As the saying goes, sharing is caring, and patients benefit from better communications all around. City of Hope staff took that into account as they recently implemented plans to improve patient care and business services through the Accelerating Care Excellence (ACE) program.
|From left, Eunice Weberg, Carrie Chong, Stella Garcia and Kevin Chan perform a skit about clinical care teams. (Photo by p.cunningham)|
One rapid improvement team of physicians, management and staff enhanced communication with external physicians who refer patients to City of Hope, while a second team redesigned clinical care teams to better focus on patients’ needs.
Both teams reported their achievements to the City of Hope community on May 7.
Managing patient referrals
Community physicians send patients to City of Hope for specialized cancer treatment available in few other medical centers; better communication with these referring physicians after patients are treated on campus can improve continuity of follow-up care. The rapid improvement team focused on changes to increase that interaction, which also enhances City of Hope’s relationships with outside physicians.
“We worked to improve the accuracy of our physician database and simplified access to that information to improve information sharing,” said Jennifer Davis, business director of the Department of Surgery and team leader for the group examining patient referrals.
The team eliminated redundant paper forms that were easily lost or misplaced. To further reduce confusion, a new process was developed for New Patient Services to gather and verify information from patients in a single session rather than from multiple sources.
Staff members also are improving electronic records to better track information about external physicians. City of Hope physicians have a new icon in patient records that allows them to easily retrieve this information, enabling them to quickly update external physicians about patients’ health.
Clinical care teams
City of Hope’s surgical clinic nurses and other professionals used to be assigned to work in specific areas of the clinic, but rapid improvement team members found that moving toward a team model could make patient care more seamless.
“We saw the opportunity to organize dedicated care teams assigned to physicians, which enhances coordination and communication of services,” said Regina Buchanan, R.N., M.S.N./E.D., clinical nurse director and team leader of the group evaluating clinical care teams.
The rapid improvement team assigned one nurse as the clinical care team leader to manage the work flow of each physician-based group. Clinical care group members get to know each other well and understand their roles, and the teams meet each morning before the first clinic visit to discuss upcoming patient appointments, exam and procedure needs and staff schedules.
Better coordination of each individual physician’s calendar with the clinic’s schedule of appointments also will improve clinical teams’ care.
|David Trejo and Claudia Cardenas perform a skit for ACE. (Photo by p.cunningham)|
In late April, the ACE program conducted its first “process opportunity event.” Such events focus on improvements that may require more than a week to implement. The team examined management of contracts with businesses that supply equipment or services to City of Hope. They worked to decrease contract approval processing times and looked to streamline the purchasing process and provide more information about the status of contracts. They also created an online reference guide to support system users.
The next two ACE events are scheduled for May 24 to 28. A rapid improvement team seeks to improve appointment scheduling for patients to reduce the need for rescheduling or cancellations. Additionally, a “process preparation” team will examine service and equipment management for a new ambulatory surgery center within the Michael Amini Transfusion Medicine Center.
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 email@example.com.
Satisfaction testifies to success of ACE program
The ACE program has conducted 13 rapid improvement events since November 2009. Teams focus exclusively on one area for a week to implement improvements immediately, but they also ensure that improvements continue over time.
“What we are accomplishing through our rapid improvement events on behalf of our patients is really important,” said Virginia Opipare, executive vice president and chief operating officer. “I want to acknowledge the hard work that everyone is putting into our efforts to continuously improve the quality of our patient care.”
Surveys administered by Press Ganey reliably take the pulse of patients’ satisfaction, an important measure to determine ACE’s success. City of Hope has achieved major gains in patient satisfaction since ACE was initiated in late 2009. Improvements in tenths of one point are considered good. Between ACE’s 2009 inception and April, surveys show these results:
- Overall patient satisfaction rose from 86.3 percent to 87.7 percent.
- Patient satisfaction in the surgical and medical oncology outpatient clinics grew from 88.1 and 87.0 percent to 89.9 and 89.2 percent, respectively.
- Satisfaction with the blood lab area grew from 85.0 percent to 87.6 percent.
- In the Pre-anesthesia Testing Clinic, patient satisfaction increased from 84.5 percent to 86.1 percent.
- Patient satisfaction with registration improved from 82.4 percent to 86.9 percent.