New Cancer Care Program recognized for putting patients first

Thursday, August 4, 2011 - 8:31am

When patients are diagnosed with cancer, they of course want to receive timely confirmation of their first appointment with an oncologist. The Cancer Care Program was recently recognized by Accreditation Canada for their work to improve their triage process to meet this important need.

Several years ago, patients were experiencing frustration and anxiety as they awaited notice of their first appointment. At the time, the Cancer Care Program was facing growing wait times, increasing demand and a shortage of medical and radiation oncologists. The existing triage system simply wasn’t working, as it relied on physicians who were facing greater demand than they could meet. The result was that patients were often notified of appointments at the last minute. Sometimes, because of the short notice between notification and the actual appointment time, patients were unable to make appointments, compounding the problem.

“The triage process didn’t seem to be a good use of scarce physician resources and wasn’t meeting patient needs,” says Vickie Sullivan, director, Cancer Care. An ambulatory care review at the time identified the need for the triage process in Cancer Care to be redesigned. The redesign, led by an interdisciplinary team, proposed transferring many of the triage responsibilities to highly skilled clerks, who would take on the role of referral officers.

To make this model work, teams for each cancer site (e.g. lung, breast) had to create written guidelines that referral officers could understand and use when triaging patient appointments. The team also revamped the referral process, notifying referring physicians (often surgeons) when an appointment was made so that he or she, who knew the patient best, could notify him or her of the appointment. This also addressed a frequent complaint that referring physicians were not aware when their patients would be seen.

Because so many team members were involved in the development of the new triage process, implementation was smooth. “We established the relationships that allowed success,” says Jodie Trembley, program officer.

Thanks to the new system, patients receive notification of appointments much more quickly, relieving their anxiety. “The number of concerned phone calls from patients and family members dropped tremendously after we changed our process,” explains Jodie.

In addition, physician time is freed up to focus on other priorities, and referral officers are able to work to their full ability.

Vickie says Accreditation Canada’s recognition of the clerical triage program as a leading practice speaks to the fact that the initiative followed best quality improvement practices, and is sustainable. The question that originally drove the initiative is even more relevant today: “How do we use our resources most efficiently and effectively for the benefit of patients and the system?”