'Act on oncology' as a new comprehensive approach to assess prostate cancer centres : Method description and results of a pilot study

Background: Multidisciplinary care of prostate cancer is increasingly offered in specialised cancer centres. It requires the optimisation of medical and operational processes and the integration of the different medical and non-medical stakeholders.Objective: To develop a standardised operational process assessment tool basing on the capability maturity model integration (CMMI) able to implement multidisciplinary care and improve process quality and efficiency.Design, Setting, and Participants: Information for model development was derived from medical experts, clinical guidelines, best practice elements of renowned cancer centres, and scientific literature. Data were organised in a hierarchically structured model, consisting of 5 categories, 30 key process areas, 172 requirements, and more than 1500 criteria. Compliance with requirements was assessed through structured on-site surveys covering all relevant clinical and management processes. Comparison with best practice standards allowed to recommend improvements. 'Act On Oncology'(AoO) was applied in a pilot study on a prostate cancer unit in Europe.Results and Limitations: Several best practice elements such as multidisciplinary clinics or advanced organisational measures for patient scheduling were observed. Substantial opportunities were found in other areas such as centre management and infrastructure. As first improvements the evaluated centre administration described and formalised the organisation of the prostate cancer unit with defined personnel assignments and clinical activities and a formal agreement is being worked on to have structured access to First-Aid Posts.Conclusions: In the pilot study, the AoO approach was feasible to identify opportunities for process improvements. Measures were derived that might increase the operational process quality and efficiency

Digital Lean Production - An Approach to Identify Potentials for the Migration to a Digitalized Production System in SMEs from a Lean Perspective

In times of rising product variants, individualization and demand for flexibility, manufacturing companies are forced to meet economic target values to stay competitive within volatile markets. In order to accomplish these targets, companies implement the principles of lean production to ensure efficient and productive manufacturing processes. As the lean production philosophy is based on synchronization and standardization, currently it is stretched to its limits due to its lack of required flexibility in manufacturing processes and ability to cope with the complexity caused by variants and individualization. Digitization offers the possibility to extend the ability of lean production systems in order to adapt manufacturing processes with respect to the requirements resulting from challenging markets. This paper demonstrates the state of the art regarding lean production as wells as digitization and presents an approach based on the consistent opinion of reviewed literature, which formulates digitization as the next step of lean management in production systems. This study reveals the demand for a methodological approach in a SME environment that quantifies the profitability of the implementation of digital technologies in lean production systems. Based on this study a model for the identification of relevant technologies is suggested and the scope of further research is derived

Economic Constraints - the Growing Challenge for Western Breast Cancer Centers

Breast cancer care in Western countries has reached a considerable level of quality and standardization, which has contributed to the decline in breast cancer mortality. Certified Breast Cancer Centers (BCC) represent an important element of this development. Related to changes in reimbursement and growing costs, BCC face economic constraints which ultimately could endanger the achievements of the past. Thus, BCC have to optimize their care strategies from an economic perspective, particularly by increasing efficiency but also by adapting their service portfolio. This could result in competitive advantages and additional revenue by increasing case numbers and extra charges to patients. Furthermore, an intensification of collaboration with the outpatient sector resulting in an integrated and managed ‘trans-sectoral’ care approach which could allow to shift unprofitable procedures to the outpatient sector – in the sense of a win-win situation for both sectors and without loss of care quality – seems reasonable. Structured and specialized consulting approaches can further be a lever to fulfill economic requirements in order to avoid cuts in medical care quality for the sake of a balanced budget. In this review, economic constraints of BCC with a focus on the German healthcare system and potential approaches to ameliorate these financial burdens are being discussed

Exemplary result of the pilot study.

<p>The graph (bottom left) shows a 50% fulfilment of requirements related to organisation of transportation, patient transport, and material transport, along with a description of problems and potential solutions (SOP: standard operating procedure; KPI: key performance indicator).</p

Listing of interview partner.

<p>Listing of interview partner.</p

Example of an automatically generated radial bar chart providing an overview of the level of fulfilment of each key process area.

<p>Beginning at the centre point, the level of fulfilment of key process areas is indicated along the radius in steps of 10%. Green colour indicates fulfilment of up to 100% (red ≤ 50%, yellow ≤ 75%). On the outer circle, the corresponding maturity level of each category is provided.</p