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Our team embarked on a multidisciplinary journey to create an exceptional care experience for our inpatient oncology patients in an effort to connect the transition from home and clinic care to the inpatient setting. We involved admitting, oncology clinic, inpatient nursing unit, clinical education, nutritional services, pharmacy, leadership, physicians, nurses, bed control, and patients.
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Kaiser Permanente, Northern California
Caritas in ActionHow Caring Science informs and inspires KP caregivers and affirms our commitment to provide our
patients and their families exceptional care
Caritas Consortium 2013
Cultivating an Exceptional Oncology Care Experience
Intent to Contribute Statement:The Hayward facility has embarked on a multidisciplinary journey to create an exceptional care
experience for our inpatient oncology patients. In this work we have connected the transition from
home and clinic care to the inpatient setting. We have involved admitting, oncology clinic, inpatient
nursing unit, clinical education, nutritional services, pharmacy, leadership, physicians, nurses, bed
control, and patients. We have evaluated current processes and experience including interviewing
our patients. The new design will include a smoother admission process aimed at having an arrival
time planned with ready bed, orders will be entered early so pharmacy can pre-prepare reducing
time patient is present waiting for chemo to be ready for infusion, designated rooms will unique
designs including sleep space for family, more connection between nurses and physicians, improved
order entry and clarity of which physician enters which orders including HBS and Oncologists,
consistent education and language between clinic and hospital, welcome package specific to
oncology patients and more. This work was inspired by one of our patients and will serve all.
Cultivating an Exceptional Oncology Care Experience
Cultivating an Exceptional Oncology Care Experience
Inspired Contributor(s) 1 : Saba Bayanzai Megan Mira Rosalinda Castro
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Service Area: GSAA
Medical Center: HAY
Affiliation: PCS
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Year Shared: 2013
Venue: Caritas Consortium
Format(s): Poster, PowerPoint…Video (separate file)
ID #: E06
Keywords:
1 Names as listed in Lotus Notes, otherwise personal e-mails indicated
Cultivating an Exceptional Oncology Care Experience
5
Caring Throughout the Journey
Jean Watson states
“Transpersonal Caring
acknowledges unity of life and
connections that move in concentric circles of caring – from individual, to
others, to community, to world, to Planet
Earth, to the universe.”
Caritas Processes• 2. Instill faith and hope and
honor others
• 4.Develop helping – trusting- caring relationships.
• 6.Use creative scientific problem-solving methods for caring decision making
• 8.Create a healing environment for the physical and spiritual self which respects human dignity
Our Purpose
To Collaborate with a multidisciplinary team of Oncologist, HBS, Pharmacist,
RN, PCT, Admitting, Managers and House Supervisor in creating a system
that will make the transition from admission to discharge a pleasant and safe one for the patient by improving
patient caring experience and satisfaction
Benefits
• Improve team communication• Improved workflow for patient satisfaction• Staffing Ratio• Inviting admission for patient • Holistic patient care ( Caritas Process #9)• Healing Environment ( Caritas Process# 8)
Our Challenge
Inconsistent practice, miscommunication and delay in care affecting patient care
experience
Intervention
• Set up Meetings with Healthcare team to collaborate in improving workflow• Created personal journals for our
oncology patients• Have designated rooms assigned • Annual refresher course for chemo
nurse providers
Oncologist notifies Bed Control, Pharmacy, 4th floor Managers via e-mail 3-5 days in advance for planned admissions. Patient calls or goes directly to admitting after clinic visit to get pre-admitted.
Admitting creates an encounter for oncologist to be able to input orders 3-5 days in advance
Oncologist enters Chemotherapy Regimen orders for pharmacy to view and verify
Chemotherapy prepared by pharmacy and delivered to floor by 0800
-Pharmacy verifies/clarifies orders once oncologist has attached orders-pharmacy will enter place holder orders into the emar
4th floor Management notifies charge nurses to keep a bed reserved. 4th floor management also makes phone call to pharmacy for a 2nd notification that a planned oncology admission is pre admitted
Patient admitted to nursing unit by 2000 the day before start of chemotherapy
a. Evening Shift: Admission paperwork, verifies orders, establish IV access and start education.
b. Night Shift: Starts pre-hydration, double verification of orders , draw needed labs and call pharmacy to request medication
c. Day shift: Verifies orders, assess patient, reviews labs, ensure patency access, starts chemo
Patient starts chemotherapy by 0900
A closer look at the workflow
1. Oncologist notifies Bed Control, Pharmacy, 4th floor Managers via e-mail 3-5 days in advance for planned admissions Patient calls or goes directly to admitting
after clinic visit to get pre-admitted
2. Admitting creates an encounter for oncologist to be able to input orders 3-5 days in advance
Workflow continue ….
3. A. Oncologist enters chemotherapy Regimen orders for pharmacy to view and verify
B. 4th floor Management notifies charge nurses to keep a bed reserved
4th floor management also makes phone call to pharmacy for a 2nd notification that a planned oncology admission is pre-admitted
4. Pharmacy verifies/clarifies orders once oncologist has attached orders
Workflow continue…
5. Patient admitted to nursing unit by 2000 the day before start of chemotherapya.Evening Shift: Admission paperwork,
verifies orders, establish IV access and start education.
b.Night Shift: Starts pre-hydration, double verification of orders , draw needed labs and call pharmacy to request medication
c.Day shift: Verifies orders, assess patient, reviews labs, ensure patent access, starts chemo
Results
• Workflow improved – one system to follow• Consistent nursing practice • Patient satisfaction • Better teamwork (Decrease
chances of errors)• Exceptional Care experience for
patient
We hope to bring awareness and inspire others to bring a Caring Experience to their
patients
Closing