QIM19-123: Addressing Opportunities for Improving Care Cadence by Driving Interdepartmental Collaboration

Abstract

Background: Southern Ohio Medical Center (SOMC) is a community hospital in Portsmouth, Ohio. Review of data pertaining to breast care delivery demonstrated opportunities for improvement. Analysis of the cadence of care processes across departments demonstrated delays in care and outmigration potential. One quality study demonstrated 10% of patients did NOT select SOMC for surgical intervention post biopsy. Method: SOMC reached out to industry for solutions and suggestions to better coordinate care and address barriers within the breast program. A team of clinical, process excellence specialists from Leica Biosystems conducted telephonic interviews and on-site assessments relative to internal processes and methods for care delivery. The SOMC Breast Health Leadership Team (BHLT) in concert with the Leica Biosystems Process Excellence Team identified the following barriers and opportunities: Barriers were (1) Lack of timely data to drive breast care coordination and prioritization; (2) Inefficiencies in patient scheduling; (3) Lack of common goal deployment across departments; and (4) Limitations of resources. Opportunities were to (1) Improve coordination, (2) improve quality and safety of care provided, (3) increase market share, and (4) increase patient loyalty. Results: The SOMC BHLT purposefully initiated interdepartmental communications and emphasized the importance of interdepartmental task interdependence. Data reviewed and collected during the on-site observational analysis provided baselines for opportunities for improvement in care delivery and pointed out where delays and risks for patient safety existed. Patients requiring additional imaging evaluation and/or comparison to prior mammograms (BI-RADS 0) experienced improvement when changes were implemented relative to scheduling; days from screening to diagnostic mammogram in 2017 was 21.8 days versus 6.5 days in 2018. Patients with BI-RADS 4 or 5 experienced improved timelines from diagnostic mammogram to biopsy, 4.5 days in 2017 to 2.5 days in 2018. Finally, 34% of patients received their biopsy within 24 hours in the fourth quarter in 2017 while 76% of the patients received a biopsy within 24 hours in the most recent quarter (July–September 2018). Conclusion: Working together, industry can provide expertise and guidance not always available in community hospital settings to help: identify barriers and opportunities, drive interdepartmental care optimization, reduce opportunity for outmigration, mitigate risks, and strive to improve quality.