Chavez Adriana L, Singh Prachee, Aleman Andrea A, Anderson Jaime E, Jernigan Colleen, Ravi Vinod
Office of Performance Improvement (Dr Chavez), Department of Sarcoma Medical Oncology (Drs Singh and Ravi), Division of Pharmacy, Clinical Pharmacy Section (Dr Anderson), Sarcoma Center (Ms Aleman and Dr Jernigan), The University of Texas MD Anderson Cancer Center, Houston.
Qual Manag Health Care. 2014 Apr-Jun;23(2):70-5. doi: 10.1097/QMH.0000000000000020.
Quality improvement strategies can be used to modify existing health care processes to reduce patient wait times. We undertook a quality improvement project to reduce the time between new patients' initial visits and the finalization of their treatment plans. Initiation of treatment of new patients at the MD Anderson Sarcoma Medical Oncology Clinic can take up to 2 weeks from their initial consultation. Treatment delays result in increased costs and anxiety for the patient, adversely affecting the quality of care provided. We performed detailed process mapping and a cause-and-effect analysis to identify and prioritize opportunities for improvement. Process improvements addressed 2 key causes of delay to develop a finalized treatment plan: (1) insufficient data for decision making at the time of new patient visit and (2) delays in obtaining diagnostic imaging. After implementing our process improvements, the median time to develop a treatment plan decreased by 89% from 70.5 to 7.6 hours. Our process changes involved minimal additional work and had the secondary outcome of resulting in time savings for the clinic team.