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Making room for change can open doors for improved patient care 

 


By Shawn Le


When staff members in the 2B surgical clinic in the Geri & Richard Brawerman Ambulatory Care Center saw that they could improve exam rooms for both patients and colleagues, they took action. Physicians, nurses and staff members formed a team as part of City of Hope’s Accelerating Care Excellence (ACE) program and conducted their own version of an extreme home makeover to enhance patients’ experiences.

A second ACE team tackled how best to implement a new computer program to track patient vital signs and make that information instantly available in a patient’s electronic medical record.

Both teams reported their successes April 1.

Photo of Adern Yu, left, Linda Tibi and Greg Hendrix Adern Yu, left, Linda Tibi and Greg Hendrix act in a skit showing how a new program will improve methods for recording patients’ vital signs. (Photo by p.cunningham)
2B surgical clinic exam rooms

During each patient appointment in the 2B surgical clinic, caregivers might leave the room several times to gather necessary equipment and forms. Each interruption can add several minutes to the visit and cause delays for other patients waiting for their appointments. Clinic staff members recognized the need to improve the process for both patients and themselves.

“Everyone was ready for a change, and we took the opportunity to renovate one exam room as a model to test a new way of doing things,” said team leader John Hillis, manager in Health Information Management Services. “We remodeled the exam room to make better use of the space and reorganized supplies so equipment was close at hand.”

The team worked to improve the workflow and patient experience in the clinic by:

  • Lessening clutter in the exam rooms by removing unnecessary furnishings and moving needed equipment to more practical locations.
  • Creating a central location for medical forms and including a simple visual indicator that signals when to order more forms.
  • Reorganizing medical supplies by centralizing them to one location and color coding items by type of service for easier and more rapid identification.

The room also received new paint, and the team developed a plan to roll out the improvements to all of the exam rooms in the clinic if they prove successful.

Vital Signs

City of Hope is implementing electronic medical records to ensure high-quality patient care. One element, the Vital Signs program, will help keep patients’ vital signs information up-to-date, accurate and immediately available to all patient care staff.

“Our patient care staff does a great job of recording a patient’s vital signs on multiple charts and forms, but the process is inefficient and can be hampered by the legibility of a person’s handwriting,” said Rose Gonzales-Cobery, clerical manager in New Patient Services and Vital Signs team leader. “Our team wanted to ensure that the upcoming rollout of the Vital Signs program is smoothly integrated into the patient-care experience.”

The team developed procedures for the program and standard methods for entering and maintaining information in anticipation of its implementation in July. This ACE event was the first step in a continuing process of preparing clinic staff and patients for implementation of the Vital Signs program.

The next ACE events are scheduled for April 25 through 29. 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.



Patients recognizing improvement efforts

One way City of Hope measures its performance and identifies potential areas for improvement is through regular surveys of patient satisfaction.

“Accelerating Care Excellence is all about our patients and continually striving to provide the best patient care,” said Tricia Kassab, vice president of quality and patient safety. “ACE is about cultural transformation, challenging us to change the way we think about what is possible.”

The latest results from a Press-Ganey patient satisfaction survey reveal sustained improvements:

  • Overall patient satisfaction currently is 91.2 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 91.0 percent approval level.
  • Satisfaction in the blood draw labs is currently 91.9 percent, rising from an initial level of 84.6 percent
  • The 1D infusion clinic saw patient satisfaction rise from an initial 83.4 percent to a current 92.8 percent.
  • The 3C medical oncology clinic is currently at 92.7 percent satisfaction, increasing from just 79.3 percent at the start of the ACE program.

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