Cleveland Clinc Improving Patients Visits to the Taussig Center

Cleveland Clinic patients who receive chemotherapy treatment often spend the greater part of their day at Taussig Cancer Center. Because the treatment process involves various steps - a physician's visit, blood work, ordering and filling the chemotherapy prescription, and receiving the treatment - long wait times are a common complaint.

As part of the Cancer Institute's ongoing initiatives to improve patient service, 15 staff members and employees collaborated in April 2006 to reduce chemotherapy wait times using FasTrack, a problem-solving business-management tool. More than a year later, data from June 2007 showed that less than 2 percent of more than 2,000 patients waited longer than 45 minutes, and most patients waited less than 15 minutes.

Communication breakdown delayed appointments
During their initial brainstorming session, which lasted for six hours, team members identified which factors caused long wait times. "We discussed everything from the effects of parking shortages to improving communication," says Beth Faiman, MSN, CNP, AOCN, who led the clinical team.

The biggest contributor to delayed appointment times was a lack of communication, which prevented chemotherapy requests from being processed correctly. For example, orders that were not correctly requested or communicated back to the prescribing physician were not sent to the pharmacy. "We were sometimes blamed for not filling an order when we actually didn't have the order," says Chris Lowe, Pharm.D., who led the pharmaceutical team.

Patients also were dissatisfied with wait times because they didn't know what to expect when they arrived for treatment. Because of Cleveland Clinic's high patient volumes, wait times tend to be longer than those at most doctors' offices. "We simply weren't communicating this to patients," Faiman says.

Improvements implemented, patient satisfaction increases
To improve communication among employees, the team focused on making "Most Wanted Improvements," or MWIs. Some of the MWIs the team implemented include: teaching new hires how to use Cancer Institute protocols; identifying effective communication tools in Nursing and Pharmacy; and establishing procedures to communicate how treatment orders are processed.

"Going through this process has helped administrators, pharmacists, nurses and doctors realize what role we each serve," Lowe says, adding that the most important step in the process is communication.

The team also created a chemotherapy education

class to help patients prepare for their visit to Cleveland Clinic. "It's about helping patients create realistic expectations," says Trennace Saleem, Department Coordinator, Hematology/Oncology. "When patients are educated, they are far less stressed because they know what to expect."

When the team collected the FasTrack data in September 2006, they found that patient wait times had been significantly reduced. Subsequently, patient satisfaction had increased. "Patients are much more satisfied," Faiman says. "We receive far fewer complaints now than we did before FasTrack, which really was our goal."