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