The sooner patients can start their chemotherapy, the sooner they can battle their cancer — and the sooner they can heal. With that in mind, City of Hope staff members recently made it their mission to reduce waiting time and accelerate the time to treatment at the 3C infusion clinic in the Geri & Richard Brawerman Ambulatory Care Center.

Sumanta Pal provides background music for a presentation on the infusion clinic. (Photo by p.cunningham)

From Aug. 2 to 6, a team of City of Hope employees focused on improving work flow in the infusion clinic as part of City of Hope’s Accelerating Care Excellence (ACE) program. Another group of staff members also addressed issues involved in sustaining improvements developed through ACE.

3C infusion clinic

Previous rapid improvement events have improved the work flow and patient satisfaction in several outpatient clinics in the Brawerman Center. The latest rapid improvement team focused its attention on the infusion clinic and made changes team members believe will help both patients and medical staff.

“Alongside simple physical improvements to the clinic, we also found that communication among physicians, nurses and pharmacy staff could be improved,” said Phyllis Burch, administrative director of the Department of Radiation Oncology and improvement team leader. “Enabling medical staff to respond to each other in a timely manner, no matter what area of the clinic they happened to be in, cuts down on waiting time for everyone involved.”

The team implemented several improvements to the infusion clinic:

• Using mobile carts to get physicians and nurses medical supplies more quickly
• Turning a vital-signs room into additional space where patients can receive infusions
• Providing Vocera, an instant voice communication system, to nurses and pharmacy staff so they can share information more efficiently
• Supplying two-way pagers to physicians so they can immediately respond to situations that could delay treatment

Be the end of the rapid improvement event, the average number of patients awaiting infusion in the 3C clinic was reduced from 13 to seven.

Sustaining improvements takes work

As part of ACE, rapid improvement teams not only suggest immediate changes to improve patients’ experiences, but also develop completion plans. These plans provide clear steps to incorporate and sustain improvements, making them part of a work routine.

A sustainment team, led by Jennifer Davis, business director for the Department of Surgery, is looking at many of the projects that remain unfinished to make sure that improvements continue.

The sustainment team examined completion plans for all 14 rapid improvement events held so far and found that many tasks in the completion plans were unclear. The team refined identified tasks in the completion plans into clearer items that could easily be resolved or scheduled for action.

Additionally, the team developed concise guidelines to help future teams create better completion plans.

“What we want to see is continual progress — ongoing movement toward desired goals is the ultimate measure of success,” said Virginia Opipare, executive vice president and chief operating officer.  

The next ACE events are scheduled for Aug. 30 through Sept. 3.

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 tkassab@coh.org.