Latest / Becker’s Healthcare Podcast / Redesigning Ambulatory Cancer Care and Advancing Nursing Innovation

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Redesigning Ambulatory Cancer Care and Advancing Nursing Innovation · Becker’s Healthcare Podcast

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This is where health care leadership comes together.
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Becker's sixteenth annual meeting brings more than 3,500
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hospital and health system executives and nearly 800
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speakers to Chicago April.
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This series event includes keynote conversations with Dallas
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Cowboys legend Troy Aikman and former president George
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w Bush. For the agenda and event details,
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visit beckershospitalreview.com
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and click on the events tab in the
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upper right. We're looking forward to hosting you
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in Chicago.
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Welcome to the Becker's healthcare podcast.
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I'm Elizabeth Gregersen, a reporter here at Becker's,
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and I'm thrilled to interview Annalisa
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Rodriguez,
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vice president of nursing and patient care services
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and chief nursing officer at Fox Chase Cancer
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Center on the podcast today. Thank you so
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much for joining me. I'm so grateful to
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be able to share your insights with our
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podcast audience.
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Thank you so much, Elizabeth, for the opportunity
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to participate in this podcast and to share
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some of our experiences
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at Fox Chase Cancer Center.
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So Fox Chase Cancer Center is actually one
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of the nation's first cancer centers.
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We are in Philadelphia, and we are a
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part of Temple University
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Health System.
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And we really have a great legacy
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of
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nationally competitive basic,
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translational, and clinical
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research.
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Fox Chase Cancer Center includes the American Oncologic
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Hospital and the Institute of Cancer
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Research.
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We are also a national institute designated comprehensive
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cancer center and actually one of the founding
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members of the National Comprehensive
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Cancer
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Network.
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I'm also proud to say that we are
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magnet designated for nursing excellence
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since 2000.
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So we are among the
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only 33 hospitals in The US who have
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earned the magnet designation
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six or more consecutive,
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times.
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And, in addition,
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Fox Chase was also awarded the gold certification
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for excellence in person centered care by Plain
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Tree International,
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and that actually just makes us one of
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only four organizations
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that focus on cancer care to be honored
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with this achievement.
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Perfect. Well, thank you for laying that out
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for us too, and and congratulations
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on,
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all those achievements.
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I think
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a great place to kick off the conversation
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too, you know,
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in light of all those achievements.
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When you look at the past year,
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what's maybe the most important initiative or achievement
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you led?
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And, you know, how did you
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reach that goal, and and what were the
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results?
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Yeah.
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Elizabeth, thank you.
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Wow. I look back at, last year, and
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there was just a lot of
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initiatives
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that we accomplished. But more notably, I think
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that what my team and I are really
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most proud of is our
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ambulatory
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care excellence
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redesign.
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We call it the ACE model
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that really emphasize
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interdisciplinary
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partnership
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and
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just
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a holistic approach to patient care
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in our cancer,
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center.
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The
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the model is a more structured approach and
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designed to really
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look at the efficiency,
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coordination,
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and patient outcomes in the ambulatory
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space.
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And,
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also part of that is focusing
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on top of license work for all of
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the care team members, be it our medical
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assistants, our nurses, our advanced practice, providers, and,
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of course, our, physicians as well.
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When we looked at our model, we really
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looked at the inefficiencies
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in our processes,
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not just in patient access, but also in
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clinic workflows.
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We also looked at the different roles in
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the various clinics, and it was apparent to
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us that there was a lot of role
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confusion.
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There was not any clarification or delineation
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of what the medical assistant would be doing
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and what the nurses would be doing as
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well as, the advanced practice providers. And so
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oftentimes,
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there is
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gap in care coordination.
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And it also
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results to a lot of the frustration by
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our team members in terms of inconsistency.
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So
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we thought about the ambulatory care excellence,
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model.
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And I I wanna describe some of the
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key features that really made this successful
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in our
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ambulatory care setting.
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As I mentioned, there was some role clarity
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issues that we had to really navigate through.
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Right? So we clearly defined and delineated roles
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and responsibilities
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across the
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care team members to avoid
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redundancies
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of work. What we did was we actually
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completed
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a task inventory, if you will. And
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with the input of the different care team
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members, they identified which task are supposed
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to fall under a specific discipline
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so that they can continue to work at
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top of their licenses or their certifications.
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We also optimize the role of our medical
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assistants so that we are ensuring also that
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they
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find a lot
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more, like, professional development,
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in their role. And so we have
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really supported them in achieving certification.
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One of the things too that's challenging in
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the ambulatory space is that we're we have
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experienced
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significant,
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growth in our
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clinical volumes.
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We added a lot of
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providers,
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yet
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the staffing
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and the resource allocation
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in the
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clinics have remained stagnant. And so
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what we looked at are
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service line specific staffing
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where we looked at resource allocation.
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We
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analyze
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the clinic templates,
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make sure that we also analyze the work
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and,
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and the time that's needed by nurses to
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ensure care coordination.
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And so
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we then dedicated time for care coordination
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for our nurses.
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When we reviewed their workload,
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we identified that
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there really was not enough time for them
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to do
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out of clinic work, if you will. So
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following up on the patient,
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results preparing for the next visit.
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So part of our
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model was to really carve out those time.
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And that really
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requires upfront investing in our staffing. Right? So
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we looked at some benchmarking.
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We looked at the workload that's needed in
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the clinic. We have identified what incremental staff
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we had to
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actually resource for our clinics
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so that we can do all of, the
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work. And so far, it has really improved
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care coordination.
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Our patients experience better continuity of care because
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now we have
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nurses who have adequate time in handling follow
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ups, medication management, and care planning.
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We've also experienced reduced delays in our clinics
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by standardization
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of our workflows.
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We now have prep for clinic time for
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our nurses so that they can ensure that
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critical task results and records are completed before
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appointments so that the appointment for the patient
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is meaningful and we're minimizing
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delays.
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So it truly has been a transformative approach,
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and,
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it is something that we are
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implementing
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across all of our service lines in the
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cancer center.
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Perfect. Yeah. I feel like, you know, that
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intentional,
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right,
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defining of roles and and tasks is something
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all health care leaders across any specialty in
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the industry,
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will appreciate.
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So I will appreciate. So thank you for
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laying that out for us. So that initiative
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was kind of looking back, in the past
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year or so. I'd love to look ahead
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maybe
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in two different directions. One,
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the biggest challenge or the hardest thing you
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think you'll have to tackle in the coming
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year. But on the flip side of that,
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also where you see the biggest opportunities for
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organizational
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growth in 2026?
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Yeah. Absolutely. So, looking ahead really,
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the priorities that, I have is continued focus
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on our quality of care. Right? You know,
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how do we continue to excel
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and provide superior patient and outcomes, and how
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do we continue to achieve the top decile
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in nursing,
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quality?
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So really thinking about how to drive accountability
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and ownership at the unit level so that
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everyone feels that this is, our responsibility
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to ensure that we deliver exceptional care for
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our, patients.
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You know, I also,
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am wanting to look at
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how do we really create an infrastructure to
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support nursing innovation at the cancer center at
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the unit level. Right? How do we continue
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to
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encourage our nurses to find innovative solutions in
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addressing some of the common challenges that they
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see in their day to day. And,
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with that, I really would like to continue
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on
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finding ways to
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continue to develop our nurses, our staff nurses,
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as well as our
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leaders.
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Now in in terms of the, headwinds, as
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you can imagine in health care,
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staffing is always something that worries us because
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we're competing with the same pool of talented
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staff in the marketplace. And so
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one of the headwinds that we always keep
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on focusing on is to how to keep
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our staff and actually even leaders engaged so
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that they can we can continue to retain
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them. How do we maintain our low, turnover?
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And with all of the process redesigns, care
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model redesigns that we have, you know, how
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can we truly sustain all of the changes
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and deliver on what we have
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hoped to deliver in terms of
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different ways of
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conducting things.
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Now the biggest opportunities,
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I think, for us in particular is,
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technology adoption, right, and increasing
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AI literacy
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in
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nursing in particular. So when I think about
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technology adaptation,
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you know, how can we really look at
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predictive analytics for our
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workload and for defining the acuity for our,
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staff?
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You know, how can we use technology to
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really improve workflows,
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and enhance,
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you know, efficiencies
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at the bedside?
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When I think about,
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you know, the adoption rates in terms of,
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some of the technology that we have implemented,
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you know, sometimes we still have low adoption
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rates. And so part of my task and
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part of my leader's task is really understanding
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what what are the challenges of our staff
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in order for them to truly buy in
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into these,
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technologies.
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When I, think about, AI, I think that
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we need to increase the literacy of, nursing
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in terms of how artificial
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intelligence can, help
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with their day to day.
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And, you know, it's not it's not really
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replacing,
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our talent, right, but augmenting
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so that we can use,
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AI, for example, to,
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you know,
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look at
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what are the early warning signs actually that
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would indicate that our patients are deteriorating.
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How can we leverage AI in just the
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amount of data that is, collected on a
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day to day basis based on our charting
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and our recording to,
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do some risk prediction of our patients. Right?
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Which of our patients are more, prone to
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fall or,
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which of our patients,
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have an increased
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readmission rate, for example, based on what we're
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tracking.
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And then in terms of
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just making things better for the nurses and
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and providing them a lot of the tools
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that really can help them, you know, how
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do we
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begin to incorporate, let's say, ambient voice, documentation
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for our nurses so that we reduce the
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time that they are actually
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manually entering
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what their notes, what their day what they
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did for the patient so that we can,
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reduce documentation burden and, more importantly,
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free up some of their time so that
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they can actually spend, with our,
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patients. So, you know, I think that there's
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just a lot of,
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opportunities that we're excited,
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for
13:55
when it comes to technology and AI. And
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you know, I often,
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you know, talk to our colleagues in our
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IT systems and say, hey. You know, we
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would welcome any opportunities
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to pilot any technology implementation
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over at the cancer center. So our team
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is ready,
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and,
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they are really excited to
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to be part of,
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the change in health care delivery.
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Absolutely. Well, it's definitely something I'll be keeping
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an eye on to see what's coming out
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of Fox Chase
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and all the different fields that you mentioned,
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but but definitely with with technology because I
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know it's such an exciting time. Yeah. That's
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all the time we have for today. So
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I just wanted to thank you again for
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joining me. I feel like it's been a
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really amazing
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and informative discussion, and I appreciate you giving
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us your time and letting us kind of
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peek behind the curtain of of what's happening
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at Fox Chase.
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Thank you so much, Elizabeth.
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Awesome. And I invite our listeners to tune
14:52
in to more podcasts
14:54
from Becker's Healthcare by visiting our podcast page
14:57
at beckershospitalreview.com.
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Thank you again. I hope you all have
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a wonderful rest of your day.