It is important to the Cancer Institute leadership that we have representation from all of our medical specialties when we consider where and how to focus next year’s work efforts, so we continue to provide the best possible care for our patients and meet our system-wide goals.
The annual retreat is a special time for providers, nurses, managers, program leaders and others to sit down together for three hours to hear and discuss updates on nationwide changes in cancer care delivery. At each year’s retreat, participants consider new ideas, think about opportunities and needs in the ABBCI, and offer opinions and advice about selecting and focusing project priorities for the upcoming year. These opinions and advice inform project selection and planning by ABBCI’s senior leaders.
Topics discussed at prior retreats
- Jan. 23, 2014: Patient Experience and Quality Pathways
- Jan. 27, 2015: Patient Experience and Advance Care Planning
- Feb. 11, 2016: OCM Implementation and Palliative Care
- Dec. 12, 2016: Shared Decision Making
- Jan. 18, 2018: Teamwork and Oncology Disease Team Projects
Recap of this year’s retreat
Nearly 50 ABBCI team members and program leaders gathered Feb. 28, in the Seraph Conference Center, to hear a keynote address by Dr. Lawrence Shulman, Deputy Director for Clinical Services of Penn’s Abramson Cancer Center and a member of the ABBCI Oncology Physicians Advisory Council, followed by remarks from Dr. Michael Ripchinski, Penn Medicine Lancaster General Health’s Chief Clinical Officer. Following these important updates, retreat attendees divided into three discussion groups. This year’s program was planned by Beth Horenkamp, Patti Roda, Nik Buescher, Larry Shulman and Randy Oyer. The program content follows, with key points from speakers and discussion groups noted.
Keynote address by Dr. Lawrence Shulman: “Oncology Practice in 2019 -- Challenges and Opportunities”
- Oncology practice will need to become much more efficient to provide increasing amounts of care for increasing numbers of patients.
- Efficient oncology practice requires leadership with changes in culture and enhancements in teamwork that improve everyone’s work.
- The oncology care team must be expanded to effectively cover survivorship and palliative care, as well as active diagnosis and treatment.
- Patients and families must be included in care teams to make our teams’ work most effective.
- Technology, including the EMR, can help improve our work when designed and utilized properly.
- Our care teams must take care of each other, so we are always up to the job of caring for patients and families.
Dr. Michael Ripchinski: “Creating a Highly Reliable Organization”
- Penn Medicine Lancaster General Health strives to continuously provide safe, reliable and effective care.
- At the center of our work is engagement (involvement) of the patient and family.
- We all need to be part of creating and sustaining a culture that is accountable for sharing the right values, holding ourselves accountable, and making it safe for everyone’s opinions and concerns to be fairly heard.
- Continuous learning is important for all of us. We need to watch for defects and point out opportunities for improvement.
- Having a shared understanding of the work we are doing, why we are doing it and how we are doing it is fundamental and is everyone’s responsibility.
Process Improvements for Clinical Practice: Culture Change and Teaming
Facilitators: Patti Roda & Randall Oyer
- High-performing teams are key to efficient and effective practice.
- High performing teams are characterized by the following:
- Shared mental model: Team members share an understanding of the work.
- Understanding roles: who does what and who knows what
- Communication that is accurate, precise and timely
- Self-monitoring and correction when results are sub-optimal
- Backup behavior: Jumping in to help when needed
- In our large organization, we are a team of teams, also known as a multiteam system.
- This makes key communication and handoffs even more important.
- Patients and families need to be part of the team.
- Patient narrative (understanding and meaning of illness) should be understood early on and communicated from team to team, including primary care and other specialties.
- Health literacy (especially the concept of informed consent and understanding instructions) needs to be more formally managed.
- Serious Illness Conversation Program may be one partial solution.
Adapting to Care Delivery Changes: Adapting the EMR and Using Technology
Facilitators: Larry Shulman, Mike Ripchinski and Nik Buescher
- The EMR should be modified to eliminate waste and improve efficiency. This is our most important technology at this time.
- Suggestions for consideration are noted below:
- There is potential for ABBCI common note template for medical/surgical team.
- Evaluate ways to make Office Visit, visit navigator, layout and workflow more efficient.
- Solutions are needed for molecular test ordering, labelling, and results storage and display.
- We must eliminate duplication of information in surgical scheduling, generation of note about surgery and generation of consent.
- Dr. Ripchinski’ s team will work directly with the ABBCI and other important partners across the organization to make these improvements.
Personal Changes: Increasing Resilience and Decreasing Burnout
Facilitators: Beth Horenkamp and Ray Foley
To maximize professional fulfillment, clinicians and team members need to be mindful of self-care.
- As a group: Please take time for scheduled reflection and venting (HUDDLES).
- Personally: Establish non-negotiables to ensure work-life balance.
- Personally and as a group: Learn EPIC shortcuts /ask for tools.
- Culture in the Cancer Institute:
- Treat one another with mutual respect.
- Incorporate generous assumptions when considering another's behavior.
- The ABBCI's Oncology Staff Forum (OSF) has enjoyable monthly events that build teamwork and relationships. See below.
The 2019 Oncology Retreat ended with a special recognition of Nik Buescher’s birthday!