Improving care coordination for brain tumor patients through value-based care redesign of a virtual integrated practice unit.

110 Background: Brain tumor care at our institution involves providers from multiple departments in separate clinics and can cause patient frustration and poor patient experience. We previously reported on engaging care teams from Neurosurgery, Neuro-Oncology, Radiation Oncology, Neuroradiology and Neuropathology using lean methodology to re-design the care pathway for patients with brain tumors. A Patient Navigator Program was also established to help with patient’s care coordination. For this study, we evaluate whether this value-based care redesign has improved patient coordination and satisfaction. Methods: The care pathway and navigator process were implemented at the end of Dec 2015. We identified 202 patients who had brain tumor resections and were followed by our Navigator Program from July 2015 – Sept 2016. We evaluated the time from surgery to appointments and whether these appointments were all made within 1 week. We also reviewed our patient satisfaction scores using Press Ganey percentile ranks and HCAHPS metrics in the areas of patient education and coordination. We compared these data from July-Dec 2015 (pre-redesign) to data from Jan-Sep 2016 (post-redesign). Results: Of the patients followed by the Navigator Program, 137 patients required follow-up with providers from at least 2 different departments for treatment planning. Pre-redesign, the program followed 49 patients and made their appointments 14 median days from surgery (range 3-37), with 59% within 1 week. The 88 patients followed after-redesign had appointments in 16 median days (range 1-33) with 70% scheduled within 1 week. Pre-redesign, our Press Ganey Percentile rank ranged from 1st-32nd. After-redesign, the ranks increased to 16th-99th percentile, with most domains over the 80th percentile. Patients also reported higher satisfaction on HCAHPS post-redesign compared to pre-redesign. Conclusions: Development of a clear process for care coordination within the patient navigator program helped improve our patient satisfaction and streamline timely follow-up care. For our future coordination, we will implement a centralized access to care for our patients with brain tumors.