Kaizen quality initiative to improve patient satisfaction and throughput in an academic cancer center.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 78-78
Author(s):  
David Dougherty ◽  
Patti Murray ◽  
Julie Ann Berkhof ◽  
Lynn Levandowski ◽  
Alok A. Khorana
Keyword(s):  
Quality Improvement ◽  
Patient Satisfaction ◽  
Induction Period ◽  
Continuous Process ◽  
Operational Efficiency ◽  
Cancer Center ◽  
Patient Throughput ◽  
Throughput Time ◽  
Patient Satisfaction Score ◽  
Improve Patient

78 Background: Lean management principles have long been employed in manufacturing to improve operational efficiency but have only recently been adopted into healthcare settings. To address prolonged wait times and inadequate performance on patient satisfaction surveys, our cancer center utilized a Kaizen event as part of a quality improvement initiative. Methods: We utilized methods of Kaizen philosophy to evaluate all processes related to the patient experience in the outpatient facilities of the James P. Wilmot Cancer Center of the University of Rochester. The Kaizen initiative was conducted by a multidisciplinary group and consisted of an intensive 5-day induction period to identify problems within the system of care followed by regular quality improvement meetings. The group developed immediate solutions to some problems and identified priorities for the longer term. Changes in patient throughput times (time from clinic check-in to check-out) and patient satisfaction (utilizing Press-Ganey surveys) were tracked before and after initiating Kaizen and this report evaluates results over the first 12-month period. Results: Our Kaizen initiative involved a group of 17 faculty and staff who assembled during the induction period and met bi-monthly over the 12-month period from May 2011 to June 2012. Prior to the Kaizen intervention, mean throughput time for a 30-minute clinic visit was 80.34 minutes (n = 259; median 76; range 18 to 261) and mean overall patient satisfaction score for the quarter preceding the Kaizen was 89.3 (43rd percentile AHA Region 2). Over the 12 months following the Kaizen, mean throughput time reduced to 57.85 minutes (n = 249; median 53; range 11 to 205) and patient satisfaction scores improved to 91.9 (p<0.05; 63rdpercentile). Conclusions: Utilizing continuous process evaluation and Kaizen methodology, we reduced patient throughput times by 28% and improved patient satisfaction percentile rank by 20%. Ongoing efforts focus on utilizing continuous quality improvement to improve patient and family-centered cancer care. Kaizen is an effective, resource-neutral method for improving operational efficiency and patient-centered outcomes in an academic oncology practice.

Cancer center improvement through practice-based clinical leadership team infrastructure.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 180-180
Author(s):  
Mary Coniglio ◽  
Regina Cunningham ◽  
Dawna Gillespie
Keyword(s):  
Patient Satisfaction ◽  
Performance Improvement ◽  
Performance Metrics ◽  
Leadership Team ◽  
Cancer Center ◽  
Team Approach ◽  
Patient Throughput ◽  
Clinical Leadership ◽  
Number Of Patients ◽  
Lean Tools

180 Background: A practice based clinical leadership team (PBCL) was created in the outpatient cancer center to identify, evaluate, and implement initiatives to improve safety, quality, and patient satisfaction. A quality leader facilitates the team which includes nursing, physician leaders, as well as subject matter experts from throughout the cancer service line. Methods: Key focus areas include data review/analysis, facilitating performance improvement teams to enhance patient satisfaction and patient safety; and to reduce variations in care. PBCL members participate in Performance Improvement in Action (PIIA) program that includes just-in-time process improvement training while completing projects in a 90-day period. The PIIA approach embeds quality/lean tools in the organization. The training provides structure, common terminology, and stresses the use of data to make decisions, relying on the voice of the customer and clear articulation of the problem statement before jumping to solutions. The methodology incorporates six sigma/lean tools and plan-do-check-act. Results: The PBCL structure has resulted in several specific improvement projects. The patient throughput project team implemented recommendations that increased the percentage of patients who arrived and completed lab tests before their scheduled appointment time by 36%. In addition, a simulation model was created which quantified a 28 minute reduction in total time in the department by increasing the number of patients seen independently by advanced practice providers and removing the room assignment constraint by assigning providers to a “pod of rooms” rather than a specified room(s). An infusion fast track program was implemented for selected medications to expedite patient throughput resulted in an 18 minute (52%) reduction of time in the department. Conclusions: Incorporating clinical leadership in a structured framework for quality improvement increases the buy-in to change while maintaining an objective, data driven approach. The team approach and use of performance metrics provides the opportunity to expedite pilot project testing while raising awareness of key metrics to inform of additional opportunities.

Quality improvement initiative for improved patient communication in an ED rapid assessment zone

2020 ◽  
pp. emermed-2019-209124
Author(s):  
Ahmed Taher ◽  
Federico Webster Magcalas ◽  
Victoria Woolner ◽  
Stephen Casey ◽  
Debra Davies ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Patient Satisfaction ◽  
Statistical Significance ◽  
Likert Scale ◽  
Secondary Outcome ◽  
Patient Anxiety ◽  
Improve Patient Satisfaction ◽  
Scale Point ◽  
Clinician Communication ◽  
Improve Patient

IntroductionPatient–clinician communication in the Emergency Department (ED) faces challenges of time and interruptions, resulting in negative effects on patient satisfaction with communication and failure to relieve anxiety. Our aim was to improve patient satisfaction with communication and to decrease related patient anxiety.MethodsA multistage quality improvement (QI) initiative was conducted in the ED of Toronto General Hospital, a quaternary care centre in Ontario, Canada, from January to May 2018. We engaged stakeholders widely including clinicians, allied health and patients. We developed a 5-point Likert scale survey to measure patient and clinician rating of their communication experience, along with open-ended questions, and a patient focus group. Inductive analyses yielded interventions that were introduced through three Plan-Do-Study-Act (PDSA) cycles: (1) a clinician communication tool called Acknowledge-Empathize-Inform; (2) patient information pamphlets; and (3) a multimedia solution displaying patient-directed material. Our primary outcome was to improve patient satisfaction with communication and decrease anxiety by at least one Likert scale point over 6 months. Our secondary outcome was clinician-perceived interruptions by patients. We used statistical process control (SPC) charts to identify special cause variation and two-tailed Mann-Whitney U tests to compare means (statistical significance p<0.05).ResultsA total of 232 patients and 104 clinicians were surveyed over baseline and three PDSA cycles. Communication about wait times, ED process, timing of next steps and directions to patient areas were the most frequently identified gaps, which informed our interventions. Measurements at baseline and during PDSA 3 showed: patient satisfaction increased from 3.28 (5 being best; n=65) to 4.15 (n=59, p<0.0001). Patient anxiety decreased from 2.96 (1 being best; n=65) to 2.31 (n=59, p<0.001). Clinician-perceived interruptions by patients changed from 4.33 (5 being highest; n=30) to 4.18 (n=11, p=0.98) and did not meet significance. SPC charts showed special cause variation temporally associated with our interventions.ConclusionsOur pragmatic low-cost QI initiative led to statistically significant improvement in patient satisfaction with communication and decreased patient anxiety while narrowly missing our a priori improvement aim of one full Likert scale point.

scholarly journals Improving Patient Satisfaction Through Nutrition Literacy Assessment: A Pilot Study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1329-1329
Author(s):  
Nicholas Marchello ◽  
Christine Daley ◽  
Jinxiang Hu ◽  
Debra Sullivan ◽  
Heather Gibbs
Keyword(s):  
Patient Satisfaction ◽  
Pilot Study ◽  
Regression Models ◽  
Assessment Instrument ◽  
Literacy Assessment ◽  
Patient Centered ◽  
Improve Patient Satisfaction ◽  
Patient Satisfaction Score ◽  
Literacy Assessments ◽  
Improve Patient

Abstract Objectives Nutrition literacy is the capacity to apply nutrition information to dietary choices and is associated with diet quality. Understanding patient nutrition literacy deficits may help dietitians provide a more patient-centered intervention and improve patient satisfaction with their nutrition care. This pilot study examined the effects of nutrition literacy assessments on patient satisfaction. Methods Participants (n = 89) were patients scheduled for an appointment with an outpatient dietitian. All participants completed the validated Nutrition Literacy Assessment Instrument (NLit) prior to their visit with a dietitian. Intervention-arm dietitians accessed patient NLit results to focus interventions towards individual nutrition literacy deficits. Control-arm dietitians did not access NLit results and provided traditional interventions. All participants returned one month later to retake the NLit and a modified version of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, a patient-centered satisfaction survey developed by the Agency for Healthcare Research and Quality (AHRQ). Correlations were used to examine relationships between patient satisfaction and baseline NLit scores, change in NLit scores, and randomization. Bootstrapped multiple linear regression models were used to examine relationships between patient satisfaction, changes in NLit score, and sociodemographic variables. Results Mean patient satisfaction score for the cohort was 9.01 (10-point scale). Patient satisfaction was correlated with improvements in NLit score (Spearman's r = 0.265, P = 0.012). Partial correlations showed a positive relationship between changes in NLit score and patient satisfaction (r = 0.302, P = 0.006) when controlling for randomization, age, sex, education, income, and ethnicity. Regression models showed a positive association between patient satisfaction and change in NLit score (adjusted r2 = 0.087, P = 0.036). Conclusions Improved nutrition literacy may improve patient satisfaction. Nutrition literacy assessments may aid dietitians to focus nutrition interventions, individualizing nutrition education, and improve patient satisfaction. Funding Sources This work was supported by a CTSA grant from NCATS and the School of Health Professions.

Improving Outpatient Infusion Clinic Wait Times at a Comprehensive Cancer Center

2021 ◽  
pp. OP.21.00118
Author(s):  
Neda Hashemi-Sadraei ◽  
Shenthol Sasankan ◽  
Nick Crozier ◽  
Bernard Tawfik ◽  
Ronald Kittson ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Patient Satisfaction ◽  
Working Group ◽  
Outcome Measure ◽  
Wait Time ◽  
Comprehensive Cancer Center ◽  
Secondary Outcome ◽  
Cancer Center ◽  
Wait Times ◽  
Patient Wait Time

PURPOSE: Many factors contribute to long wait times for patients on the day of their chemotherapy infusion appointments. Longer wait time leads to nonoptimal care, increased costs, and decreased patient satisfaction. We conducted a quality improvement project to reduce the infusion wait times at a Comprehensive Cancer Center. METHODS: A multidisciplinary working group of physicians, infusion center nurses, pharmacists, information technology analysts, the Chief Medical Officer, and patient advocates formed a working group. Wait times were analyzed, and the contributing factors to long wait time were identified. Plan-Do-Study-Act cycles were implemented and included labeling patients ready to treat earlier, loading premedications into the medication dispensing system, increasing the number of pharmacy staff, and improving communication using a secure messaging system. The outcome measure was time from patient appointment to initiation of first drug at the infusion center. The secondary outcome measure was patient wait time satisfaction on the basis of Press Ganey score. RESULTS: Postintervention, the mean time from appointment to initiation of first drug decreased 17.6 minutes ( P < .001; 95% CI, 16.3 to 18.9), from 58.1 minutes to 40.5 minutes (43.5% decrease). Patient wait time satisfaction score increased 8.9 points ( P < .001; 95% CI, 6.0 to 11.82), from 76.2 to 85.1 (11.7% increase). CONCLUSION: Exploring real-time data and using a classic quality improvement methodology allowed a Comprehensive Cancer Center to identify deficiencies and prevent delays in chemotherapy initiation. This significantly improved patient wait time and patient satisfaction.

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