Background: Radiation Oncology had 8.5 day access in March 2017 and desired to achieve same day access as per VA Secretary David M. Shulkin’s goal. In addition, we wanted to decrease the time from diagnosis to first treatment for cancer patients. This took 45 days for non-small cell lung cancer in March 2016 and ROPA (radiation oncology practice assessment) required 28 days between diagnosis and first treatment.
Methods: We developed use of an e-consult process to screen and workup patients the same day that the consult is received. This allowed workup, pathology review, and other team consultations to occur in parallel, therefore decreasing time between diagnosis and first treatment of any kind. Our Radiation Oncology nurses reorganized their workflow to track each step in the workup and contact patients when they miss a step. We also track the time that it takes our MSA to reach a patient to schedule a face to face meeting, discovering that it requires multiple telephone calls
throughout the day in order to reach a patient.
Conclusions: We have been able to reliably complete consults within 1 day since initiating this process. We have been able to decrease the time between consult made and patient scheduled from 4 to 2 days. We have been able to decrease the time between consult made and patient seen face to face in Radiation Oncology from 7 to 3 days. Time from diagnosis to first treatment of any kind decreased from 45 days to 39 days.
