Hospitals in pursuit of excellence

Streamlining Radiation Oncology Practices to increase Patient Satisfaction

The Problem

ThedaCare selected its radiation oncology (rad-onc) department to kick off a systemwide effort to introduce lean management principles. Because it was preparing to invest in a CyberKnife and wanted to maximize its use, the department started by conducting a value-stream analysis. A team of representatives from rad-onc and other hospital departments and patients mapped the total process, from making the first call for an appointment to ending treatment. After taking radiation oncology patients through the diagrammed flow, the department discovered the patients found value in only 10 percent of the treatment process.
The three areas of value were seeing a physician, receiving treatment and talking to a care navigator. "It was so striking—how long our patient waits were and what the patient really valued," says. Editha (Edie) Krueger, MD, radiation oncologist.

The Solution

Adhering to lean practices, the radiation oncology department held a series of rapid improvement events to help physicians, nurses and staff eliminate inefficient daily tasks and allow patients more face-to-face interactions. During this process, a sensei (leader) led representatives of the department, administrators and patients in a hands-on effort to brainstorm new approaches and build action plans. For each changed process, they set quality, business and employee engagement goals. "We take on the urgency of patient care. So at first, it seemed counter-intuitive to slow down to understand our processes and roadblocks," says Karen Flom, manager of the rad-onc unit.