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Tools to Expedite the Development of Treatment Plans

Chavez, Adriana L. PhD; Singh, Prachee PA-C, MS; Aleman, Andrea A. RN, OCN; Anderson, Jaime E. PharmD, BCOP; Jernigan, Colleen PhD; Ravi, Vinod MD

Quality Management in Healthcare: April/June 2014 - Volume 23 - Issue 2 - p 70–75
doi: 10.1097/QMH.0000000000000020
Original Articles

Quality improvement strategies can be used to modify existing health care processes to reduce patient wait times. We undertook a quality improvement project to reduce the time between new patients' initial visits and the finalization of their treatment plans. Initiation of treatment of new patients at the MD Anderson Sarcoma Medical Oncology Clinic can take up to 2 weeks from their initial consultation. Treatment delays result in increased costs and anxiety for the patient, adversely affecting the quality of care provided. We performed detailed process mapping and a cause-and-effect analysis to identify and prioritize opportunities for improvement. Process improvements addressed 2 key causes of delay to develop a finalized treatment plan: (1) insufficient data for decision making at the time of new patient visit and (2) delays in obtaining diagnostic imaging. After implementing our process improvements, the median time to develop a treatment plan decreased by 89% from 70.5 to 7.6 hours. Our process changes involved minimal additional work and had the secondary outcome of resulting in time savings for the clinic team.

Office of Performance Improvement (Dr Chavez), Department of Sarcoma Medical Oncology (Drs Singh and Ravi), Division of Pharmacy, Clinical Pharmacy Section (Dr Anderson), Sarcoma Center (Ms Aleman and Dr Jernigan), The University of Texas MD Anderson Cancer Center, Houston.

Correspondence: Adriana L. Chavez, PhD, Office of Performance Improvement. Unit 0466, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 (

This work was previously presented at the ASCO Quality Care Symposium in November 2012 at San Diego, California.

The authors have no conflicts of interest to report.

The authors have no disclaimers to report.

© 2014Wolters Kluwer Health | Lippincott Williams & Wilkins