Enhancing the patient experience in a new purpose-build MDT meeting room with adjoining procedure and sterilizing room for head and neck cancer patients
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St Vincent’s Head and Neck Clinic is a well-established, multidisciplinary clinic which has provided a co-ordinated team approach to the head and neck patient’s complex needs for over three decades. With the development of a new, purpose-built cancer facility, a clinical redesign project was undertaken, with the aim to further enhancing the patient experience and improving the quality of care for patients attending the weekly Multidisciplinary Head and Neck Clinic.
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Enhancing the patient experience in a new purpose-build MDT meeting room with adjoining procedure and sterilizing room for head and neck cancer patients
- 1. Day/Month/Year Footnote to go here Page 1
- 2. Enhancing the patient experience in a new purpose-built multidisciplinary meeting room with adjoining procedure and sterilising room for head and neck cancer patients Author: Helen Brake and Colette Dolan
- 3. Background • St Vincent's Hospital had a well established Head and Neck Multidisciplinary Clinic (>30 years) • The weekly clinics were held in a tutorial room which was not purpose built • Patients were assessed in front of 30 medical, nursing, allied health professionals and students • Assessment using nasendoscopes were also conducted in room with inadequate infection control facilities and clinical processes • Patient Privacy Issues - patient consultations took place in corridors • Case summary discussion and development of management plans occurred once the patient left the room Page 3
- 4. Improved patient experience • The Kinghorn Cancer Centre - development of a new, purpose-built cancer facility • A clinical redesign project was undertaken to identify issues in the old facility and how we could improve the patient experience in the new facility • We focused on patient experience to delivering a more patient-centred model of care • Infection control, patient safety, comfort and privacy drove the design of the new facility Page 4
- 5. How we did it… • The Centre for Healthcare Redesign Methodology (ACI NSW Agency for Clinical Innovation) was used to guide the stages of the project • Working party was established (CCC, NUM of CSSD, CNS, Infection control CNC Speech Pathologist) • Extensive consultation with medical oncologist, radiation oncologist and head and neck surgeons ensuring the best technology was purchased for the rooms • Stakeholders were contacted and engaged (project managers, architects, and builders) • Process mapping: • The journey of the Head and Neck Cancer patient • Handling of nasendoscopes following Infection control guideline Page 5
- 6. What we came up with… • A purpose built procedure room with adjacent sterilisation service • State of the art technology for medical assessment and diagnostics • The MDT meeting room with live streaming of procedures • Policies and procedures for the new procedure room and sterilising room were developed and implemented Page 6
- 8. Page 8 How it works…
- 10. Page 10 MDT meeting room
- 14. Page 14 Patient Outcomes • Since opening in January 2013 a total of 634 patients have been seen in the MDT Head and Neck Clinic • Improved communication between members of the multidisciplinary team resulting in improved patient management • A new model of patient centric care incorporating mission and values of the hospital maintaining the dignity of the patient • Improved infection control process through the design of the rooms • There has been a cost benefit from improved equipment management.
- 15. Page 15 Patient Outcomes • Meet the mission of the organisation • We are especially committed to people who are poor or vulnerable. • Patients comments • “I have been impressed with all aspects of support provided” • “My impressions of the centre is 5 star from amenities to nursing it is an amazing centre for which I am most appreciative”
- 16. Page 16
Hinweis der Redaktion
- Introduce myself, my name is Colette Dolan and I'm the Cancer System Innovation manager & building service manager TKCC co author of this presentation is Helen Brake Manager of Speech pathology Stephanie Scarf Clinical Nurse Specialist I would like to thank the Head and Neck multidisciplinary team Richard Gallagher Director of Cancer services and Gabrielle Prest medicine stream manager
- St Vincent's head and neck clinic is a well established multidisciplinary clinic which has provided a coordinated team approach to the head and neck patients complex needs for over three decades. Prior to the setting up of TKCC The clinics were held in a tutorial room which was not purpose built. Patients were assessed in front of medical , nursing , allied health professional and students. As the Patients were been scoped in the room. There was noise , rustling of papers and whispers amongst the multidisciplinary teams. The Patient waited in corridor outside the tutorial room, informal consultation were occuring in the corridors in front of other patients and relatives, staff entering the tutorial room during discussions. Registrars were taking history from patients out on a corridor and in the room while the clinic nurse was setting the for the procedure. it wasn’t uncommon to see Social workers hunching over patients explaining how the clinic worked and what to expect you could see the obvious anxiety in their faces. This gives you an idea what it was like for patient, very intimidating and this lead to increased anxiety, especially with this group of patients who are very sick, rural patient often first time in the city, a more vulnerable patients population The waiting area was hospital corridor with near theatre, busy thoroughfare in the main hospital. Social workers were hunching over patients explaining how the clinic worked there was obvious anxiety in Patients faces. Equipment had to be brought from other building for the clinic.
- With the development of new, purpose-built cancer facility, The Program manager, Director of Cancer services and Director of Allied Health seen the importance of improving the patient experiences and the need to improve the care we were providing to our patients A clinical redesign project was undertaken, with the aim of enhancing the patient experience and improving the quality of care for patients attending the weekly Multidisciplinary Head and Neck Clinic. Sterilisation processing unit (steris), drying cabinet for the storage of nasendsocpes for up to 72 hours– timer
- A working party was established ( CCC, NUM of Sterilising unit, Infection control CNC, Speech pathologist, CNS who ran the clinic) and key stakeholder were contact medical oncologist, head and neck surgeons, radiation oncologist To working with the architects, builders, project team to design and build a state of the art purpose build MDT meeting room with adjoining procedure room and sterilising area. We process mapped the Patient Journey for the time they booked in to the clinic to consultation and to discharge from the clinic Process mapped the handling of the naso endoscopes We were very mindful of the Infection control guidelines in the handling of the naso endoscopes and consulted with our colleague in the sterilising unit to ensure we were followed the Gastoenterological society of Australia guidelines ( for sterilising and storage of scopes)
- Followed NSW health infection control guideline and Standards endoscopic facilities and services for GENCA endoscopy guidelines One door to enable access to the room for infection control, patient privacy and comfort. Request for a door between the procedure room and seminar room for ease of access for medical staff could not be accommodated. Sterilisation processing unit (steris), drying cabinet for the storage of nasendoscopes for up to 72 hours Technicians from the Sterilising Processing Centre for processing of scopes ensured compliance with cleaning and processing standards and skill maintenance Extensive consultation with medical oncologist, radiation oncologist and head and neck surgeons took place ensuring the best technology was purchased.
- Here is a picture of the procedure room as it stands One door to enable access to the room for infection control, patient privacy and comfort. Request for a door between the procedure room and seminar room for ease of access for medical staff could not be accommodated. Chair and light for examination of patients (procedures around cleaning) The original design was not purpose built for clinical purpose (we then had to revisit stakeholder) Very hard to get everyone to agree …
- Patients enters the room, the multidisciplinary team in MDT meeting can start the assessment from the time the patient enters the room. They can see the image of the Patient up on a screen in the MDT room they are looking at the patient posture, if there is an obvious lesion and anatomical alignment
- GESA Gastroenterological Society of Australia professional aim is to ensure endoscopy facilities provide a range of safe, high quality endoscopic services NSW infection control policy All that is in the room is the Nurse, surgeon, and a family member if the patients wants one…
- Streamed in to the MDT meeting room were the multidisciplinary team can discuss their cases. We have 3 screens in the room 75 inch one is used for pathology, medical imaging and the middle is used for reporting ( MOSAIQ) data can be entered in real time.
- Sterlising is done on site. The dirty scope is pasted from the procedure room in the sterlising room via a sliding window. Scoped in cleaned in the double sinks that your see here in the picture from there it goes into …
- The steris can sterilise 2 scopes at a time it takes approximately 20 mins. This allows us time to rotate the scopes through. Once they are sterilised they go into the drying cabinate The sterilising is done by a technician from the Sterilising unit, they come over for a few hours on a Tuesday morning
- A drying cabinet. Scopes are sterile for 72 hours, as you can see the there are in individual trays, so the Nurse can pull out a tray prior to patient coming into the room and set up for the procedure.
- Less damage of scopes - costing
- Leave you with some comment from Patients Patients have told me and my colleagues they feel valued and respected with the care that has been provide with the head and neck clinic.