Management of Cancer Specialized Hospital An Example of JFCR

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1 Management of Cancer Specialized Hospital An Example of JFCR Executive Director Takahiro, Ota September 1 st, 2014

2 2 The Characteristics of Cancer Institute Hospital of JFCR

3 3 THE CANCER INSTITUTE HOSPITAL HISTORY 1908 JFCR founded ( 1st Japanese Organization Specialized in Cancer) 1934 Institute and Hospital of JFCR established in Otsuka 2005 JFCR Relocation Project to Ariake completed 2011 Ministry of Health, Labour, and Welfare designated JFCR as an advanced Performance(2013) In-Hospital Cancer Registration ;8,620(2010) Outpatient;395,363 Inpatient;215,094 Cancer Surgery ;7,449 Patient for Radiation ;1,613 Patient for Chemotherapy;28,609 ESD and EMR for Upper GI;596 ESD and EMR for Lower GI ;474 International Clinical Trial;21 Land Area; 20,000 m 2 Total Floor Area; 78,000 m beds, 12 th Floor Employee: 1,705 Operation Room; 20 Room

4 4 Number of Inpatients by Disease 3,000 Number of Inpatients FY2013 2,751 (Person) 2,500 2,000 1,500 1, , ,633 2, ,321 1,

5 Ranking of the Top 5 Japan s Hospitals in Cancer Surgery in 2012 CIH: Cancer Institute Hospital Asahi Shimbun Publications Inc. Feb 2014 Diagnosis / Rank 1 st 2nd 3rd 4th 5th CIH National Cancer Center Shizuoka Cancer Center National Cancer Center East Niigata Cancer Center Stomach St. Marianna University School CIH St. Luke s International Hospital Sagara Hospital National Cancer Center Breast of Medicine Kyoto University Hospital - 2nd Hyogo Cancer Center - 2nd The Jikei University Hospital CIH Keio University Hospital Gynecology Place Place Kashiwa Colon Head and Neck Endoscopic Treatment (Stomach) Hepato-Biliary- Pancreas Radiotherapy Colonoscopic Treatment Esophagus Endoscopic Treatment (Esophagus) Lung Thyroid CIH Shizuoka Cancer Center Osaka Medical College Hospital Toranomon Hospital - 4th Place Komagome Hospital - 4th Place CIH National Cancer Center East Aichi Cancer Center Hospital Saitama Medical University International Medical Center Tokyo Medical and Dental University Hospital Faculty of Dentistry Shizuoka Cancer Center CIH National Cancer Center Sendai Kousei Hospital Toranomon Hospital Tokyo Women's Medical Nihon University Itabashi CIH University Hospital Hospital National Cancer Center Shizuoka Cancer Center Shizuoka Cancer Center National Cancer Center East CIH National Cancer Center Komagome Hospital Showa University Northen Yokohama Hospital Kishiwada Tokushukai Hospital Kagawa University Hospital CIH Saiseikai Nakatsu Hospital National Cancer Center East Keiyukai Sapporo Hospital Juntendo University Hospital CIH National Cancer Center Osaka Medical Center for National Cancer Center National Cancer Center East Cancer and Cardiovascular Keiyukai Sapporo Hospital CIH Diseases National Cancer Center Himeji Medical Center National Cancer Center East Juntendo University Hospital CIH Kuma Hospital Ito Hospital Noguchi Hospital Tsuchiya General Hospital CIH *Total of Cervical, Uterine, and Ovarian Cancer Surveyed in

6 6 Residence of New Patients (Oct.2010~Dec.2010) 90% of the patients are from Tokyo and neighboring area. (Kanagawa, Saitama, and Chiba)

7 7 Palliative Care and Pain Control It begins from the point of diagnosis through the end of life. We have 25-bedded palliative care ward, as well as 2 teams of palliative care team which covers the enter hospital. It s a comprehensive care, including medical treatment, nursing, social welfare and psychological care: Palliative care team consists of doctor, psychooncologist, specialized nurse, dietitians, etc. Surgery Radiation Palliative Therapy, Cancer Pain Service Chemotherapy Palliative Care Palliative Care as the 4 th column of cancer treatment Volunteers Regional Care Network Palliative Care Psycho- Oncologist, Clinical Psychologist Specialized Certified Nurse Dietitians

8 8 Key Factor of Success for Cancer Screening Center

9 The Ideal Vision of Cancer Care contributed to consolidated credential for each value chain Critical to establish the consistent cancer care system from cancer screening to palliative care Surgical Treatment Screening Outpatient Care Treatment Radiation Therapy Palliative Care Chemotherapy Continuous Treatment Cancer Treatment Process The Cancer Institute Hospital of JFCR Major Hospitals in Japan The Cancer Institute Hospital provides the consistent cancer care system, which contribute to have a consolidated cancer screening. 9

10 10 Infrastructures and Systems for Hospital Management

11 11 Ward Ward Information Technology Ward nursing notes with wireless LAN Nursing system (Fujitsu) Urine collecting machine system (Fujikougaku) Risk management with barcode attached on patients wrists. Financial division Personnel division Accounting division Logistics division Conference Management support system (Fujitsu) Personnel/ payroll system (Fujitsu) Logistics system (Fujitsu) Conference system (Fujitsu) Blood transfusion division Diagnostic division Charitable corporation accounting system (Fujitsu) Pathology division Clinical trials division Blood transfusion system (Fujitsu) Specimen/ bacteria diagnostic system (Fujitsu) Pathology/ cytodiagnosis system (Fujitsu) Clinical trials system (Fujitsu) Various diagnostics machines Endoscopy division Endoscopy filing system (Olympus) Cancer Screening Center system Cancer Screening Center System (Fujitsu) Endoscopy picturizing machine Physiology diagnostic division Physiology filing system (Nihon Kohden) Medication division Medication information system (Fujitsu) Physiology diagnostic machines including electrocardiogram etc. Rehabilitation division Rehabilitation system (Fujitsu) OR/ Anesthesiology division ICU/ HCU division OR/ Anesthesiology system (Nihon Kohden) ICU system (Nihon Kohden) Various operations/ anesthesiology/ ICU machines Patients-centered team approach by sharing information within divisions and throughout the hospital Radiation oncology division Dietary division Radiation oncology system (Yokogawa electric) Radiation oncology machine Dietary system (Fujitsu) Administrative division Medical accounting system (Fujitsu) Outpatients accounting Automatic accounting machine (ALMEX) Outpatients reception PHS system (Matsushita) Return visit reception machine Automatic accounting machine Speciality treatments and divisions Electronic Medical Records system (Fujitsu) 1,000 terminals for EMR are deployed. It makes speedy and definite treatment possible by quick referring appropriate medical information. Diagnostic imaging division Diagnostic imaging division Images management system (Fuji film medical) Engineer support system (Fujitsu) Patients call PHS Various picturizing machines including CT, MRI, Ultrasound, etc Hardware: JAPANESE 70 FOUNDATION servers, 750 FOR desktop CANCER PCs, RESEARCH 300 laptop PCs, 300 printers High-definition interpretation display 11

12 12 Multi-Disciplinary Treatment Experts from different fields collaboratively work together to bring the best outcome for each patient.

13 13 Internal Decision Making Meetings Board of Trustee Board Meeting Management Meeting Management Strategy Unit Healthcare Unit Hospital Management Meeting Held 2 / year Held 1/month Held 2 /week Held every week Financial disposition Daily operation Reorganization Approval of budget Research Unit Cancer Clinical Treatment Non-Cancer Sections Central Diagnostic and Treatment Sections Central Diagnostic and Treatment Sections Nursing Pharmacy Clinical Trial and Research

14 14 Reformation Activites

15 Operational Reform Organize the Operational Reforms Task Force 220 Change Leaders (Reform promoters) assigned All 1700 members of the JFCR to participate in the campaign The next management activities depth and widen are followed by these management reformation activities

16 16 Financial Management

17 17 P&L by Department Annual budget is drawn up every year, and the budget and the actual is monitored. Revenue, cost, and the profit is monitored by department monthly. (2013)

18 Revenue-Cost Structure 18 Actions are being taken to maximize the revenue and minimize the cost.

19 19 International Activities

20 20 Number of International Patients International Patient Language Assisted Patients

21 21 Steps toward the First Appointment International Center will support the whole process. The fee for step 1 to 3 is for FREE Decision Arrangement of Inquiry by Doctor Appointment First Consultation Call: intl.info@jfcr.or.jp

22 22 Tele-Pathology Advisory Service JFCR provides remote pathology consultation service to Peking University Shenzhen Hospital, and the neighboring hospitals. JFCR receive digital pathology slides and send back the pathological advice. Neighboring Hospital Neighboring Hospital Pathology Slides Pathology Slides Patien t Inform ation Peking Univ. Shenzhen Hospital Patien t Inform ation Send Digital Data The Cancer Institute Hospital of JRCR Neighboring Hospital Digital Data Patholog y Report Pathology Slides Neighboring Hospital Patien t Inform ation Digital Data

23 23 International Relationships Sister Relationship Peking University Shenzhen Hospital, China Massachusetts General Hospital, USA Other Medical Institution MD Anderson Cancer Center, USA Memorial Sloan Kettering Cancer Center, USA Rockland Hospital, India Gading Pluit Hospital, Indonesia China-Japan Friendship Hospital, China Shanghai Senmao Clinic, China Bangkok Hospital, Thailand Parkway Hospitals, Singapore Kazakh Research Institute of Oncology and Radiology, Kazakhstan The Regional Clinical Centre for Oncology in Khabarovsk, Russia