For cancer patients, the repeat visits required for blood tests, treatments and appointments with their oncologist mean that time spent in hospital waiting rooms can really add up. In fact, when the RCN commissioned a patient satisfaction survey in order to target improvements, one of the areas that patients felt most needed to be worked on was the wait time involved for out-patient chemotherapy.
As part of its commitment to improve the experience for patients in the network, an RCN team took on the challenge of finding ways to improve patient flow and reduce backlogs. By using focus groups with patients and clinicians to discuss the current care pathway, along with time mapping and benchmarking at the McGill University Health Centre (MUHC), the Jewish General Hospital (JGH), and St. Mary’s Hospital Center, the team was able to identify changes that could save patients time.
The MUHC and JGH followed St. Mary’s lead and moved from single day chemotherapy — where blood work and treatment took place on a single and often long day — to alternate day schedule for chemotherapy. Patients now have their blood drawn and see the doctor on the first day they visit, and when they return on the second day, their chemotherapy prescription is already prepared and waiting for them. Additional changes such as booking less complex cases earlier in the day, separating check-in and check-out tasks and streamlining the review of patient files before they reach the pharmacy were also found to have an important impact on shortening the waiting period.
At St. Mary’s, a number of additional changes were put in place to streamline the workflow around blood tests (phlebotomy), which was a part of the chemotherapy process that could get backlogged on very busy days. A new phlebotomy chair was added to the centre to increase the capacity of patients that could be seen by nursing staff in a short period of time. Patients are used to being given vibrating pagers which allow them to walk around if they choose and to know when it’s their turn to have their blood drawn. Now, an indicator light in the reception area lets the secretaries at reception know immediately when a phlebotomy station is free, so they can call patients more quickly.
Just as importantly, a new software connection between the automated kiosk at registration and the computer in the chemotherapy area allow staff there to know when patients have arrived for their treatment and call them in at the time of their appointment.
“We really see the difference this project has made. We don’t have the same kind of bottlenecks in the waiting area that we used to. Patients no longer have to wait to register, then wait again to be called,” explained Manon Allard, the oncology program manager at St. Mary’s. “It makes the process much easier on our patients and frees up the staff to see other patients more quickly.”