Decreasing Sleepless Nights for Patients and Practitioners by Fast Tracking Patients with Diagnostic Images Highly Suspicious for Cancer



 

Rischl Alindogan, BSN; Brian Doerning, MD; Robert Lin, MD;
Jamie Difiori, MD; Harold Chow, MD; James Carter, RPA;
Cynthia Payne, PhD

https://doi.org/10.7812/TPP/19-039-16

Abstracts from the Kaiser Permanente 2019 National Quality Conference

From Southern California

Background: Development of the No Sleepless Nights program began in 2015, with a goal of streamlining the patient’s care experience after receiving diagnostic images highly suspicious for cancer. A chart review of the top 10 diagnosed cancers within the Baldwin Park service area showed a 35-day average between the time of highly suspicious diagnostic imaging to specialty appointment. This chart review also revealed variances with examinations and referrals ordered for the same type of cancer.
Methods: A committee of hospital administrators, specialists, primary care practitioners, radiologists, pathologists, and nurses organized to analyze current processes and formulated the No Sleepless Nights program. The program entails the use of a closed-loop system, and under specialty-developed protocols and direct supervision of specialty services, a nurse coordinator contacts the patient with examination results, places orders for tests and referrals on behalf of primary care, and assists with scheduling these appointments. After program implementation, the length of time from highly suspicious diagnostic imaging to specialty appointment was tracked and reported to the committee throughout the year.
Results: Implementation of the No Sleepless Nights program has reduced the average number of days from highly suspicious diagnostic imaging to specialty appointment from 35 to 10 days. In addition, this program has developed standardized guidelines for cancer workup, optimized use of the organization’s resources, and improved patient care. The program exceeds 1050 participants, has captured 39 different cancer types, and has wide acceptance and appreciation by patients, families, primary care practitioners, and specialists. As a byproduct of this program, patients are reaching the specialty department with the necessary workup completed, therefore, saving precious time for both the patient and physician. Furthermore, patients have an additional resource of support as they navigate this uncertain and frightening time involving their health.
Discussion: This program has been limited to patients within the Baldwin Park service area. Because this program has been chosen for regional spread, we anticipate an expansion of its utilization and overall development. With regional spread, access to services outside of the Baldwin Park service area, such as positron-emission tomography scans and radiation therapy, will enhance and further streamline the No Sleepless Nights program. We have identified the importance of forming a multidisciplinary team committed to the program’s goal, along with excellent leadership and administrative support, as keys for the successful development and implementation of the No Sleepless Nights program.

Abstracts from the Kaiser Permanente 2019 National Quality Conference

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