Download Faster Cancer Treatment

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
19- 20 November 2015, Sydney
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
[email protected]
+64 (0)21 023 98264
Ko Awatea (Counties Manukau DHB)
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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.
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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.
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Baseline Data / Current Situation
Receive
referral
Grade referral
First Specialist
Appointment
Multi
Disciplinary
Meeting
Decision To
Treat
1st Treatment
performed
Target = 62 days
• None of the tumour streams
met the target
• Data analysis of the
performance per tumour
stream for the above process
step showed where
improvement efforts should be
focused
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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
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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.
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Outcomes so far
% of 62 day target patients passed per month
2014
10 (Oct)
09 (Sep)
07 (Jul)
08 (Aug)
06 (Jun)
05 (May)
04 (Apr)
02 (Feb)
03 (Mar)
01 (Jan)
12 (Dec)
11 (Nov)
10 (Oct)
09 (Sep)
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
08 (Aug)
•
•
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
07 (Jul)
•
2015
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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
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Contact for this Innovation
For more information Contact:
Bob Diepeveen
Improvement Advisor at Ko Awatea
Tel: +64 (0)21 023 98364
Email: [email protected]
@diepbob
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