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By Susan Martin, Vice President, Midmark RTLS
In a recent survey conducted by the Association of Community Cancer Centers (ACCC), 75% of oncology program leaders cited workflow inefficiencies as the top concern during a typical workday. Even in the best oncology centers, a host of factors contribute to inefficiencies—communication gaps, missing equipment, unbalanced patient volumes, resource issues and more. Day-to-day operations can quickly get behind schedule, despite the best of intentions.
Inefficiencies are often chalked up to the cost of doing business because their impact seems impossible to measure. Yet there is a financial impact on the organization. When high-value resources like exam rooms and infusion chairs are underutilized, it can be difficult for patients to secure timely, convenient appointments. The result? Patients may be dissatisfied enough to seek care elsewhere.
These issues can be remedied with access to the right data. If you can measure waste, you can manage change and remove inefficiencies.
MEASURING WASTE TO DRIVE IMROVEMENTS
When it comes to resource utilization, how do you accurately measure waste to reduce it? And how have some of the nation’s leading cancer centers used data to achieve measurable results?
Often selected to help care teams improve patient flow in the moment with proactive prompts and alerts, real-time locating system (RTLS) technology provides powerful retrospective data, an excellent way to understand operational performance.
Time-, location- and interaction-based data makes it easier to identify process gaps and support improvement programs that better utilize key resources. Metrics like patient wait times, room utilization, door-to-doctor times, overall visit length and equipment utilization can enable cancer program leaders to achieve greater operational efficiencies, including:
- Increasing exam room utilization
- Revealing untapped infusion chair capacity
- Optimizing care team efficiency
- Benchmarking continuous improvements
- Fostering patient and staff safety
1. INCREASING EXAM ROOM UTILIZATION
Visibility to patient wait times and exam room utilization rates has allowed many cancer centers to adjust scheduling and rooming practices to accommodate more patients, without adding physical space or short-changing each patient’s time with the provider.
Utilization data showed Dana-Farber Cancer Institute that exam rooms were empty 60% of the time, despite providers stating they did not have enough exam space. The objective data was used to create a simulation model supporting dynamic room assignments, placing patients in first-available exam rooms rather than “physician owned” rooms. As a result, they saw a 10% increase in capacity while reducing patient wait times by nearly 5 minutes per patient.
2. REVEALING UNTAPPED INFUSION CHAIR CAPACITY
Live polling at the 2019 ACCC National Oncology Conference revealed that inefficient infusion chair utilization is a significant pain point for cancer programs. Staff and providers often feel that they need additional infusion chairs to meet demand. However, many are finding evidence of untapped capacity.
Aggregate RTLS data reveals trends in peak chair utilization and average length of stay. Armed with these measurable insights, cancer centers are adjusting scheduling templates to create added capacity within existing spaces.
3. OPTIMIZING CARE TEAM EFFICIENCY
The anesthesiology team at Memorial Sloan Kettering’s Josie Robertson Surgery Center was skeptical of adopting RTLS, debating its effectiveness in perioperative care efficiency. This led Cindy Yeoh, MD, FASA, assistant attending anesthesiologist, and colleagues to develop a study to measure the impact of the technology. Specifically, to establish whether RTLS facilitated better communication and improve workflow.
Drawing on data from more than 8,000 patient cases, Josie Robertson’s anesthesiologists who use RTLS were found to be consistently more efficient than those who did not. The team’s findings were published in the Journal of Anesthesia & Clinical Research, citing faster time to preoperative anesthesia clearance and shorter duration to anesthesia induction upon patient arrival to the operating room. This translates directly into increased efficiency in perioperative workflow.
4. BENCHMARKING CONTINUOUS IMPROVEMENTS
At Lafayette Family Cancer Institute, part of the Northern Light Cancer Care network, access to location and interaction data allows administrators to assess trends in capacity and resource utilization and use them as benchmarks to drive improvements across the organization.
Brenda Farnham, MBA, BSN, RN, OCN, associate vice president, oncology services shares, “We are using data-driven process improvements to decrease patient wait times, decrease door-to-doc times, mitigate waiting room congestion, and increase patient satisfaction.”
Learn more about their continuous improvement efforts during a special Association of Cancer Executives webinar on March 3, 2021: “Data-driven Process Improvements that Improve Workflow Efficiency in Cancer Care.” Register here.
5. FOSTERING PATIENT AND STAFF SAFETY
St. Elizabeth Healthcare opened a state-of-the-art cancer center in late 2020. To assist with the challenges of serving patients during a pandemic, the center uses RTLS location and interaction data for automated contact tracing. Compared to manual efforts, this offers significant time savings and greater accuracy for tracking potential exposures to COVID-19 or other contagions.
Manual processes often fail to identify all exposures. In comparing RTLS-reported visits to self-reported visits to the patient’s room, caregivers at one facility underestimated their contact with the patient by an average of 58%.
With RTLS in place, St. Elizabeth can more accurately and efficiently identify potential exposures to contagions, quickly implementing protocols to contain transmission without undue alarm to unaffected patients or staff.
OBJECTIVE DATA: THE MVP IN PERFORMANCE IMPROVEMENT
RTLS addresses workflow inefficiencies both with real-time data and historical insight into operations. While real-time visual cues can streamline caregiver communications and improve patient flow in the moment, rich aggregate data accessible through RTLS enables health systems to uncover the hows and whys of process inefficiencies.
You can’t manage what you can’t measure. Whether the objective is to add capacity, improve throughput or reduce waste, measurable data is the evidence you need to uncover inefficiencies and support performance improvements.
Susan Martin is the Vice President of Midmark RTLS, a division of Midmark Corp., a leading provider of medical, dental and veterinary equipment, technology and services. With over 25 years of experience defining and executing commercial business strategies that propel organizational growth, she is responsible for accelerating the business transformation and growth of Midmark RTLS.