1. CHEMOTHERAPY PROJECT EXPECTED OUTCOMES Completed Mapping Process Completed Capacity and Demand Redesign

2. CHEMOTHERAPY PROJECT TEAM n Dr Gallagher n Claire Murrell n Kate Marshall n Janet Smith n Mary Maclean

3. PATIENTS LIKELY TO BENEFIT n Barts has a large chemotherapy unit treating patients referred directly as well as tertiary referrals from Homerton and other Trusts both inside and outside of the Network. There is a unit seeing around 350 patients a week and 4 other wards dedicated to inpatient Oncology care.

4. –Patient Journey Mapping Exercise –Patient Group Discussion –Patient Questionnaire –Data Collection –Outside Input How it all started! PATIENT EXPERIENCE

5. Colorectal Mapping Exercise

7. Patient Experience Group Discussion – 5 colorectal patients Wonderful staff! All received useful written information Excellent CNS but communication gap Good symptom control Waiting for 1st chemo treatment not too long Overall waiting on the day much too long Poor environment Staff too busy Difficult line removals Unnecessarily frequent medical consultations

8. Patient Experience Questionnaire – 24 colorectal patients Newham patients treated sooner and did not wait on day of treatment Not all received written information Poor conditions for patients and staff on Paget and GHF ward Overall positive & encouraging comments

12. Data Collection 8 Week period  Time & Motion – nurses & doctors Medical consultation time 17 mins (Range from 4 – 29 mins) Nurse assessment time 20 mins  Demand – bookings & cancellations 885 visits : 368 patients 113 bookings weekly 10.5% cancellations  Capacity – hours & kit Maximum 6 nurses, often only 4. One medical oncologist. Shared kit.  Activity – timings FBC 80 mins U+E 100 mins (Urgent) Chemo prep 60 mins  Backlog 4 Weekly

13. SCHEDULE PATIENT CHOICE IMPROVED PATIENT EXPERIENCE FLEXIBILITY EFFICIENT USE OF TIME REDUCED OVERCROWDING SAFER ENVIRONMENT

14. CHEMOTHERAPY BID DID WE MEET OUR EXPECTED OUTCOMES? Completed Mapping Process? Completed Capacity and Demand? Redesign?