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Multidisciplinary Management & Pulmonary Nodule Clinic

Multidisciplinary Management & Pulmonary Nodule Clinic. The St. John experience. St. John Hospital and Medical Center is a 772-bed teaching hospital in Detroit A part of the St. John Providence health system and Ascension health

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Multidisciplinary Management & Pulmonary Nodule Clinic

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  1. Multidisciplinary Management & Pulmonary Nodule Clinic The St. John experience Presented By: Zyad Kafri, MD

  2. St. John Hospital and Medical Center is a 772-bed teaching hospital in Detroit A part of the St. John Providence health system and Ascension health We offer treatment at multiple system-wide Cancer Centers of Excellence We are committed to improve the quality and timeliness of cancer care We have developed system-wide strategies to emphasize early detection and improve early stage lung cancer care St John Hospital and Medical Center

  3. Many cases presenting to the hospital (ER) are accidently found to have abnormal chest imaging Many patients in our community are considered at high risk of developing lung cancer and are without access to routine screening tests Patients presenting with symptomatic lung cancer usually have an advanced, non-curable disease Accidently discovered lung nodules are often managed by different specialists so patient care is fragmented and often delayed (missed opportunity) Lung nodules that are detected early in high risk patients have a good chance for a cure Standardization of evaluation and follow up processes (quality) are needed to make the process more predictable (timeliness) Problem Statement

  4. Currently no routine follow up is done on patients with abnormal chest imaging (at the ER) Patients with lung nodules are managed individually on a case by case basis No standardization of care or referrals Evaluation is usually delayed and fragmented Referring staff awareness Patient satisfaction Constraints

  5. Develop a mechanism to capture all missed opportunities Improve the quality of care by developing and organizing a predictable lung nodule evaluation and management process The process has to be self-sustained and system-based Consistent with standard practice guidelines Increase staff awareness of the process Patient-centered to improve patients’ satisfaction Aim Statements

  6. We met with the multidisciplinary thoracic team and decided to proceed with the stated aims We formed a core committee that meets on a weekly basis We developed a flow chart, value stream map and process map Action Plan

  7. Data/Results/Charts

  8. Improvement Measures

  9. Change: Improve the system • Now we’ll review the St. John Hospital & Medical Center Pulmonary Nodule/Mass Pathway

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  12. Sustain • Hire a full time thoracic program navigator • Maintain lung nodule case database • Maintain weekly lung nodule board meetings (case conference) • Monthly review of the data tool/registry • Quarterly reports to cancer committee and administration • Develop partnership with other health network sites • Develop partnership with referring network

  13. Thank You

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