Date of Paper/Work

2-2014

Type of Paper/Work

Systems Change Project

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Emily Nowak

Abstract

The United States is facing challenges in cancer care delivery due to aging population, growing demand for care, rising costs, shortage of adequately trained workforce, and increasing complexity of treatment. Given the complexity and costs of cancer care today, patients need considerable help navigating the course from diagnosis to survivorship or end of life. Efforts must be focused on means to produce quality care outcomes, conserve precious health care resources, and ensure positive patient experiences. Well-supported, well-designed cancer care coordination can improve outcomes for patients and providers alike. However, when unclear roles, scope of practice, and inefficient work processes are present within a system, provider satisfaction and patient outcomes can suffer.

This systems change project (SCP) was developed to evaluate and amend current care coordination practices at the University of Minnesota Masonic Cancer Center (MCC). The current telephone triage system in the MCC is inadequate due to inefficient and non-standardized practices that affect care coordinator and triage nurse role clarity, workflow, time management, and overall ability to deliver care. The purpose of this SCP was to support MCC nurses by identifying and addressing their barriers to delivering best quality care. This project consisted of an informal focus group with MCC nurses, collaboration with key clinic staff and providers, and development, implementation, and evaluation of a standardized clinic telephone triage protocol. It was intended that implementation of the protocol would improve triage workflow, time management, documentation, clarity of nurse scope of practice in this role, and comfort with performing triage care. Although this project was not statistically significant in its entirety, it did demonstrate some unique, interesting, and clinically relevant outcomes that provide insight into and implications for present and future practice, research, and social justice.

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