Including Center of Excellence Development in a Hospital's Strategic Plan

The key to hospital leaders reaching their goals is developing and implementing tactics that align with the hospital's strategic plan. Each project the hospital implements — each tactic — should tie back to the organization's mission, vision and values reflected in the strategic plan. For example, the Cancer Treatment Centers of America at Midwestern Regional Medical Center in Zion, Ill., has goals of delivering the highest quality care and meeting the needs of patients, among others. One tactic the hospital used to achieve these goals was developing a breast cancer center of excellence. While the center of excellence is dedicated to breast cancer care specifically, creating the center was part of the hospital's overall strategy and supported its mission and vision.

Connecting center of excellence development to strategy
"We have an enterprise-wide strategy around the development of specific tumor centers of excellence," says Anne Meisner, president and CEO of CTCA at Midwestern.

CTCA at Midwestern recognized that developing a breast cancer center of excellence was an important part of its strategy and supported its mission. To determine the strategic value of the project, hospital leaders assessed the benefits to patient care and what resources the project would need, including staff, time and external support. "Once we had a better understanding of that, we as a team said this is a priority for us, let's put this on one of our strategic initiatives and make it happen," Ms. Meisner says.

Below are elements of the hospital's culture and strategy that align with the center of excellence project.

Continuous improvement

"There's a fundamental culture we have at CTCA that's about continuous improvement," Ms. Meisner says. The hospital uses Lean and Six Sigma techniques to eliminate non-value-added activity in processes.

Process changes
Developing a center of excellence supported the hospital's culture of continuous improvement by focusing on improving breast cancer care. The breast cancer care team evaluated providers' existing processes and identified and eliminated inefficiencies. For example, the team improved communication between different oncology care providers, which reduced the time from patients' intake to their receiving a treatment plan from five days to three days.

Looking at the hospital's processes critically and making changes to improve was not only necessary to receive the center of excellence designation, but was also important in driving continuous improvement. "It was actually more about the process than the designation," Ms. Meisner says.

Data analysis
Another way the center of excellence project supported continuous improvement was the emphasis on ongoing data review. "It allows us to compare our performance to other programs that have a similar designation. As we understand how our performance is compared to those [centers], it provides insight into opportunities for improvement," Ms. Meisner says.

System-wide improvement
In addition to promoting continuous improvement within CTCA at Midwestern, creating a breast cancer center of excellence also encouraged continuous improvement at CTCA's four other hospitals. "One of our missions was to learn how to get through this process in the best way possible and then take our learnings and work with other hospitals to assist them in the same process," says Stephen Ray, MD, medical director of the breast center and oncoplastic and reconstructive surgery.

Delivering the best care possible

One of CTCA at Midwestern's core goals is to deliver the best care possible. "Our mission is to constantly meet and exceed the kind of care that patients are getting in terms of the whole cancer experience, not only from the standpoint of clinical care, but also their experience in receiving that care," Ms. Meisner says.

The breast cancer center of excellence initiative helped the hospital move toward this goal by improving processes, coordination of care and outcomes. Being selected as a center of excellence reflects the hospital's attainment of national quality standards.

Meeting the needs of the patient

"Another clarifying and focal point for us is how to best meet the needs of patients and their family members," Ms. Meisner says. Creating a center of excellence specifically for breast cancer patients supports this part of the hospital's culture, as it recognizes that these patients have specific needs. "One of the things we know and understand about taking care of patients is there are unique dimensions and needs specific to populations within a broader oncology context," she says.

The hospital is also working on creating centers for lung cancer, prostate cancer and gastrointestinal cancer to add to its existing centers of excellence.

Transparency

CTCA at Midwestern values transparency, and aims to provide patients with all the information they need to make decisions.

The breast cancer center had to track and report data to achieve accreditation as a center of excellence. "CTCA is really committed to the idea that consumers should have that information; that's another reason why this [center of excellence] initiative was so important to us," Ms. Meisner says.

Empowering clinicians and staff

"Another important cultural element of CTCA is empowering people that do the work to be able to improve their processes and be in control of that [improvement]," Ms. Meisner says.

The breast cancer center project was a bottom-up initiative, not an administrative project. The breast center leadership team included all clinicians involved in breast cancer patients' care, from nutritionists to medical oncologists to surgical oncologists.

The role of the administration was to provide support for the project, which required first understanding what the needs of the project were and second, committing resources to meet those needs, according to Ms. Meisner. For example, she says one need may be finding time for clinicians to change their processes while continuing their day-to-day activities. Administration can help by assigning support personnel to help clinicians manage their added responsibilities.