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In This Issue:
Cancer. The very word instills fear, uncertainty and vulnerability. As patients and their family members struggle to grasp the realities of being an oncology patient, the challenge of creating and fostering an environment that addresses both the medical and emotional needs of these individuals lies at the heart of compassionate and effective care.
Transitioning from the hospital to home is often a frightening experience for these patients. “Our goal is to create an improved discharge process that allows us to release patients earlier in the day while cultivating an environment of support and caring,” said Dianne Cerce, executive director, Dana-Farber Cancer Institute (DFCI) and BWH Oncology Services. Cerce; Nancy Kruger, DNSc, vice president, Patient Care Services at BWH; and James Griffin, MD, chairman of Medical Oncology at DFCI and chief of the Division of Oncology at BWH, are serving as executive sponsors of a recently formed Oncology Discharge Process Improvement Team. “Working with our colleagues at Dana- Farber, we hope to bolster patient satisfaction and security during the discharge process, improving our Press Ganey inpatient scores and increasing the number of discharges that occur by noon,” added Cerce.
Currently, only seven percent of oncology patients are discharged by noon and admissions from the DFCI clinics and infusion rooms, the Emergency Department, the Infusion Center, or from home are often delayed due to a lack of available beds. By establishing clear discharge plans and anticipating discharge needs soon after admission, and then reviewing these plans daily in multidisciplinary rounds, the team hopes to be able to make leaving early on the day of discharge a smooth, well-coordinated experience for patients. The team is also working on ways to streamline paperwork, orders, labs, and prescriptions to make the work of discharging patients safely much more efficient and pleasant for staff.
“This will take a great deal of collaboration among physicians, nurses, social workers, pharmacists and other ancillary staff, but it could have an enormous impact on patient satisfaction. Our aim is to send patients and families home or to other health care facilities in a way that they feel prepared, organized and ready to leave us,” said Pat Reid-Ponte, DNSc, RN, chief nurse, DFCI and clinical director of Inpatient Oncology at BWH, who is co-leader of the group with Lawrence Shulman, MD, chief medical officer, DFCI.
The team will be working with individuals at BWH and DFCI, the BWPO, and the organization’s strategic partners to develop recommendations that are both sustainable over time and applicable to other BWH services. The oncology discharge process pilot initiative is one of four projects launched in 2003 under the BW/F Service Excellence program. The program seeks to create a culture of service excellence through the implementation of several projects annually over the next five years.