Managing for Growth, Volume II

Best Practices for Expanding Access to Care

Nine best practices for improving access to care in order to accommodate rising demand for cancer services.

Executive Summary

Cancer Providers Face Staffing Shortages in Midst of Rising Demand
The last few years have seen cancer programs experience an explosion in the demand for cancer-related care that is unlikely to abate any time soon. Due in large part to technological and therapeutic advances, cancer patients are living longer and have more treatment options at their disposal. As cancer programs struggle to accommodate rising demand for their services, they must do so in the face of increasing staff shortages. Vacancies for key staff, such as physicists, radiation therapists and oncology nurses, are all too common, and pose a major threat to programs’ ability to provide cancer patients with timely access to care.

Workforce Issues Threaten Patient Access to Care
The shortage of physicians, particularly medical oncologists, has reached critical levels in some markets. Medical oncologists increasingly struggle to balance the competing priorities of addressing newly diagnosed patients needs, with those of survivors seeking follow-up care. As a result, it is not uncommon for a newly diagnosed patient to wait as long as three weeks for an initial consult. Considering the emotional crisis that typically accompanies a cancer diagnosis, this is a major psychological burden for patients to bear.

Patients Often Lost in Increasingly Complex Systems
Access concerns do not end when the patient enters the cancer center for treatment. The numerous challenges associated with managing cancer patients’ clinical and supportive care needs are well documented. Throughout their treatment journey, patients must navigate numerous obstacles and balance often conflicting information from their numerous care providers, all while coping with their disease. All too often, the system simply lets patients down at a time when they need help most.

Providing Guidance for Expanding Access to Care
Given the increasing demand for cancer services forecasted across the next twenty years, patients’ limited access to care cannot be addressed overnight. That said, hospitals can take immediate steps to streamline patient flow and increase current capacity. In staffing terms, hospitals are best served by utilizing staff more efficiently through the use of technologist aides and medical assistants. Additionally, mid-level providers are an untapped resource that not only expand physician visit capacity, but can also improve overall care quality. While the value of patient navigators has long been recognized, a significant portion of patients needs remain unmet. Navigators have a critical role to play in ensuring timely access to care, and streamlining the treatment process. Finally, as clinical innovation in cancer care continues to advance at an unprecedented rate, academic and community programs must seek new ways to increase patient access to these services through the development of regional networks and affiliations. The pages herein are intended to serve as an implementation guide for members seeking new models for increasing patient access to care. A wide range of case examples are presented so that cancer programs can find the strategy most applicable to their situation.

Identify the staff shortages and the increasingly complex care systems brought on by an explosion in demand for cancer services.

By reading this study, members can:

  • Implement best practices for utilizing staff efficiently and facilitating the care process
  • Increase patient access to new cancer services through the development of regional networks and affiliations

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