ORLANDO, FL—Employing the kaizen lean methodology of daily huddles and huddle boards in ambulatory oncology over 10 months has led to improved patient care, a study presented at the ONS 40th Annual Congress concluded.
Kaizen—from the words “kai,” for change, and “zen,” for the good—is a component of lean health care, a system of quality improvement based on eliminating financial and process waste to enhance value for patients.
The Baylor Scott & White Cancer Center (BSWCC) in Waco, Texas, uses lean methodologies in clinical care, including daily huddles (meetings) and huddle boards (wall displays) to share information, capture ideas, analyze processes, and escalate issues for quick resolve, said Joni Watson, MBA, MSN, RN, OCN®, of Baylor Scott & White Health.
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“Frontline clinical leaders are the best individuals to identify gaps or duplicative elements within patient care,” said Watson. “In addition, their ideas—large or small—can dramatically improve patient care or eliminate waste in order to remain sustainable in the ever-financially competitive oncology health care environment.”
Shortly after opening, and new to implementing lean principles in daily care and work, BSWCC leaders added huddle boards to all areas of the ambulatory center and conducted monthly audits to be sure appropriate information was included, with monthly refinements.
“It is an expectation that huddles occur at least once daily and during each shift, and anyone can lead a huddle,” Watson said.
This has led to “numerous and ongoing improvements,” she said. Examples include tracking Commission on Cancer efforts, identifying missed revenue opportunities to prevent future recurrences, developing in-house education programs, obtaining external education for team members, analyzing appointments to determine root causes of missing items, creating a patient assistance fund, initiating campus-wide cancer awareness events, reducing overtime and increasing department productivity, and eliminating wasteful medical supply use.
“At first, some nurses felt that huddle boards were taking time away from patient care. That was our cue to further explain the value of huddle boards. This is patient care,” she explained during the presentation.
“Initial monthly audits indicated an overall 30% compliance with all components and team members huddling daily less than 25% of work days.
With ongoing refinement, monthly huddle audits now routinely show 90% or greater compliance, with necessary huddle board elements and team members consistently huddling daily, leading to idea generation, implementation, and evaluation to improve oncology care,” Watson said.
One example of the effect of the huddle boards has been a reduction in overtime throughout the cancer center by 84%.
With training and ongoing attention, lean methodologies are replicable in the oncology clinical environment, “leading to triple aim success and empowered frontline team members,” she concluded.
