Purpose: The ENT Clinic will provide safe and quality care to its head/neck cancer (HNC) patients with optimal treatment interventions and cancer surveillance through regularly scheduled follow-up visits by preventing patients from being inadvertently lost to follow-up care.
Background/Problem: ~ 400,000 new cases of HNC are diagnosed and reported each year. A study reported a 47.3% disease recurrence in the first year post-treatment. HNC patients require frequent follow-up care due to the high percentage of potential disease recurrence.
Before activation of a HNC Cancer Surveillance Program a record review in 2012 showed 31.1% of HNC patients in the ENT clinic were lost to follow-up care when appointments were canceled or missed by patients and did not get a rescheduled appointment.
Methods: Vigorous Lean Six Sigma methodological tools were used to carefully assess the problem and to improve outcomes encompassing such tools as root-cause analysis, defining waste barriers, Plan, Do, Study, Act (PDSA).
In Phase I, an Excel spreadsheet was created to manually track and monitor HNC patients for cancer surveillance. Monthly reports thereafter proved that tracking HNC patients using an Excel spreadsheet was successful, and 100% of HNC patients had received follow-up appointments. However, the manual process of tracking HNC patients on an Excel spreadsheet was time consuming with limited functionality.
Phase II – A robust automated electronic identification system was implemented for tracking HNC patients which included additional features that far exceeded the capabilities of manual tracking.
Data Analysis: During the first 8 months of its operation (February 2014 – September 2014) 25 newly diagnosed HNC patients were identified electronically; patients that manual tracking might have missed.
Results: FY15 and FY16 targeted goal was achieved. 100% of HNC patient appointments were recaptured for cancer surveillance that otherwise might have been lost to follow-up using the automated electronic tracking system.
Implications: The automated HNC Dashboard has proved to be a vital tool providing improved access to care. It can be used and customized for tracking other cancer types.
