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EPHA Awards finalists 2022 – Patient focused initiative – Fundación Jiménez Díaz University Hospital, Madrid

HOPE – Personalised Oncology Hospital

Fundación Jiménez Díaz University Hospital, Madrid

Quironsalud offers its patients the HOPE (Personalised Oncology Hospital) programme. The personalised oncology hospital is a project that places the patient at the centre of the care process and stems from the need to improve the safety and comfort of oncology patients.

Based on the great advantages of interdisciplinary work and technological innovation, we have created an integrated practice unit that allows us to combine all the appointments in a care process into one. This significantly reduces travel and the time the patient spends in hospital.

There is a strategic commitment to improve and standardise clinical processes at group level, with the aim of improving the efficiency and quality of procedures and care provided, including the selection of the most appropriate therapeutic procedure available.

The initiative is based on 3 points:

1) Standardisation and automation of treatment protocols: this allows the standardisation of the complete trajectory of all cycles that patients will have from the first medical appointment to the medical discharge.

2) Assisted transformation of the daily oncology patient pathway: the evolution of the process consists of eliminating time loss by introducing “point of care” analysers into the process that provide blood test results in just 3 minutes.

3) Continuous communication with patients between treatment days: by implementing a web dialogue and a medical chatbot.

Objectives

1) reducing waiting times for treatment, increasing the comfort, safety and quality of life of cancer patients;
2) standardising the entire trajectory of cancer patients with intravenous treatment;
3) multidisciplinary and coordinated work of professionals;
4) more efficient use of resources.

The main objective of HOPE is to improve value-based health care in the patient’s journey in the day hospital.

Improvement of the patient experience:

  • Clinical effectiveness: reduced side effects of treatments, which also reduces hospital admissions due to toxicity.
  • Quality of life: more agile, safe, close and coordinated patient-centred care that allows for a normal daily life. In addition, mobile communication tools are available on the patient portal throughout the process (web dialogue, chatbot).
  • Efficiency: reduction of administrative procedures, enhancement of professional time and reduction of expenses.
  • Reduction of crowds in waiting rooms.
  • Improved adherence to treatment.

Dr. Cristina Caramés is specialist in Medical Oncology at the Fundación Jiménez Díaz in Madrid and responsible for the project HOPE, Personalized Oncology Day Hospital

Origin of the project

The project started with a group of patients with metastatic breast cancer and has since been launched in other clinical studies on digestive, pulmonary, melanoma, urothelial and gynaecological tumours, among others. It has fundamental aspects that make it a promising project in the treatment of cancer. The first of these aspects concerns the structuring of clinical data collection in accordance with the most internationally recognised scientific evidence and quality programmes, as well as the standardisation of the process to reduce errors due to individual variability. The use of a health outcome assessment programme through PROMs (Patient-Reported Outcome Measure) questionnaires allows for the quantification of outcomes, thus making medicine value-based. The importance of interdisciplinary work, as well as the benefits offered by technological innovation and digital change to improve the quality and efficiency of care, patient experience, as well as organisational improvements, were kept in mind. The artificial intelligence assistant developed for two-way communication with the patient is an example of the fusion of medicine with technology. On the other hand, the guidance system has evolved, with psychological counselling and webcam entertainment workshops, increasing the values of the humanisation strategy.

HOPE incorporates fundamental aspects that make it a promising project in cancer treatment. Standardisation of processes and collection of clinical data according to scientific evidence aim to reduce treatment errors arising from individual variability. The technological application in electronic medical records and artificial intelligence to control data management sets a precedent in healthcare management for cancer treatments that require review by multidisciplinary teams in a hospital setting. The characteristics of innovation in the application of non-presence, digitalised and continuous, two-way services between the care service and the patient, accelerate and improve the quality of therapies, key points for quality cancer care. The study and analysis of data is essential for cancer research.

The initiative has improved patient quality of life and satisfaction, reduced waiting times by more than 80%, improved efficiency indicators and reduced hospital use due to toxicity or adverse effects of treatments. In this way, we ensure that patients feel less ‘tied’ to the hospital and that the process of receiving their treatment does not interfere with their relationships, work and life in general.

The entire oncology team of the Red 4H Hospitals of Quironsalud

Main clinical and organisational benefits for patients:

  • 30% reduction in hospital admissions due to side effects and toxicity, thanks to physicians’ anticipation and proactive actions.
  • 80% reduction in the time cancer patients spend in hospital, leading to better adherence to treatment.
  • 60% reduction in unnecessary medical consultations, avoiding a total of 10,000 consultations per year, allowing professionals to spend more time on consultations that need it, thus improving health outcomes.
  • More free slots for new medical consultations and new health problems: no crowding.
  • Reduced total process time by 97% from 4-5 days to just 3 hours: This is very important for patient satisfaction, eliminates downtime and waiting time between appointments and minimises crowds, hospital trips and waiting room occupancy.
  • Reduction of 90% of the doctors’ administrative procedures, which consequently improves their satisfaction with the process.
  • With regard to the standardisation and automation of treatment protocols, there are a total of 995 new patients with standardised trajectories and a total of 10 000 automatically generated services.
  • Due to clinical safety and efficiency, there is a 30% reduction in medical admissions for oncology patients due to the anticipation of serious problems.