Purpose/Rationale: The purpose of this quality improvement project was three- fold; (1) To develop a cancer tracking dashboard that would replace a cumbersome and outdated paper-driven process; (2) To improve the cycle time to initiate treatment by one week; and (3) To decrease clinical time spent reviewing patient charts for timeliness.
Background: Bay Pines VA Healthcare System (BPVAHCS) established a Cancer Care Navigation Program (CCNP), specific to the head and neck cancer patient population. The nurse navigator is responsible for facilitating the Veteran’s progress through a complex healthcare system. The Veterans Health Administration system does not have one specific standard instrument to track the veteran across the cancer care continuum.
Methods: This project was limited to head and neck cancer cases who were to receive concurrent chemotherapy and radiation. Exclusions included surgical cases, adjuvant chemotherapy and/or radiation, and patients receiving care through the community. The cycle time is defined as: time pathology is signed to initiation of treatment. A retrospective chart review was conducted to calculate the cycle time for two fiscal quarters prior to implementation of the tool. We also documented daily the amount of time spent by the nurse in the Computerized Patient Record System (CPRS) to coordinate seamless cancer care. The data were then entered into an excel spread sheet and analyzed. As a result, this systems redesign project, an electronic tracking dashboard was designed and implemented. The exact data were extrapolated using the tool for the next two fiscal quarters.
Results: The quantitative data was a comparison of two samples; two quarters prior/after two quarters after implementation of the dashboard. The two sample unpaired t-test was utilized for analysis. Group one (n = 22) and group two (n = 23), the P value is < .0001 by conventional criteria; this difference is considered to be extremely statistically significant.
Conclusions/Implications: Utilizing the dashboard has rendered an additional 115 nursing hours dedicated to direct patient care and has improved by timeliness to treatment by five days. Current work includes building the dashboard to represent most cancers and the integration of the cancer tracking dashboard with CPRS enabling data to auto populate.
