Faster Cancer Treatment: Using a health target as the platform for delivering sustainable system changes

Transcription

1 Faster Cancer Treatment: Using a health target as the platform for delivering sustainable system changes Organisation Name: Ko Awatea, Counties Manukau Health Presenter: Bob Diepeveen HRT 1520 Innovations Workshops and Awards November 2015, Sydney

2 Presenters Summary Slide New Ministry of Health target: Faster Cancer Treatment introduced First publication of the results showed in Counties Manukau Health 52% of the patients received their first cancer treatment within 62-days of being referred with a need to be seen within two weeks and a high suspicion of cancer, where 85% is the target. The Improvement Advisors worked together with Doctors, Cancer Nurse Coordinators and Service Managers via a structured, Lean, data-backed approach to sustainably improve the timeliness of cancer diagnosis & treatment. A few of the implemented improvements are: - Re-design cancer pathways through collaboration between services - Introduce electronic grading to reduce the time from referral to grading - Introduce CanTrack, a web-based database, which helps Cancer Nurse Coordinators have oversight of where their patients are on the pathway Counties Manukau health has improved their performance to 63% in July (Q4) 2015 in the Ministry reporting and tracking at 84% for September 2015 (Q1) and continues to improve the care for all cancer patients. Bob Diepeveen Bob.diepeveen@middlemore.co.nz +64 (0) Ko Awatea (Counties Manukau DHB) 2

3 Key Problem Introduction of a new health target Faster Cancer Treatment: 85% of patients receive their first treatment within 62 days of being referred with a high suspicion of cancer and need to be seen within two weeks. In December 2014 Counties Manukau Health scored 52% on this measure. 3

4 Aim of this innovation Provide diagnosis and treatment for cancer patients in a timely manner. Identify opportunities for improvement in a short time frame. Implement the improvement ideas to enable a sustainable cancer pathway for all cancer patients. 4

5 5 Baseline Data / Current Situation Receive referral Grade referral First Specialist Appointment Multi Disciplinary Meeting Decision To Treat 1 st Treatment performed None of the tumour streams met the target Target = 62 days Data analysis of the performance per tumour stream for the above process step showed where improvement efforts should be focused

6 Key Changes Implemented Improved identification of FCT patients from the start of the process by better IT use Radiology: FCT referral stamp to increase visibility of patients within radiology Improved coordination of appointment/procedure scheduling, earlier involvement of Cancer Nurse Coordinator Cancer Nurse Coordinators given access to Agfa-Ris to track completion of radiology scans CanTrack, a web-based database to support tracking of patients, is being implemented Screenshot from CanTrack 6

7 Key Changes Implemented (2) Urology & Breast: Implemented e-grading, more specialties to follow Upper/Lower GI: Cancer Nurse Coordinator are immediately contacted after a suspected scope and follow-up CT is immediately booked Lower GI: order CT scan immediately after colonoscopy Gynaecology working with primary care to increase number of GPs requesting diagnostics prior to referral Lung extended pilot for an upfront PET-scan for cancer patients and use designated cancer clinics All tumour streams have put actions in place to prevent another Christmas glitch. 7

8 07 (Jul) 08 (Aug) 09 (Sep) 10 (Oct) 11 (Nov) 12 (Dec) 01 (Jan) 02 (Feb) 03 (Mar) 04 (Apr) 05 (May) 06 (Jun) 07 (Jul) 08 (Aug) 09 (Sep) 10 (Oct) Outcomes so far 62 day pass rate has gone up from 52% in December 2014 to 59% in March 2015 to 63% in the latest ministries report (July 2015, Q4) September s performance was 84% Continuous effort is put into improving the timely diagnosis and treatment of cancer patients % of 62 day target patients passed per month 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

9 Lessons Learnt Focusing on better outcomes for all cancer patients helped acceptance of improvement efforts with clinicians The problem/actions need to be owned by the right people in the organisation Let it happen vs Help it happen vs Make it happen It is hard to show a direct link between improvements and results, because of: Size of the project and number of tumour streams Multitude of interactions between services Multitude of improvements starting at once Small number of patients 9

10 Contact for this Innovation For more information Contact: Bob Diepeveen Improvement Advisor at Ko Awatea Tel: +64 (0)