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Optimizing Outpatient Radiation Oncology Consult Workflow by Using Time-Driven Activity-Based Costing: Efficiency and Financial Impacts.
Weng, Julius; Mesko, Shane; Chronowski, Gregory; Lee, Percy; Choi, Seungtaek; Das, Prajnan; Koong, Albert C; French, Katy; Aloia, Thomas; Ehlers, Richie; Elrod-Joplin, Dorothy; Kerr, Ashley; Smith, Regina; Martinez, Wendi; Bloom, Elizabeth; Shah, Shalin J; Ning, Matthew S; Liao, Zhongxing; Herman, Joseph; Moningi, Shalini; Moreno, Amy C; Nguyen, Quynh-Nhu.
Afiliación
  • Weng J; Division of Radiation Oncology, MD Anderson Cancer Center, Houston, TX.
  • Mesko S; Division of Radiation Oncology, Scripps MD Anderson Cancer Center, San Diego, CA.
  • Chronowski G; Division of Radiation Oncology, MD Anderson Cancer Center, Houston, TX.
  • Lee P; Department of Radiation Oncology, City of Hope National Medical Center, Los Angeles, CA.
  • Choi S; Division of Radiation Oncology, MD Anderson Cancer Center, Houston, TX.
  • Das P; Division of Radiation Oncology, MD Anderson Cancer Center, Houston, TX.
  • Koong AC; Division of Radiation Oncology, MD Anderson Cancer Center, Houston, TX.
  • French K; Division of Radiation Oncology, MD Anderson Cancer Center, Houston, TX.
  • Aloia T; Surgical Oncology, Ascension Health, Pearland, TX.
  • Ehlers R; Department of Breast Surgical Oncology, MD Anderson Cancer Center, Houston, TX.
  • Elrod-Joplin D; Division of Radiation Oncology, MD Anderson Cancer Center, Houston, TX.
  • Kerr A; Division of Radiation Oncology, MD Anderson Cancer Center, Houston, TX.
  • Smith R; Division of Radiation Oncology, MD Anderson Cancer Center, Houston, TX.
  • Martinez W; Institute for Cancer Care Innovation, MD Anderson Cancer Center, Houston, TX.
  • Bloom E; Division of Radiation Oncology, MD Anderson Cancer Center, Houston, TX.
  • Shah SJ; Division of Radiation Oncology, MD Anderson Cancer Center, Houston, TX.
  • Ning MS; Division of Radiation Oncology, MD Anderson Cancer Center, Houston, TX.
  • Liao Z; Division of Radiation Oncology, MD Anderson Cancer Center, Houston, TX.
  • Herman J; Radiation Medicine, Zucker School of Medicine at Hofstra/Northwell, Lake Success, NY.
  • Moningi S; Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA.
  • Moreno AC; Division of Radiation Oncology, MD Anderson Cancer Center, Houston, TX.
  • Nguyen QN; Division of Radiation Oncology, MD Anderson Cancer Center, Houston, TX.
JCO Oncol Pract ; 20(5): 732-738, 2024 May.
Article en En | MEDLINE | ID: mdl-38330252
ABSTRACT

PURPOSE:

Clinical efficiency is a key component of value-based health care. Our objective here was to identify workflow inefficiencies by using time-driven activity-based costing (TDABC) and evaluate the implementation of a new clinical workflow in high-volume outpatient radiation oncology clinics.

METHODS:

Our quality improvement study was conducted with the Departments of GI, Genitourinary (GU), and Thoracic Radiation Oncology at a large academic cancer center and four community network sites. TDABC was used to create process maps and optimize workflow for outpatient consults. Patient encounter metrics were captured with a real-time status function in the electronic medical record. Time metrics were compared using Mann-Whitney U tests.

RESULTS:

Individual patient encounter data for 1,328 consults before the intervention and 1,234 afterward across all sections were included. The median overall cycle time was reduced by 21% in GI (19 minutes), 18% in GU (16 minutes), and 12% at the community sites (9 minutes). The median financial savings per consult were $52 in US dollars (USD) for the GI, $33 USD for GU, $30 USD for thoracic, and $42 USD for the community sites. Patient satisfaction surveys (from 127 of 228 patients) showed that 99% of patients reported that their providers spent adequate time with them and 91% reported being seen by a care provider in a timely manner.

CONCLUSION:

TDABC can effectively identify opportunities to improve clinical efficiency. Implementing workflow changes on the basis of our findings led to substantial reductions in overall encounter cycle times across several departments, as well as high patient satisfaction and significant financial savings.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pacientes Ambulatorios / Oncología por Radiación / Flujo de Trabajo Tipo de estudio: Health_economic_evaluation / Prognostic_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: JCO Oncol Pract Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pacientes Ambulatorios / Oncología por Radiación / Flujo de Trabajo Tipo de estudio: Health_economic_evaluation / Prognostic_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: JCO Oncol Pract Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos