US Oncology Manufacturing-Inspired Practice Management Model Producing Quality and...

US Oncology Manufacturing-Inspired Practice Management Model Producing Quality
and Efficiency Improvements
Patient wait times down; use of resources, accuracy and new patient visits
improved

HOUSTON, June 6 /PRNewswire/ -- A new oncology practice management model
adapted from a successful manufacturing process is yielding substantial
results for enhancing patient access to advanced cancer care while improving
efficiency.
The model, developed by the US Oncology Practice Quality and Efficiency
(PQE) Program committee, stresses defining and measuring a problem,
determining root causes, mobilizing change initiatives and sustaining
improvements, said David Fryefield, MD, PQE committee chair and US Oncology
network member. Oncology practices that have introduced the PQE model have
realized declining patient wait times, increased efficiency of chemotherapy
staff and infusion room resources, improvements to the timeliness and
completeness of orders, and improved efficiency for physicians, who can then
devote more time to patient care.
"When we started this process, we wanted to focus on what we could
realistically accomplish -- not what we may want to do," said Dr. Fryefield,
who discussed the PQE model over the weekend at the annual conference of the
American Society of Clinical Oncology (ASCO). "It was important that the
program could be easily adopted by any oncology practice, large or small. We
didn't want any barriers to program adoption, so we strived to keep the cost
of the program and the impact on the physician workload to a minimum. This is
designed to be a quality program for the common doctor."
PQE introduces elements of Lean Six Sigma, an approach commonly used in
systematically managing workflow in just-in-time manufacturing settings, to
oncology practices. The goal is to ensure that every patient treated in a US
Oncology affiliated practice receives the right treatment, delivered the right
way, at the right time. Process improvement models have been utilized in
healthcare delivery for a number of years, particularly in hospitals. But no
standard benchmarks existed for oncology practices -- until now.
"At the beginning, most practices that we surveyed were engaged in some
quality related activities, but there was very little consistency," said Dr.
Fryefield, medical director at Willamette Valley Cancer Center in Eugene, Ore.
"There were plenty of good ideas, but not the full package. The PQE
program was designed to bring consistency to the quality and efficiency
related activities within the network practices."
A PQE guiding principal is that an unmeasured process is an uncontrolled
process. Applying the Six Sigma methodology to introduce stringent
practice-efficiency processes has produced results across the network.
Overall, practices have experienced a:
-- 33 percent decline in patient wait times
-- 16 percent increase in chemotherapy chair utilization
-- 12-16 percent improvement in timely and complete physician orders
-- 10-15 percent increase in availability of physicians to see new
patients

While each practice is unique and must examine the effectiveness of its
own processes and protocols, the methodology is the same. In the case of
patient wait times, barriers contributing to the problem are identified, e.g.,
lab reports not being ready for the physician at the time of the patient visit
or an order for the lab not being written by the physician before the visit.
Each barrier is addressed and corrected with value-added solutions, meaning
the outcome is quantifiably improved patient care without the addition of
cost, time or staff. In the case of lab reports, a re-education with
scheduling staff and physicians may be all that is necessary to ensure lab
reports are available at the scheduled visit, ultimately resulting in a
reduction in patient wait times and a more utilized and balanced patient
schedule.
The PQE committee was formed to develop a single quantifiable quality
program that could be universally adopted by network practices. It identified
five critical program elements and introduced them to the US Oncology network
in 2005.
PQE program elements and the percentage of current network adoption rates
are as follows:
1. Ownership of quality improvement by the practice's governing board
(71%)
2. Implementation of the network's evidence-based best practices
guidelines program, Pathways (95%)
3. Adoption of the PQE Balanced Scorecard, a standardized set of quality
metrics (49%)
4. Adoption of standardized patient, referring physician and employee
surveys (53%, 50%, 21% respectively)
5. Adoption of the PQE-LSS (Lean Six Sigma) process improvement
methodology (70%)

"These measurements are proving to make us better caregivers and better
stewards of our resources," said Dr. Fryefield. "You must start by being
willing to ask the questions and take a hard look at what you're doing. The
PQE model provides the structure and resources to make the changes that are
necessary to provide the right treatment, delivered the right way, at the
right time."
About US Oncology, Inc.
US Oncology, headquartered in Houston, works closely with physicians,
manufacturers and payers to identify and deliver innovative services that
enhance patient access to advanced cancer care. US Oncology supports one of
the nation's foremost cancer treatment and research networks accelerating the
availability and use of evidence-based medicine and shared best practices.
US Oncology's expertise in supporting every aspect of the cancer care
delivery system -- from drug development to treatment and outcomes measurement
-- enables the company to help increase the efficiency and safety of cancer
care.
According to the company's last quarterly earnings report, US Oncology is
affiliated with 1,247 physicians operating in 472 locations, including 91
radiation oncology facilities in 39 states.
For more information, visit the company's Web site,
http://www.usoncology.com.
About David Fryefield, MD
David Fryefield, MD, is board-certified in radiation oncology. Since
1998, he has been the medical director of Willamette Valley Cancer Center in
Oregon, a community partnership comprised of the physicians of Oncology
Associates of Oregon in conjunction with PeaceHealth and US Oncology.
Dr. Fryefield received his medical degree from the University of
Cincinnati. He fulfilled a rotating internship at San Francisco General
Hospital and completed his residency at the University of California, San
Francisco.
SOURCE US Oncology, Inc.

Lisa Henderson, +1-813-775-6208, Lisa.Henderson@hillandknowlton.com, for US
Oncology, Inc.