Aim: The aim of the oesophago-gastric (OG) cancer rapid improvement event was to use redesign methods to tap into the expertise of the whole team working with OG cancer in a regional centre. Emphasis was placed on analysing the current process as well as identifying blockages to flow and areas with wasted time.
Method: A rapid improvement or ‘Kaizen’ event was held at a regional Victorian hospital. This is a recognised method focussing on a narrowly-scoped process improvement opportunity. The event was extensively planned beforehand, with invitations extended to all members of the involved team. Attendees were shown timeliness measures (e.g. mean time from referral to diagnosis) calculated for a cohort of OG cancer patients diagnosed locally between 1/7/16 and 31/12/16. As part of a root cause analysis, the five whys method was utilised where required. Following the workshop, solutions were prioritised for further analysis and potential implementation.
Results: Project staff developed a current state value stream map with information collected from relevant oncology staff prior to the event. Cycle time, process time and waste areas were identified. The half-day rapid improvement event was attended by representatives from all OG cancer relevant areas including surgery, medical and radiation oncology, pathology, medical imaging, specialist clinics, dietetics, administration of the cancer centre and the project team. Following validation of the current state value stream map, ideas to reduce waste and solve problems were brainstormed. Solutions that were deemed to have the highest potential benefit and greatest ease of implementation were prioritised by the project team using a PICK (possible, implement, challenge and kick out) chart.
Conclusion: At the workshop conclusion, targeted solutions were clear. The primary solutions selected were processes and capacity in the area of referral to diagnosis, followed by internal processing from diagnosis to first treatment.