical trials billing. “The team developed a report that pulls relevant information from several systems using the data warehouse as a broker. This report eliminates the need for staff members to dig for the information needed to perform billing, saving valuable staff resources.”
Team members will continue to work to automate the report and improve efficiency.
The next ACE events are scheduled for June 20 through 24. For more information, employees may visit www.coh.org/ACE. Questions about ACE also may be addressed to Tricia Kassab, vice president of quality and patient safety, at firstname.lastname@example.org.
Patients recognizing improvement efforts
City of Hope regularly surveys its patients to measure its performance and identify areas for improvement.
The latest results from a Press-Ganey survey reveal sustained gains in patient satisfaction.
- Overall patient satisfaction is 90.6 percent, far above the 86.3 percent reported at the start of ACE in 2009.
- Patient satisfaction in the registration area rose from an initial 82.4 percent to a current 90.9 percent approval level.
- Satisfaction in the blood draw labs currently runs at 91.6 percent, rising from an initial level of 84.6 percent.
- The 2B surgical clinic saw patient satisfaction rise from an initial 88.1 percent to a current 95.6 percent.
- The 3B medical oncology clinic is currently at 91.0 percent satisfaction, up from just 84.2 percent at the start of the ACE program.