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| Cancer Treatment Centers of America: Complete Overhaul |
| Specialized Hosp. | |
| Written by Jill Rose | |
| Friday, 29 February 2008 | |
 At Cancer Treatment Centers of America, Steve Bonner and his team may be discovering a cure for healthcare’s ills. When you read the story behind successful businesses, you’ll often find a regular guy or gal who was using a product (or service), found it unsatisfactory, and set out to make a better one. Since most hospitals were founded decades ago, the same is not usually true in healthcare.  Steve Bonner, CEO Today, the organization comprises four cancer centers around the country and employs 2,100, all of whom are dedicated to doing just that. Steve Bonner joined the organization as CEO in 1999, having seen a tremendous opportunity. “This is my first healthcare experience. But I was always looking for a position in a company that seemed to be uniquely addressing needs, and I believed that was present at CTCA,” he said, adding that the company has grown five-fold since he joined. Get together Integrated care with a maniacal focus on the patient is the main thrust of CTCA’s philosophy. Patients, many of whom have late-stage cancer, are treated like family members in a hotel-like setting. Families are encouraged to stay with patients regardless of the hour, and patients are highly engaged in healthcare decisions. CTCA’s hospitals are located in Philadelphia, Tulsa, and Zion, Ill., with a cancer treatment and wellness center in Seattle.  “As a cancer patient, you might see a massage therapist, a nutritionist, and so forth, but you’re left trying to figure out, for example, how do your vitamins and nutrients and food fit with your chemotherapy, and how does that fit with your radiation therapy,” he explained. “In our model, all of our caregivers (about 40 physicians and clinicians) sit around a table three days a week and talk about the patients who are in the hospital.” These meetings are possible because all the physicians at CTCA are employees, so they are not missing out on billable hours. This was part of Stephenson’s original model. “He believed that if you rely on physicians to bring you customers, pretty quickly, the physician becomes your primary focus,” said Bonner. At CTCA, direct-to-consumer marketing, rather than physicians, brings in patients. And Bonner said the care meetings are critical to achieving better outcomes. “By having these meetings three days a week, on Wednesday, we can look where we were on Monday, what we set out to do, and what has actually happened. Then we can adjust to make sure we’re getting the best out of all the therapies,” he explained. “Our ability to manage side effects is also much more sensitive. We can watch them emerge and make adjustments and try additional therapies to help with that.”  Satellite lab Around the country, hospitals are waking up to the fact that their processes, many of which were developed years ago, involve a lot of wasted time and/or movement. CTCA is among these, and it will come as no surprise that its Lean Six Sigma efforts are focused on the patient. About four years ago, Bonner and his team began looking at Lean Six Sigma, and the head of the pharmacy at the Zion facility volunteered to host the organization’s first kaizen event. “It seemed a perfect place to start,” Bonner said, explaining that a growing number of patients and the complexity of delivering chemotherapy drugs meant patients were waiting longer for treatments. Because blood tests must be conducted before the start of each chemotherapy treatment, the time from draw-time to received-in-lab was targeted as a way to reduce wait times. Changing the way blood-draw labels were printed and distributed and reducing other process steps led to a 60% time reduction. To further reduce patient wait times, a satellite lab was built next to the infusion center to eliminate a two-floor walk to retrieve therapies.  “He said, ‘If I can walk off an airplane at any major airport, go to a Hertz counter, tell them who I am, and drive off in a $40,000 vehicle, why do our patients have to spend 40 minutes telling us who they are?’” The greeting process is especially important at CTCA, said Bonner. “Imagine you’re a third- or fourth-stage cancer patient—you’re not feeling well, you’ve traveled many miles to come to us for treatment, and the first thing you’re asked to do is spend time filling out forms.” Today, patients walk in, identify themselves, and are greeted by a First Connection employee who knows who they are. “It warms up the whole process,” he said. Measure up The efficiencies created by streamlining processes are fairly easy to measure; the effect of creating a truly caring environment is less so. Still, Bonner and his team are slowly proving the therapeutic effects of treating the whole patient—and treating everyone like a human being. “The core of our care model is recognizing that traditional therapies like chemo, radiation, and surgery treat the tumor, which you need to do, but the tumor is not the disease—it’s a symptom,” he said. “The reality is that something has gone wrong with this patient’s immune system, and anything we can do to take stress out of the system is going to counteract that.” Examples of this approach are everywhere at CTCA, from its system-wide Mother Standard of care (treat each patient as though he or she is a family member) to pet therapy, laughter therapy, employee empowerment, and family accommodation. “Families are welcome 24/7,” said Bonner. “So you might see a little kid taking a nap in the infusion room while her mom is having chemotherapy. You’re taking stress out of the system, and that’s therapeutic.” Employees, regardless of their position, are encouraged to think along the same lines. “We have created an empowering environment for our people,” said Bonner. “If you’re working on the housekeeping staff, and you go into a room to clean but sense that a patient needs something, don’t clean the room—take care of what the patient needs. We’ll get the room cleaned later.” As a result, anecdotes of employees going above and beyond abound, including a housekeeper encountering a patient who was thirsty and wanted a certain drink not available at the hospital. The housekeeper left the hospital, drove to a local Walgreens, bought the drink, and brought it back. “She didn’t have to ask her supervisor or anything like that. The impact of an act like that on a patient in a hospital is very exciting,” Bonner said. Of course, patient satisfaction can be measured through surveys, and at CTCA, that process is a daily occurrence. Paper surveys are distributed in common areas, and results are entered into an electronic system for tabulation. The results are fed back to the operating units daily, and a summary is included in the monthly board report. Respondents can choose anonymity, but if they have a complaint and include their name, a manager will visit the patient to let them know what action has been taken. To make sure that type of patient focus flows to the highest levels of the organization, Bonner said each board meeting at each facility begins with a patient telling his or her story to the board. “It reinforces our culture of patient centrism. When investment bankers come through, or someone from a company like GE, we ask them how long it’s been since one of their customers has been in to visit with their board,” he said. “It seems so logical, but companies never do it. That’s the way the chairman created the culture here, and we just continue to nurture that. I think it’s a major driver of our ability to get better at what we do from the patient’s perspective.” |
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