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BWH has achieved its highest scores to date in six specific sections of the most recent Press, Ganey patient satisfaction survey. One such section is Discharge, an area that the hospital has targeted for improvement through the Oncology Discharge Process Project, one of four Service Excellence projects launched in the spring of 2003.Comprised of individuals from the Dana-Farber/Brigham and Women’s Cancer Center, the BWPO, and the hospital’s strategic partners, the Oncology Discharge Process Improvement team has been working diligently to create improved processes that allow BWH to release patients earlier in the day, while cultivating an environment of support and caring. As part of the initiative, the team has introduced three new processes in the Oncology units over the past few months, including multidisciplinary morning rounds, early morning phlebotomy and a Care Coordination Model that is unit-based. In July 2003, Oncology Services began conducting multidisciplinary rounds involving all clinical staff for a given pod—attending physicians, interns, residents, nurses, nurse care coordinators and pharmacists. “The multidisciplinary rounds have helped to stimulate improved communication and collaboration amongst all of the disciplines,” said Ted Alyea, MD, Hematologic Oncology, Dana-Farber Cancer Institute.Oncology Services has also piloted early morning phlebotomy for the past few months, with lab tests drawn at 5 a.m. rather than 7 a.m. Having experienced tremendous success, with as many as 95 percent of all lab results available by 7:30 a.m. for multidisciplinary rounds, early morning phlebotomy will be extended house-wide over the next few months. In addition, the Care Coordination Model has transitioned from a team-based approach to a unit-based design. “The new model enables the RN Care Coordinators to better facilitate care plans and communications among patients/families and interdisciplinary providers,” said Joanne Hogan, MS, RN, director, Care Coordination.“At the onset of the Oncology Discharge Process Pilot Initiative, only seven percent of oncology patients were discharged by noon, causing admissions from the DFCI Clinic, the Emergency Department, the Infusion Center, or from home to often be delayed due to a lack of available beds,” said Pat Reid-Ponte, DNSc, RN, chief nurse, DFCI and clinical director of Inpatient Oncology at BWH. “In October, 12.6 percent of patients were discharged by noon, which is a marked improvement based on the many efforts of the Oncology Discharge Process Improvement team.” The Oncology Discharge Process Improvement team would like to thank frontline clinical and support staff for their hard work and dedication to this project. Questions regarding this project can be directed to Dorothy Goulart, MS, RN, director, Performance Improvement, BWH Center for Clinical Excellence.