Unless you go through the process firsthand as a patient or family member, it’s difficult to fully comprehend all the emotions and stress involved with a cancer diagnosis. Newly diagnosed cancer patients are often in the midst of one of the scariest, more vulnerable, and anxiety filled times of their lives. Everything seems to change in a moment and fear, confusion, and frustration amongst a host of other feelings can quickly set in.
With barely any time to navigate all the emotions, newly diagnosed cancer patients also have to begin filling out patient history forms and work to schedule numerous appointments before seeing a physician and moving forward with care plans.
Since the patient’s experience and care are of utmost importance, the Duke Cancer Institute (DCI) has made it a priority to focus on improvements around access to care. Under the leadership of Natalie Wilde, administrative director, Oncology Service Access, access staff members have made great leaps and bounds around both general logistics of access to care as well as overall enhancements in the patient experience.
More specifically, a goal to offer patients appointments with their provider within 72 hours, has allowed for recognized improvements in access for cancer patients across all cancer disease groups within the DCI. For instance, within a year, the number of days between scheduling an appointment and seeing a specialist was cut in half for (GU) genitourinary cancer patients.
Further, there have been a number of critical success factors best summarized by taking a closer look at the team, the process, and the technology that all lead to improvements in access.
The Team. The role and value of a new patient coordinator at the DCI was quickly realized after an initial trial of this position within a subset of the oncology disease programs. Today, the Oncology Access Services team is comprised of 11 new patient coordinators, each having a dedicated role with a specific disease group.
“It’s really the people component,” said Phyllis Dalton R.N., M.S.N., melanoma new patient coordinator within the Oncology Access Services team. “We are known across the globe for our advances in clinical care but further differentiate ourselves through the relationships we build with our patients.”
New patient coordinators serve as the front door to oncology and the first point of contact for newly diagnosed cancer patients. Their role allows for a focus on building relationships with patients, their clinical teams, and referring offices.
“New patient coordinators serve to bridge any gaps between the provider and patient,” said Cheryl Hart, new patient coordinator for prostate and GU oncology. “They are also in a unique position to offer patients and referring providers an excellent first impression.”
The new patient coordinators team up with patients and their families to serve as a resource for initial scheduling, general information and visit preparation. The new patient coordinators build these important relationships with patients during a very stressful and critical time of care.
The Process. In addition to a strengthened initial relationship with the patient and family, a focus on relationships between the access services team, clinical operations, and physician leaders in the disease programs has also been critical to the success around access improvements within the DCI.
Shared knowledge and partnerships around the specific needs for each oncology disease group has allowed patient preferences and specific needs to be incorporated into access to care.
Hope Uronis, M.D., a medical oncologist, also helped champion many efforts to decrease wait times by serving as a liaison between clinical staff and access team members.
“These partnerships allow upfront identification of patients who need multidisciplinary evaluation so the appropriate team can be assembled,” Uronis said. “As many patients receive care from multiple providers, the opportunity to increase collaboration amongst all specialties has helped optimize the patient visits while also accommodating patient preferences.”
The Technology. Implementation of a new integrated electronic health record, known as Maestro Care, has been yet another key component to improved access for patients. Maestro Care allows the access team and clinical teams to optimize provider templates by designing new patient appointment slots. It has also aided in increased education around the impacts of scheduling practices in general.
Redesigning scheduling templates that optimize clinic efficiency, patient access, and scheduling accuracy has been critical to ongoing improvements. In short, Maestro Care has been instrumental in bringing together both the team and processes key to access improvements initiatives.
In addition to the tremendous work by the team of new patient coordinators and team of clinical and administrative leads, Natalie Wilde, Administrative Director, oncology access services, has been instrumental in leading access improvement efforts.
“Natalie is an inspiration to our team,” said Dalton, who joined Duke 22 years ago. “Her knowledge, expertise and commitment have been a driving force behind our team’s success.”
The DCI’s recent improvements to access have not only been a result of the more logistical efforts centered around process and technology optimization, but also stem from a focus on the patient experience and the value behind building meaningful and productive relationships with patients and referring providers.
It’s of no surprise; the team’s approach complements our core value to care for our patients, their loved ones, and each other. Moving forward, the access team will continue to identify potential areas for improvement, ever ensuring the patient’s experience is optimal.
Circle photo (top): Duke Oncology Access new patient coordinators Stacy Strickland (front) and Ashley Solomon confer with one another while at offices located in Hock 1. Both women, members of the DCI oncology access team, provide access support for breast oncology. Strickland has been on staff for more than 15 years. Solomon joined Duke in 2006.
Vanessa Gruver is a Duke University Hospital Administrative Fellow serving primarily with the DCI team as part of the second year of her fellowship. A native of Pennsylvania, she received both her undergraduate and graduate degrees in health administration from Penn State University.