AONN 9th Annual Navigation and Survivorship Conference

The Ninth Annual Navigation & Survivorship Conference has more than 900 nurse and patient navigators are anticipated to come to Dallas and discuss their role in the perpetually evolving oncology care landscape.

Workflow Analysis – Why do we do it?

The EQUICARE CS installation and support program includes a full analysis of your clinical workflow, conducted to ensure survivorship, navigation, and patient engagement tools  are incorporated into your daily operations effectively.  Finding a workflow that works for your organization important to the success of your  programs; and in fact, we think it’s so important that we employ a full time Workflow Specialist.  Meet Tricia Cox, former Nurse Navigator and ECS user, and current Clinical Workflow Specialist at Equicare.

Every organization is different, so Tricia works with each customer to develop workflow solutions that work for their unique needs.  What does that look like?  Tricia describes the process and how it can help below…

What does a workflow specialist do for customers?

I work with clients to determine what is working and what is not within their current workflow.  Usually that means I find processes that need to be added to benefit patients for navigation and/or survivorship care.  Many facilities are trying to incorporate new standards of care for distress screening or survivorship care, but others are trying to improve current models of care.  The ultimate goal is to improve the patient care process within the facility.

Do you have any examples of how a Workflow analysis helps customers?

Yes, I’ve got lots!

When one site began using the software, the nurse navigator was using check marks on paper to figure out her patient contacts.  She then entered her data into an excel spreadsheet to meet reporting guidelines for her administrative team.  After taking a look at her needs, I showed her how to use the report capabilities within our software and was able to generate excel spreadsheets and reports automatically—freeing her time to see more patients.

Another site self-identified workflow problems and so I went out for a site visit after they had been running for several months.  Upon visiting the facility, we mutually determined some workflow enhancements, like a centrally located print station and the consolidation of efforts between team members.  Often care providers are entrenched in their systems and find it difficult to see the problems, although they know they exist!

When does a workflow analysis usually occur?

I typically get involved with an institution or center once ECS has been purchased and decisions on implementation are being made.  We start this process with something called Kick off, and this is usually when the nuances of the software are presented.  I like to get involved as early as possible to better understand who is involved with patient care, what their roles are and how they currently impact their patients.  We have frequent calls/web interactions as we go over workflow.  I can go on site early in the process if we cannot figure out the workflow process via web calls, otherwise we can wait and have an on site visit closer to going live or after going live.  Ultimately the timing is driven by customer needs.

Why does Equicare feel so strongly about the value of Workflow Analysis?

This analysis makes a BIG difference to customers, usually by identifying ways to save time on administrative tasks, leaving more time to focus on patient care.  Planning  workflow is one of the tasks that may be overlooked by busy organizations, but taking the time to find out the most efficient was of using the software ultimately benefits not just the organization but the patients, by enabling more regular contact and follow up.

And from my perspective – I just love problem solving!  Every site is slightly different and so is their workflow, which is very appealing from a problem solving perspective. Each site uses software features differently and working to see what works best for each site is very gratifying. Ultimately, if we work to improve patient care and patient experience, everyone wins.

Please contact us to learn more about conducting a workflow analysis in your organization.

CASE STUDY: Southside Regional Medical Center Installs ECS

“EQUICARE CS is incredibly intuitive and user friendly.  The great service and easy-to-use interface has made implementing ECS at Southside extremely easy, and we’re very pleased with the results.”
Lori McNulty, RN,
Oncology Nurse Navigator, SRMC

pdfDownload the SRMC Case Study (pdf)

BACKGROUND

Southside Regional Medical CenterThe Cancer Center at Southside Regional Medical Center (SRMC) offers advanced technology for treating a wide range of cancers and is fully accredited with Commendation by the American College of Surgeons (ACS) Commission on Cancer (CoC). SRMC has a busy radiation therapy center that diagnoses nearly 500 new cases of cancer each year. In 2012 the center introduced a medical oncology program, added a full time Nurse Navigator to their team, and began seeking a software tool that would enable the provision of organized navigation and survivorship care for their patients. Additionally, as the next phase of CoC  accreditation requires that cancer centers have a formal plan for the delivery of continuum of care services (which include navigation, psychosocial distress screening and survivorship  programs), SRMC wanted to be proactive in providing these programs to maintain their  accreditation.

Initially using a paper based system to track patient navigation, SRMC was seeking a  software solution that would provide the tools necessary for the Navigator to centrally track patients in both Radiation and Medical Oncology. SRMC was also looking to provide  long term survivorship care plans, distress assessments, questionnaires, and educational materials for their patients. SRMC wanted to ensure that all of the information collected  through the system would be available to the full care team, including care providers working externally. Finally, with a rapidly growing cancer program, SRMC also wanted to ensure that  their selected solution was scalable, intuitive and easy to use, with minimal administrative overhead.

SOLUTION

Southside Cancer center selected EQUICARE CS (ECS) as their navigation and survivorship  tool in March 2012 and went live with the system three months later in June 2012. The installation process began with a kick off meeting at which members of both the Equicare and SRMC teams discussed and agreed upon IT needs, workflows and other system configurations, and was followed by routinely scheduled status meetings to ensure the process went smoothly. SRMC’s Nurse Navigator is the primary system user and administrator, but ECS is also used by infusion nurses, social workers interns and others.

SRMC analyzed their workflows and use cases prior to installation and as a result, were able to launch with customizations specific to their organization including unique documentation, specific categorization and display of various assessments, and several custom fields. Equicare provided training, suggestions, and back-end development, but with the configurable design of ECS, the SRMC team was able to  perform many configurations on their own.  SRMC ramped up their Navigation program over a period of time and as of April 2013 all patients requiring Navigation were entered using ECS.

SRMC’s nurse navigator  uses the system to track referrals and patient appointments, distribute and collect responses to distress screening assessments, add notes to patient records, assess pain, provide nutritional and educational information, and track the financial resources that are sourced for patients. The system is also used to generate a variety of reports including system utilization and user time tracking, referrals assessment, changes in patient distress over time, patient outcomes, and navigational summaries. SRMC uses the survivorship functionality in ECS to provide their radiation oncology patients with long term survivorship care plans that include treatment summaries, care team information, follow-up plans, and educational information specific to each patient. This printed plan is generated through ECS by the radiation therapy RN, and then provided to patients at the one month follow up appointment after radiation completion.

Results

EQUICARE CS meets the needs of SRMC by providing organizational, clinical, and administrative benefits, as well as enabling their maintenance of accreditation compliance. By taking advantage of the navigation features in ECS, the center can include more patients in their navigation program, and by providing survivorship care plans and distress assessments they may also improve the quality of care for patients. With EQUICARE CS, Southside is on track to provide full navigation, psychosocial distress screening, and survivorship programs in  order to meet the next phase of CoC accreditation requirements.

Through ECS, SRMC’s Nurse Navigator has the tools to become more efficient in tracking referrals, appointments and assessments, and the center can therefore include more patients in the navigation program. The number of patients included in the Navigation program has approximately doubled since ECS was implemented. Additionally, Equicare’s navigation tools provide the center with a centralized way to store and access documents, patient details, and care team information, which ensures that accurate data is available to all members of  the care team, regardless of their physical location. As the center continues to grow, they will also have the capability to easily scale their  program to include more campuses and care team members.

By providing patients with distress assessments and questionnaires that can be completed prior to their appointments, SRMC minimizes the time patients spend waiting in the clinic, which may improve satisfaction with care. Additionally, through analysis of patient responses, SRMC now provides feedback to patients in distress, and aggregates population data to determine points of care where the patient experience can be improved. SRMC’s provision of long term care plans in printed format can also improve patient care by reducing the distress patients may feel at the end of treatment, which is often a time of uncertainty

Prior to ECS implementation, the generation of printed care plans was prohibitively time-consuming, and so this information was shared with patients orally. Through ECS survivorship care plans are now provided to 100% of Radiation Oncology patients, many of whom have provided positive feedback to the center on the content of these plans. Additionally, the inclusion of targeted educational material in these plans ensures patients are aware of side and late effects of treatment, and provides suggestions for health and nutritional activities that can improve outcomes.

As a busy and growing cancer center, it was important for SRMC to minimize the administrative overhead involved in implementing a new tool like ECS. The Equicare project team fixed issues as they arose, and also added feature requests to the product road map to ensure future releases better meet SRMC (and other customer) needs. ECS was intuitive and easy for SRMC’s team to learn, and the software has rapidly become an integral part of their cancer program.

SRMC sought out a care coordination solution to improve the quality of care for patients, and thereby maintain CoC accreditation; with ECS, the center is on track to do both. Not only do the tools in ECS provide functionality to improve the patient experience and meet CoC requirements for continuum of care, but the reports generated by ECS make providing information to auditors faster and easier. Additionally, by documenting Navigator time, and the benefits to patients, SRMC can rapidly evaluate and rationalize the investment in a Navigation program.

ABOUT SOUTHSIDE REGIONAL  MEDICAL CENTER

Southside Regional Medical CenterSouthside Regional Medical Center is a 300-bed, general acute care hospital located in central Virginia. The hospital has more than 1,500 employees and the medical staff is comprised of nearly 340 physicians representing more than 35 specialties.  The 420,000 square foot facility is situated on a 50-acre campus and offers the latest technology in order to serve more than 200,000 local residents. SRMC offers a full array of comprehensive outpatient services on its main campus and boasts five satellite outpatient centers: Southside Regional Renal Services (Petersburg), Southside Behavioral Health Services (Petersburg), Southside Rehabilitation Services (Petersburg and Colonial Heights), and Colonial Heights Imaging, a full service diagnostic imaging center (Colonial Heights).  The hospital is also home to three professional schools: Southside Regional Medical Center School of Nursing, School of Radiation Sciences, and School of Diagnostic Medical Sonography. A new cancer center will open on campus, adjacent to the hospital in January, 2014. For more information, please visit: www.srmconline.com

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