The 2nd Annual Ambulatory Celebrate Improvements Fair includes quality improvement projects across Ambulatory operations.
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Improving Vaccination Rates Among Cancer Patients
Ella Ariza, Jennifer Jackson, Kelley Tealer, Laura Kaufman, Michael Vondenstein, Welela Tereffe, Aleza Espinosa, Joleesa Abraham, and Imelda Alvarado
Patients with cancer are at higher risk for complications from infectious complications, and advancements in immunization assessment would allow an improvement in vaccination practices at our institution and thereby reducing vaccine-preventable infection. Unfortunately, rates of immunization in cancer patients remain low. The aim of this project is to improve vaccination assessment, documentation, administration, and referrals.
As baseline data, we evaluated the assessment of immunizations at the Infectious Diseases clinics during June-December 2022 and found out that 82 % of the new patients evaluated in the clinic did not have their immunization records reviewed during their outpatient visit, and that 97% of the patients during Flu season in 2023 did not have documentation of Influenza vaccine administration. Our project consists of two phases:
Phase I- Aimed to improve the immunization assessment and documentation by 20%, and Phase II- To improve Influenza vaccination administration by 10%.
The project tools included among others a) the use of a “green sticker” as a reminder for the nurses to assess for immunization, b) a smart phrase for nurses and providers to improve documentation, c) improvement of communication with pharmacy and allocation of influenza vaccine in the clinic.
By developing a standard workflow for immunization assessment in the Infectious Diseases Outpatient Clinic, we successfully met and exceeded our aim of decreasing the percentage of patients that did not have vaccination assessed from 82% to 1% and to improve the percentage of patients that did not receive the influenza vaccine from 97% to 85%.
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Innovative Nursing Education through a Digital Learning Management System
Jin Huang and Mark J. Templonuevo
Innovative Nursing Education through a Digital Learning Management System
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Access Same-Day/Next Day Initiative
John Jones III and Shalamar Spears
When a new patient to MD Anderson calls seeking an appointment, they want reassurance that they will be seen by oncology experts as quickly as possible. Our Patient Access team and the entire intake/scheduling process can have such a big impact on their initial experience and overall journey.
In April 2023, a Retreat was organized with the Service Lines and Access leaders to investigate how we can remove scheduling barriers that their teams may be facing. What resulted was the “Same Day Next Day Scheduling Initiative,” an organized call to action around expedited scheduling.
The shared goal is to increase same day next day scheduling for our target population. Same day next day scheduling is defined as referral creation within 18 business hours. What is presented is the incredible improvements that were made from this initiative.
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Bridging the Gap: Collaboration of Nursing Continuing Professional Development with Nurses, Clinical Development Specialists, and Advanced Practice Providers in the Ambulatory Oncology Setting
Cori Kopecky, Kimberly Potts, Shirlene Tabao, Praise Thomas, Eron Wahid, and Lilli Ann Mauricio
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Interventional Radiology Expansion of Transperineal Hydrogel Placement for patients with prostate cancer in the Woodlands
April D. McBride and Kathleen Bugarin
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Improve Plan of Care Management for Physical & Occupational Therapy in an Inpatient Hematology Unit
Joseph A. McCarty, Christina Fries, Brian Kao, Stacey Rivers, Jordan Schorlemmer, Vi Nguyen, and Brent Braveman
Improve the met frequency rate of physical and occupational therapy plan of care in an inpatient hematology unit (G19) by 10% by the end of 3 months.
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Controlling Specimen Temperatures During Transport
Ron A. Phipps, Ann C. Reynolds, Waheed N. Muses, Emily M. Walker, Michelle C. Beltran, Melinda N. Garza, Geroge J. Muppattayil, Claude G. Sawney, Bedia Barkoh, Zenaida Richards, and Cheryl F. Hirsch-Ginsberg
This project provides an overview of the challenges, causes and interventions deployed associated with temperature monitoring compliance of laboratory specimens being transported by couriers from the Houston Area Locations to the Texas Medical Center.
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Workflow Optimization for the MDACC Echocardiography Lab
Leticia Vasquez-Mendoza, Karen Whitmore-Radford, and Elie Mouhayar
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Work From Home Initiative in the Leukemia Center
Shani Crosby, Elsy John, Lavett Wallace, and Krista Moore
Patient workload did not decrease during the COVID-19 pandemic but adjustments in healthcare, such as telemedicine, were made to accommodate patient care. Burnout contributes to higher turnover rates, lower career satisfaction, and absenteeism. The March 2023 Employee Engagement Survey for the Leukemia Center showed an increase in the burnout level at 9% compared to the March 2021 Big Survey results of 5%. The objective of the WFH initiative was to decrease burnout to 15% by April 2024 by providing standardized flexible staff schedules. The data from the pre-implementation survey and the 6-month post survey showed that staff reporting elevated levels of burnout decreased from 35% to 19.05%. Alternatively, staff who reported low levels of burn out increased from 65% to 80.95%. The WFH initiative to decrease burnout may be transferrable to other centers depending on adequate staffing and integration with their current workflow.
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The MD Anderson Symptom Inventory (MDASI) survey discloses persistent moderate to high-level symptoms in cancer survivors
Katherine R. Gilmore, Patricia Chapman, Johnny Rollins, Soo-Hyun Lee-Kim, Justine Robinson, Ellen Mullen, Haleigh Mistry, Robin Coyne, Ana Nelson, William Osai, Karen Stolar, Susan Knippel, Danielle Fournier, Tamera Plair, Angela Peek, Lori Williams, and Maria Alma Rodriguez
cancer survivorship care; patient reported outcomes
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The Impact of Online Self-Scheduling Platform Optimization on Patient Directed Access to Screening Mammography Appointments During the COVID-19 Pandemic
Megan Kalambo, Rosalind Candelaria, Thu Nghiem, Deralyn Miller, and Mike Everding
Screening mammography is a low complexity exam for scheduling coordination. Optimization of our online self-scheduling platform with EHR integration resulted in a 26-fold increase in patient utilization and a 16-fold reduction in patient access team hands-on screening mammogram scheduling engagement.
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Unlocking the Power of Data Through an Access Analytics Bootcamp
Mitchell Ruiz and Princess Roy
Analytics boot camp training program focused on improving the understanding and comfort of utilizing data reports to support leaders with day to day operations.
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Improving Pain Assessment Documentation In Leukemia Center
Maria Saenko, Heather Cienfuegos, Shani Crosby, Lavett Wallace, and Krista Moore
In 2022, the Leukemia Center was non-compliant with organizational pain assessment (PA) documentation requirements (goal 95%) with documentation rate of 69%. Nurses, who primarily complete PAs, may encounter multiple barriers including unclear organizational policies, changing documentation requirements, and inefficient documentation practices. Educational materials were developed to inform all staff on institutional policies, current PA documentation rates, step-by-step instructions, and utilization of the Nursing Checklist tool as a visual reminder to double check completion of documentation. Six months post-implementation, the average rate of PA documentation compliance increased to 87%. To achieve substantial change in nursing PA documentation compliance, the following were necessary: guidance on the policy and specific documentation criteria, staff coaching and educational efforts, direct leadership involvement, audit, feedback, clear accountability, and alignment with performance goals.
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Concordance Analysis Between Practice and Algorithm Recommendations for Cardiac Screening in a Cohort of High-Risk Lymphoma Survivors
Whittney Thoman, Katherine Gilmore, Patricia Chapman, Weiqi Bi, Haleigh Mistry, Ellen Mullen, Anita Deswal, Ihab Hamzeh, and Alma Rodriguez
A comprehensive review of lymphoma survivorship patients receiving cardio-toxic therapies such as anthracyclines and mediastinal radiation to evaluate the concordance between their survivorship care and the algorithm recommendations.
