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Addressing Opportunities for Improving Care Cadence by Driving Interdepartmental Collaboration

Wendi Waugh, R.T. (R)(T) CMD CTR BS
Rhondalyn Bomkamp, RN, BSN, MBA

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 Process Excellence Team, identified the following barriers and opportunities:

Barriers:

  • Lack of timely data to drive breast care coordination and prioritization
  • Inefficiencies in patient scheduling
  • Lack of common goal deployment across departments
  • Limitations of resources

Opportunities:

  • Improve coordination, improve quality and safety of care provided, increase market share, and 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 identify barriers and opportunities and drive interdepartmental care optimization, reduce opportunity for outmigration, mitigate risks and improve quality of care delivery.

Projections and Realized Results are specific to the institution where they were obtained and may not reflect the results achievable at other institutions.

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About the presenters

Kimberly Byrwa-Neff is a registered nurse with a background in both clinical nursing as well as in evidence generation in industry. Her clinical expertise lies in cardiology as well as oncology, specifically breast cancer. As a nurse, black belt in process excellence, daughter of a breast cancer patient, and survivor of breast cancer herself she brings the full patient experience to her work to improve care for breast cancer patients. Kimberly has authored numerous papers and presented improvement in clinical outcomes as a result of working with breast teams across the country.

Wendi Waugh, R.T. (R)(T) CMD CTR BS

Wendi Waugh, R.T. (R)(T) CMD CTR BS, is employed at Southern Ohio Medical Center and has worked in healthcare for more than 30 years. Wendi’s current role at SOMC is the Administrative Director of Cancer Services & Community Health and Wellness.

She is a graduate of the Radiologic Technology Program at Shawnee State University and received her training for Radiation Therapy at Weber State University. Wendi completed her Bachelor of Science at Kennedy Western Reserve in Health Administration and Health Informatics. Wendi is also a Certified Cancer Registrar and Certified Medical Dosimetrist.

Wendi’s passion for community health and community development emerged after a battle with breast cancer. Wendi is now a 14 year survivor of breast cancer and attributes success to maintain positive mental and physical wellness.

Rhondalyn Bomkamp, RN, BSN, MBA

Rhondalyn Bomkamp, Principal, Content and Evidence, Leica Biosystems, is an accomplished Director/Nurse Leader with a proven track record of effectively managing complex projects and health system performance improvement initiatives. As a registered nurse, she has experience in Quality and Patient Safety and Project Management/Development in the oncology, cardiac and intensive care arenas. She has strong clinical knowledge and management experience with the ability to recognize opportunities for improvement, coordinate the work of many areas and develop collaborative relationships with diverse groups to facilitate the implementation of change.