Annual Report - 1996-1997
Opening the Clinic Services Facility in 1996 ushered in a new era of cancer patient care at M. D. Anderson, which was named one of the nation's 10 best hospitals by U.S. News & World Report's annual survey.
When the 11-story addition opened last April 29, M. D. Anderson - known worldwide for its team approach to cancer care - enhanced its outpatient services by combining the previously separate specialty based clinics into multidisciplinary care centers foc used on a particular group of cancers (hematology) or disease site (breast).
The new centers combine many services previously offered in numerous clinics, often requiring patients to walk long distances throughout the complex.
Now, in a single location, a pathologist, surgeon, radiation oncologist and medical oncologist, for example, collaborate to determine the best possible treatment plan for an individual patient. Where possible, diagnostic services are also located in the centers so that patients receive much of their ambulatory care via "one-stop shopping."
By summer's end, five of the 10 planned multidisciplinary care centers were operational, with others in development for the coming year. By mid-1997, the conversion to care centers should be complete, with the consolidation of 32 specialty clinics into 22 care centers. Redesigned job descriptions and focused training have been crucial elements as staff assume new responsibilities in a modified patient care setting.
"Patient satisfaction with outpatient services increased from 74 percent to 83 percent during this past year, with the areas of improvement attributable to training in computer skills and customer service, which enhanced our staff's ability to meet patient expectations," said Diana Browning, administrator for ambulatory operations.
With changes in the delivery of cancer care came a renewed focus on improved therapies and patient outcomes. M. D. Anderson's Patient Outcomes Program represents a fundamental shift in patient care, emphasizing quality even while payors require reduced costs.
Dr. Mitchell Morris, associate vice president for medical informatics, has spearheaded the effort to develop collaborative care pathways, written documents that define the standard of care for specific therapies and procedures. By following individual p atients assigned to each pathway and monitoring how each patient progresses, M. D. Anderson physicians will be better able to assess the benefits of each test and procedure, while also better understanding the actual cost of care for a given patient.
"Our goal is to identify and eliminate wasteful or ineffective therapies as we define appropriate standard care," Dr. Morris said. One byproduct of the program is the opportunity for enhanced patient education, with caregivers setting realisti c expectations for what patients will experience during and after treatment.
Dr. Morris pointed out that the assessment of financial outcomes will be critically important as M. D. Anderson enters into more capitated managed care contracts in which the institution assumes greater financial risk for a set population of patients.
Even as the care pathways are seeking to define the standard of care, new therapies have emerged through M. D. Anderson's continued emphasis on clinical research. Some 500 clinical studies were under way in the last year, the largest number of clinical trials anywhere in the world, according to Dr. David C. Hohn, vice president for patient care.
"Today's standard therapy is the result of yesterday's clinical research," Dr. Hohn said. "One of our highest priorities continues to be the expedient translation of laboratory findings into patient care. For many patients who sought our care in the last year, M. D. Anderson offered innovative therapies not yet available anywhere else."
While faculty work tirelessly to improve cancer therapy, enhancing patient access to those therapies is another important goal. With patient self-referral made possible by Senate Bill 192 two years ago, 7,800 new patients referred themselves to M. D. An derson in the last year - 35 percent of the 17,000 new patients registered.
Improved patient billing systems, a new patient/family business center, improved menu plans for inpatients and expanded services for international patients also highlighted the year. All of these efforts kept in mind a focus on patient satisfaction, and in surveys conducted throughout the year, M. D. Anderson patients gave the center high marks. In fact, more than 93 percent of the patients surveyed said their expectations were met or exceeded while receiving services, and almost 90 percent said they & quot;definitely would recommend" M. D. Anderson to others for cancer care.
M. D. Anderson also received high rankings in the annual "best hospitals" survey published in August by U.S. News & World Report magazine. The survey of medical experts around the country cited the cancer center's excellence in nine specialty areas: cancer, gynecology, urology, otolaryngology, orthopedics, neurology, endocrinology, gastroenterology and rheumatology.