Challenging the status quo
Here at Mount Vernon Cancer Centre we, as most other centres, used a paper referral (booking form). The booking form (BF) was filled out at the District Hospital then handed to the admin team when the Oncologist next came to Mount Vernon. This took an average of one week for the admin team to process the referral.
Cancer patients are on a National 31day cancer waiting time (CWT) target and as soon as the BF is signed the clock starts ticking. Losing 7 days in receiving the bookings form put much more pressure on the Cancer Centre to meet the CWT whilst also ensuring compliance with complex IMRT treatment pathways.
Receiving the BF was not the end of the problems encountered using the standard paper system — misplaced forms, lost forms, illegible writing, transcription errors and more all caused delays in the patient starting treatment Such problems also made it much harder for the bookings team to ensure that the appointments were tracked appropriately.
Every part of the cancer pathway is carefully planned with strict timeframes between fiducial insertion, CT planning, physics planning and the treatment start date. If decision to treat dates are either illegible or the bookings form received late, makes it much harder to track the patient pathway sufﬁciently to ensure high quality treatment for the patient;
The status quo had to be challenged. There needed to be improvements in the treatment and referral pathway and paperless proved to be the way forwards. The problems posed by the paper pathway were well known and the prostate treatment pathway here at Mount Vernon is now completely paperless and other treatment sites are now completing transition in the
Casper has been instrumental to this process. Here at Mount Vernon we have been utilising Casper for over a year and found from 2014/15 to 2016 Casper allowed patients to start their treatment on average 13 days sooner than the paper bookings form patients. That is huge improvement and equivalent to almost hahc the cancer waiting time target. This has enabled patients to start, in some cases, the day they became clinically available to commence treatment and Casper in combination with the rest of the paperless pathway allowed on average a 20day improvement in treatment start date for the patient. We also now receive referrals that are legible and have a complete and accurate data set as soon as the referral is made, regardless of where they are coming from.
This has enabled better workload management through efficiency savings and allowed our systems to be able to absorb peaks and troughs in capacity much more readily.
Casper booking referral is now mandatory for all treatment sites as a response to its benefits to the patient and the department. All relevant data on the Casper form is filled out in an easy to follow, easy to read format and instantly accessible to the bookers. Casper has been paramount in driving efficiency and service improvement for the patient pathway here at Mount Vernon and hope collaboration with Cievert will continue for the foreseeable future.