Jessica Smith, RN, Sheila Berra, RN, Pamela Fellenz, RN, Dr. Jonathan Ticku, Kimberly Burkhalter, PharmD, Heather Kujak-Coon, RN, Jan Hutchens, RN, and Paul Olson, Lean Specialist
May 2015
Inpatient Chemotherapy
Kaizen Team
,
RNs and more
Cancer Center and 7th Medical
Mayo Clinc Health System - Franciscan Healthcare
La Crosse
,
WI
United States
This nomination is for the Inpatient Chemotherapy Kaizen Team led by Pamela Fellenz, RN, Cancer Center and Jessica Smith, RN, 7th Medical. This team was formed and this event held when nursing staff from the cancer center and 7th Medical identified gaps in the process of inpatient chemotherapy. Due to the passion, enthusiasm and professional commitment of this group of nurses and other care team members, a Kaizen event was held in late September, 2014.
This Kaizen was intended to improve process flows and communication between all the departments involved and initiate inpatient chemotherapy without significant delays. Specific problems with the process included patients not receiving their chemotherapy until late afternoon resulting in dissatisfaction for the patients/family members related to long wait times; multiple, confusing conversations and communication between all departments involved; multiple pages and interruptions for providers and most importantly, potential patient safety issues. The team members developed standard work and Job Breakdown Instruction Sheet (JBIs) for all processes and for each team involved (cancer center nurses, providers, inpatient nursing staff, pharmacy - both cancer center and inpatient pharmacy).
In addition, a dedicated Electronic Medical Record message center pool between the cancer center, 7th floor and the pharmacy was developed to communicate without multiple phone calls. A comprehensive "go forward" plan is being trialed with patients undergoing inpatient chemotherapy. Thus far there have been 4 different inpatient chemotherapy events where patients have gone through this process. Gemba time and frequent performance board huddles have been held with the team representatives with followup "tweaks" to the standard work and JBIs. Current results show each time the patient has had chemotherapy initiated prior to 12 noon (which was the team's target) and this timeframe improved each subsequent time. Dedicated followup and team work has resulted in a much improved and safer process and greater patient satisfaction.
The nurses involved were true leaders who brought information and process changes back to their co-workers which resulted in understanding and a greater likelihood of sustainability of the process over time. This team's work is an example of multiple departments working collaboratively to understand each other's workflows, support the organizational values of teamwork and innovation, implement LEAN thinking and has had an ultimate result of much safer inpatient chemotherapy treatment delivery.
Inpatient Chemotherapy Kaizen Team Members:
Pamela Fellenz, RN
Jessica Smith, RN
Sheila Berra, RN
Dr. Jonathan Ticku
Kimberly Burkhalter, PharmD
Heather Kujak-Coon, RN
Jan Hutchens, RN
Paul Olson, Lean Specialist
This Kaizen was intended to improve process flows and communication between all the departments involved and initiate inpatient chemotherapy without significant delays. Specific problems with the process included patients not receiving their chemotherapy until late afternoon resulting in dissatisfaction for the patients/family members related to long wait times; multiple, confusing conversations and communication between all departments involved; multiple pages and interruptions for providers and most importantly, potential patient safety issues. The team members developed standard work and Job Breakdown Instruction Sheet (JBIs) for all processes and for each team involved (cancer center nurses, providers, inpatient nursing staff, pharmacy - both cancer center and inpatient pharmacy).
In addition, a dedicated Electronic Medical Record message center pool between the cancer center, 7th floor and the pharmacy was developed to communicate without multiple phone calls. A comprehensive "go forward" plan is being trialed with patients undergoing inpatient chemotherapy. Thus far there have been 4 different inpatient chemotherapy events where patients have gone through this process. Gemba time and frequent performance board huddles have been held with the team representatives with followup "tweaks" to the standard work and JBIs. Current results show each time the patient has had chemotherapy initiated prior to 12 noon (which was the team's target) and this timeframe improved each subsequent time. Dedicated followup and team work has resulted in a much improved and safer process and greater patient satisfaction.
The nurses involved were true leaders who brought information and process changes back to their co-workers which resulted in understanding and a greater likelihood of sustainability of the process over time. This team's work is an example of multiple departments working collaboratively to understand each other's workflows, support the organizational values of teamwork and innovation, implement LEAN thinking and has had an ultimate result of much safer inpatient chemotherapy treatment delivery.
Inpatient Chemotherapy Kaizen Team Members:
Pamela Fellenz, RN
Jessica Smith, RN
Sheila Berra, RN
Dr. Jonathan Ticku
Kimberly Burkhalter, PharmD
Heather Kujak-Coon, RN
Jan Hutchens, RN
Paul Olson, Lean Specialist