Speed of Care at Cancer Treatment Centers of America

CTCA was one of the first hospital systems to embrace Lean Thinking principles, a concept that helps us identify treatment and process improvements that will benefit patients. Improvement projects range from large to small and always have the patient's needs and wishes at the center.

For example, we recently explored the amount of time patients spend in the waiting area to receive chemotherapy infusions through port access procedures. Using Lean Thinking, we made small changes that made a big difference for patients:

• Daily peaks of activity were identified and new scheduling guidelines were implemented.
• The appointment schedule was changed from 15-minute time slots to 20-minute intervals, preventing unnecessary delays.
• Instead of depending on the lab technicians to print patient port access labels, the department's secretary now prints them as each patient arrives.

These and other process changes slashed patient wait time by more than 75%, from over 40 minutes to now an average of ten minutes.

Lean Thinking was first developed by the Toyota Production System and is now widely used by leading service providers and manufacturers.

CTCA was one of the first hospital systems to embrace Lean Thinking principles, a concept that helps us identify treatment and process improvements that will benefit patients. Improvement projects range from large to small and always have the patient's needs and wishes at the center.

For instance, we recently explored ways to improve outpatient clinic wait times. At CTCA, we strive for what is called "single-piece flow," a process in which patients seamlessly transition from one step to the next, ensuring them as little stress as possible during their stay at a CTCA hospital. Toward that goal, we’ve used Lean Thinking to make small changes that make a big difference for patients:

• Prior to patients meeting with oncologists, new and improved scheduling procedures allow for nurses to draw and assess lab work.
• New paging and printing systems were implemented to improve communication between the front desk and lab technicians.
• Oncologists arrive to patient appointments with all needed materials ready at the front desk.

As a result of these changes, the average wait between a patient’s arrival at a scheduled appointment time and the moment when they meet with the oncologist dropped from 32 minutes to just over 10 minutes—a savings of more than 20 minutes per appointment.

Lean Thinking was first developed by the Toyota Production System and is now widely used by leading service providers and manufacturers.

Across CTCA, improvement teams find ways to enhance the patient experience every day. As a result, patients often tell us that our service and care are the best they have ever experienced. Even though 10 minutes is a “reasonable” amount of time to wait, we understand and value our patients' time and are continually working to reduce wait time to zero.

CTCA was one of the first hospital systems to embrace Lean Thinking principles, a concept that helps us identify treatment and process improvements that will benefit patients. Improvement projects range from large to small and always have the patient's needs and wishes at the center.

For instance, we know that many patients find it stressful to have blood drawn, especially if unreliable results require blood to be drawn a second time. And while redraws are sometimes necessary for reasons beyond our control, we work hard to avoid the discomfort, anxiety, and delay that unnecessary redraws can cause patients. That’s why we employed Lean Thinking to identify and reduce situations that might lead to unnecessary redraws.

As part of a Lean project, our team identified and took several easy steps to further prevent patient blood redraws, including:

• Nurse supervisors now provide a Questionable Specimens identification sheet to document and track incidents of questionable blood results.
• Nurses attend an additional education seminar at the CTCA annual Skills Fair and at New Staff Nursing Orientation in order to standardize the port blood draw process.
• Annual Nursing Competencies are now used to review nursing skills and continuously reinforce good practices.

With a few simple steps such as these, we have reduced the number of redraws by 45%, from 27 per month to only 15. Even better, by reducing the number of unnecessary redraws, the wait for necessary redraw results has dropped from an average of 1.8 hours to just one hour.

Lean Thinking was first developed by the Toyota Production System and is now widely used by leading service providers and manufacturers.