Immediate improvements in patient-care processes are a cornerstone of City of Hope’s Accelerating Care Excellence (ACE) program. But some changes take longer to become fully integrated.
Five teams of staff members, physicians and City of Hope volunteers recently shared updates on long-term projects under way through ACE to ensure that new programs are on solid footing, established programs become more efficient and previous ACE events sustain their improvements.
Teams reported their successes Nov. 4.
Sharon Steingass, left, and Brenda Williams act out a skit on sustaining infusion clinic improvements. (Photo by p.cunningham)Patient navigation
Patients appreciate the welcoming, green landscaping of City of Hope’s campus, but the openness also means patients may have to walk a long distance from their cars. A team aimed to improve patients’ arrival at City of Hope.
“A welcoming smile, a helping hand or wheelchair and a helpful guide can make a world of difference for both new and returning patients from the moment they get on campus,” said Terry Closson, director of patient access and team leader for the patient navigation project.
The team established a dedicated tram route between the patient and visitor parking lot to the main entrance to enable more timely transportation. The team also helped develop responsibilities for a dedicated greeter who provides physical assistance, wheelchair service, water and blankets as necessary to arriving patients.
Outpatient Surgery Center
City of Hope recently opened an outpatient surgery center in the Michael Amini Transfusion Medicine Center. Several ACE teams started meeting in 2010 to develop efficient work flows for administration of the center and patient care.
“We had an opportunity to put our best foot forward and establish practices for the outpatient surgery center that met the specific needs of the staff and patients,” said Lupe Ojeda, R.N., clinical nurse manager for the outpatient surgery center and team leader for most of the center projects.
The teams addressed the key areas for the surgery center, including purchasing, supply management, patient registration and the patient discharge process. Since its opening in September, the outpatient surgery center has performed more than 200 procedures.
Sustaining infusion clinic improvements
A team focusing on sustaining ACE improvements reviewed results from nine previous ACE events related to infusion clinics. They were able to detect opportunities to improve the ACE process itself to identify how the process can be improved and produce both improved initial results from ACE projects as well as better sustainment of the gains. .
“We need to provide our ACE teams with bettert information going into the project week to maximize the benefit of their efforts,” said Dan Ross, Pharm.D., vice president and chief pharmacy officer, who also served as one of the process owners for the sustainment team. “In turn, those teams can provide staff with more comprehensive implementation and completion plans that not only spell out the goal, but provide steps to achieving those goals.”
The team is developing comprehensive tools to help future teams better target their observations and develop and implement improvements.
Regulatory support services
City of Hope relies on its regulatory support services team for administrative management of the hundreds of clinical trials taking place on campus. The group handles new research proposals, amendments to existing trials and other clinical research documents that must be submitted and reviewed.
“The regulatory support services group has a very important role in clinical research operations, but their work was distributed unevenly and difficult to prioritize,” said Doug Stahl, Ph.D., M.B.A., vice president of clinical research operations and executive sponsor for the clinical research value streams.
The team created a new workflow, established standard work, and implemented visual management tools to help prioritize incoming work and distribute it more evenly among coordinators.
Purchasing
A team examined bottlenecks in the purchasing process to identify and implement a more efficient method for staff to order supplies. The improvements cut order times in half and reduced inventory waste. The team also helped implement an electronic ordering system that provides reports to help better manage purchasing requests.
The next ACE events are scheduled for Dec. 5 through 9. For more information, employees may visit www.coh.org/ACE. Questions about ACE also may be addressed to Tricia Kassab, R.N., B.S.N., M.S., vice president of quality and patient safety, at tkassab@coh.org.
