City of Hope staff members are striving to improve the experiences of patients and staff, and their first initiative has already shown initial success. The Accelerating Care Excellence (ACE) program’s first “rapid improvement event” team reported on its achievements — which addressed patient registration — on Nov. 6.

Registration representative Lisa Marie Zamora, left, registers patient Courtney Bardsley using new, streamlined registration processes. (Photo by Kim Proescholdt)

For most City of Hope outpatients, staff interaction begins the moment they step through the front door, making it critical to patient satisfaction. That is why the ACE steering committee designated registration as its first rapid improvement event. Its mission was to evaluate, design solutions and make improvements to streamline the patient registration process.

A team of 10 City of Hope staff from a variety of disciplines and departments came together from Nov. 2 to 6 to contribute their experience, ideas and talents to the effort.

“There will be no better way to identify the issues and find workable solutions to fix our problems than to use the expertise of our own staff,” said Alexandra M. Levine, M.D., chief medical officer.

Team members began by watching registration firsthand. They also examined data and analyzed issues surrounding registration. They then identified a “target state” — their vision of how registration should be — using metrics such as wait time, productivity and patient satisfaction. Next, they devised and implemented realistic solutions.

Results clearly demonstrate the team’s success. They vastly streamlined the wait time at registration through the sharing of resources across departments during peak patient-registration times. They also increased registration staff’s productivity by removing clutter and implementing a barcode system for quicker, easier patient check-in. In turn, these moves improved efficiency and, most importantly, increased patient satisfaction.

“The first thing that came to mind when I got here was, ‘Wow, there is no line,’” said outpatient Courtney Bardsley. “I had a bone marrow transplant three years ago, and with the old outpatient check-in process, I needed to have someone with me to register because I was so sick I couldn’t stand in line. With this new process, I could have done it myself.”

The team included Sharon Steingass, R.N., M.S.N., ambulatory services vice president; See “Cecilia” Lau, R.Ph., B.C.O.P., pharmacist; Robert Lee, radiology technician; Paula Ramos, phlebotomist; Kathleen Dorsey, R.N., B.S.N., clinical nurse manager; Lucy Vizcarrondo, patient registration manager; Rosa Velazquez, ambulatory care assistant; Beatriz Armenta, registration; Ruth Nolen, quality improvement specialist; and patient Kommah McDowell.

“The hard work of this team resulted in a more streamlined patient registration process and greatly improved patient satisfaction,” said Virginia Opipare, executive vice president and chief operating officer, who called the team’s accomplishments “a major milestone.”

Levine agreed. “The collaboration we saw with this team, not only among themselves but with other departments as well, was remarkable and truly demonstrates the capacity we have at City of Hope for teamwork,” Levine said. “We are looking forward to many more successful rapid improvement events.”

The next two such events will take place from Nov. 30 to Dec. 4. One team will develop a process for efficiently preparing the patient to be seen by the physician in the clinic, while the other will focus on improving patient flow in phlebotomy.

For more information, visit the ACE intranet site at 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.