City of Hope staff members are building on the success of the Accelerating City of Hope Excellence (ACE) program by using ACE’s improvement processes in a variety of new ways. Five ACE teams recently made gains in these areas:
- Efficiently scheduling blood transfusions
- Tracking clinical trial costs
- Preparing new volunteers, vendors and students to work at City of Hope
- Instituting quick improvements across the medical center
- Improving the bone marrow transplant experience
Teams reported their successes April 27.
Nancy Jenkins, left, and Joe Singh perform a skit. (Photo by p.cunningham)
Scheduling blood transfusions
Some cancer patients need blood transfusions during their treatment. City of Hope’s patient care staff tried to anticipate when a patient might need a blood transfusion and reserved appointment times to make sure the patient’s possible needs were covered. Yet 40 percent of reserved transfusion appointments did not occur.
“In an average month, we would have close to 400 appointments set up for potential blood transfusions, but many were not needed,” said Christian Flores, a scheduler for the infusion clinics in the Geri & Richard Brawerman Ambulatory Care Center. “We’d have appointment times being cancelled last minute that could have been available for other infusion treatments.”
Flores led an ACE team that set up a new system to provide blood transfusions as they are needed. The team established the Transfusion Walk-In Service Area, which has a coordinator who manages transfusion requests. The improved efficiency allows staff to schedule more timely infusion treatments.
Clinical trial bills
Clinical trials may be sponsored by grants from City of Hope, the U.S. government, a philanthropic foundation, a drug company or any combination of those groups, and City of Hope must ensure that all clinical trials can be linked and tracked to their sponsors. An ACE team focused on refining a method to more precisely track sources of funds for clinical trials.
“With so many potential funding resources, we have to match up the different ways each group may identify a clinical trial so we can accurately reconcile the costs of a trial,” said Marie Jackson, director of clinical research administration and services.
Orientation for non-employees
Every year, new students, volunteers and vendors come to learn and work at City of Hope. They need to adhere to City of Hope’s process for new staff to ensure their safety and compliance with policies. The ACE team focused on improving the process.
“We currently have 1,800 vendors, students, volunteers and the like who need to understand City of Hope’s work policies and safety guidelines while they are on campus,” said Boris Rashkovsky, manager of training and organizational development. “We simplified the process of bringing these people on board to work with City of Hope staff to the best of their ability.”
Refining daily improvements
Through a pilot program, medical center employees are encouraged to identify and solve challenges affecting their work processes or performance immediately, without waiting for a monthly ACE event. This enables staff throughout the medical center to improve processes each day and reduces the need to keep fixing the same problems. The pilot program was run in six groups including infusion clinics, respiratory therapy, diagnostic radiology and the blood bank.
“The pilot program has helped us to tailor our daily improvement process to different departments,” said Brenda Williams, R.N., clinical nurse manager in the Brawerman 1D infusion clinics. “We now have expanded our program to three new areas in hematology and our outpatient clinics.”
Bone marrow transplant program
City of Hope is known as a pioneer and national leader in hematopoietic cell transplantation, or HCT, to treat blood-based cancers. An ACE team examined every aspect of the HCT process and aims to improve the patient experience through ACE events planned for the next 18 months.
Staff members will address issues ranging from expanding patient education to simplifying staff procedures.
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 .