Tracking vast amounts of complicated medical and research information can be a challenge, but City of Hope employees want to make it as efficient as possible. Three teams of staff members and physicians recently met through the Accelerating Care Excellence (ACE) program to improve patient care and clinical trials processes.

From left, Blanca Herrera, Rosalinda Massie and Joe Singh III perform a skit about improving clinical trials submissions. (Photo by p.cunningham)

The teams tackled complex scheduling issues among hematopoietic cell transplantation (HCT) patients, ways to smooth out the clinical trials submission system and a reorganization of a nursing station in the Geri & Richard Brawerman Ambulatory Care Center.

Teams reported their successes Sept. 2.

HCT schedules

Department of Hematology & HCT clinicians keep a schedule of important treatment events for each patient who undergoes transplant. Because treatment is so complex, the schedules can change frequently — so ensuring that all staff members have the most current revision of the schedule can pose a challenge.

An ACE team met to streamline the time-consuming process.

“We found that by making some simple changes in the process, such as removing unnecessary elements and reducing the distribution list, we made a huge impact and reduced redundancies,” said Tracey Raffoul, R.C.P., R.R.T., M.H.A., director of respiratory care and neurology services and team leader for the event.

The team made these improvements:

• streamlined the distribution process for HCT schedules to minimize the number of copies requiring confirmation and re-work, and make the update process more efficient
• used collaboration software so that clinical staff could create standardized, consistent HCT schedules
• used health information management software to ensure updates in the HCT schedule become available to all relevant staff immediately

Staff members reduced the number of different templates used to track HCT treatments to create a simplified, easier-to-understand HCT schedule.

Clinical trials submissions

When investigators submit new clinical trials for approval, review committees return many applications with requests for corrections. This causes delays and reduces efficiency. An ACE team aimed to understand and resolve the problem.

After analyzing a year’s worth of submissions to the Internal Review Board and the Clinical Protocol Research Management Committee, the team made these improvements in the clinical trial submission and review process:

• created checklists to help investi-gators create and submit protocols and posted checklists on the intranet
• modified City of Hope’s clinical trials submissions software, called iRIS, so that key application questions can no longer be left blank and mandatory attachments cannot be omitted, and clarified and simplified certain problematic questions
• instituted a mandatory annual training and recertification program for clinical research support staff and investigators

“Our long-term goal is to reduce the number of conditions and corrections by 50 percent,” said Blanca Herrera, C.C.R.P., diabetes clinical research coordinator and team leader of the event. “Because the review committees meet every two weeks, we aren’t able to measure yet if we met our goal; however, we feel confident that the changes we implemented so far will greatly improve the process.”

Clinic 1D nurses station

Another ACE team set out to upgrade the 1D clinic nursing station in the Brawerman Center to improve efficiency.

“The team members really rolled up their sleeves on this event,” said Rosa Velazquez, ambulatory care assistant and ACE team leader, who noted that the team’s improvement made the station feel bigger and more accommodating.

Additional improvements made by the team include:

• improved tracking of charts so nurses can more quickly determine patients’ statuses
• added more computers
• created more counter-top workspace and removed unnecessary furniture

The next ACE events are scheduled for Sept. 26 through 30. 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.