A better way

Staff at the Tom Baker Cancer Centre is reducing the time prostate cancer patients wait for radiation treatment.  

Right now, it can take 21 working days from the time a radiation oncologist writes a requisition for treatment to when the patient receives that treatment. The goal is to reduce the wait to 11 days over the next few months.

That’s just one of many ways the Tom Baker Cancer Centre and the Cross Cancer Institute in Edmonton are improving productivity and speeding up treatment for cancer patients.

About 16,000 new patients a year are diagnosed with invasive cancer in Alberta. About 75 per cent receive some form of treatment such as radiation therapy, chemotherapy or surgery at one of the cancer centres.

Using a process called lean (originally developed by Toyota), staff at the two cancer centres are identifying and implementing hundreds of initiatives that can increase productivity and therefore accommodate patients more efficiently.
 
Dr. Anthony Fields, vice-president of cancer care for Alberta Health Services, says the lean process is like a lens through which you examine a particular process. 

“Things may seem straightforward—that’s the way it’s always done and it’s as good as it can get. When you examine them through lean, you can find there are all sorts of ways to reduce the multiple fragments of wait times.”

Chemotherapy, surgery and every other department in both cancer centres are expected to adopt the lean process, but the radiation therapy department—which has a goal to increase its productivity by 15 per cent—is the first to use it.

Earlier this year, Tom Baker staff worked with lean consultants over two days to map out every detail of one specific step of planning treatment for prostate cancer patients. 

“Their initial brainstorming sessions generated more than 100 potential things that could be changed,” says Fields.  “The process from there is to distill those down and rank them in terms of things that could be applied immediately and are likely to have a high impact versus ones that are longer term, and so on.”
 
One initiative has already been implemented: an easier, faster system for radiation oncologists to see computerized axial tomography (CT) scans remotely. This allows them to then prescribe precise radiation treatment plan for a patient without having to come to the building. (This improvement has been adopted for all cancer patients, not just those with prostate cancer).
 
Many other initiatives are improving the flow of information at the clinics and will further reduce delays over the course of a patient’s radiation treatment.

In Edmonton, staff at the Cross Cancer Institute has been examining the radiation treatment process for patients with brain cancer. The two institutions will share the information and initiatives they’ve identified. 

Fields says the lean process is not a one-time intervention; rather, at least 70 per cent of cancer centre staff will be trained to diligently identify ways to refine and improve patient care.
 
“We face backlogs at many points, starting with just getting patients who are referred to cancer care to their consultation with an oncologist,” Fields says. 

“We can probably adopt this technique involving different groups of individuals to work on increasing the efficiency of these processes.”