Cancer care involves collaboration across multiple clinical departments, such as radiology, surgery, and chemotherapy; therefore, proper coordination between these departments is required. Poor coordination and lack of collaboration often lead to delays in treatment. Such delays can worsen disease progression, increase costs, and reduce survival rates.
Leaders like Dr. Mohiddin Lone are tackling these challenges by streamlining operations to improve outcomes. With over 12 years of experience in healthcare operations and research, Dr. Lone currently works with the Children's Cancer Center at City of Hope National Medical Center, where he collaborates on leading clinical and research initiatives while managing the center's financial and personnel resources.
Previously, as a Senior Transformation Specialist at City of Hope, Dr. Lone spearheaded initiatives that reduced patient wait times and improved patient experience scores from the 94th to 96th percentile. He also optimized operating room utilization through streamlined processes and performance metrics, enhancing efficiency and accountability.
A key achievement was Dr. Lone's leadership in helping to prepare City of Hope to deliver newly FDA-approved CAR T-cell therapies for advanced cancers. His work in developing infrastructure and systems facilitated timely care delivery, increased patient throughput, and improved billing processes.
Dr. Lone's strategic leadership not only improved patient care but also reinforced City of Hope's reputation as a leader in timely cancer treatment.
Why Time Matters in Cancer Care
Time is an invaluable resource in cancer care, where delays can mean the difference between life and death. Dr. Lone emphasizes, "Timely access to cancer care improves the outcomes and reduces mortality associated with cancer." Research supports this, revealing that even a four-week delay can increase mortality risks by 6% to 13%, with the risk compounding over time. For specific cancers like lung, kidney, and pancreatic cancers, delays result in a weekly mortality risk increase of 1.2% to 3.2%, while head and neck cancers face threefold higher mortality rates if treatment is delayed by more than two months. Breast cancer patients, especially in underserved populations, similarly experience worsened survival rates with prolonged delays. These delays not only endanger patients but also impose financial and emotional burdens on families and the broader healthcare system.
Recognizing these challenges, Dr. Lone and his team launched a multi-year program to address the systemic factors causing delays in care. This initiative was driven by discussions with key stakeholders to identify bottlenecks and implement targeted solutions. According to Dr. Lone, "Timely access to care promotes longevity, saves lives, and reduces financial burdens on families and the health system." By engaging various departments and fostering collaboration, they developed interventions to address these delays, ensuring more efficient and compassionate care delivery.
One standout effort was the Patient Access Initiative, a comprehensive five-year plan to reduce waiting times for first appointments. The initiative tackled systemic issues by introducing projects such as First Call Resolution, which allowed patients or caregivers to book appointments during their initial call. Other measures included documenting reasons for delays, implementing a streamlined decision tree for scheduling, and eliminating triage steps that had previously caused significant bottlenecks. Dr. Lone's team also conducted supply-demand analyses, redesigned appointment templates, and prioritized active cancer patients over those with benign tumors.
Despite these achievements, Dr. Lone faced significant challenges, including delays in building decision tree technology. Convincing established doctors to refer patients to other colleagues required strategic communication and persistent advocacy. By working closely with physician leadership, Dr. Lone demonstrated how these changes would directly benefit patient care, fostering collaboration and buy-in from key stakeholders. Through these efforts, the initiative significantly improved access to timely cancer care, illustrating the transformative impact of focused leadership and innovative problem-solving.
Better Outcomes and Stronger Institution
The changes implemented under Dr. Lone and his team's leadership have had a profound impact on patient care at City of Hope, both in terms of efficiency and experience. Through targeted initiatives, the median "days to seen" metric was significantly reduced from 15 to 8 days over a span of five years. This reduction reflects not only the institution's commitment to timely and compassionate care but also the tangible benefits of Dr. Lone and his team's strategies for streamlining operations. As he noted, these efforts have been met with widespread appreciation from both medical staff and patients, who recognized the improvements in their experience and outcomes.
Although direct measurement of the impact of these initiatives on patient outcomes can be challenging, Dr. Lone points to an indirect yet compelling indicator: the organization's rising stature among cancer centers. The institution's US News & World Report ranking recently climbed to #5, with health outcomes serving as one of the critical criteria for evaluation. "The organization has a strong emphasis on providing timely and compassionate patient care," Dr. Lone emphasized, noting how these operational improvements align with the institution's mission to deliver excellence.
Dr. Lone's Patient Access Initiative played a pivotal role in strengthening City of Hope's reputation for providing timely cancer care. By prioritizing access and reducing delays, the initiative ensured that patients received prompt attention during a critical phase of their treatment journey. He remarked, "We reduced the 'median days to seen' metric from 15 to 8 days in 5 years," underscoring how these efforts addressed a key area of need. Through this work, Dr. Lone and team have not only transformed patient experiences but also fortified the institution's position as a trusted name in cancer treatment.
Collaboration for Better Care
Dr. Lone and colleagues have implemented a range of strategies to improve patient throughput and resource utilization while maintaining high standards of care. Central to these efforts was optimizing the scheduling process by introducing decision tree systems, which allowed for streamlined and efficient appointment handling. Some areas also benefited from self-scheduling options, empowering patients to take control of their appointments. Expanding clinic hours beyond 5 p.m. and opening radiology modules on weekends further enhanced accessibility, ensuring that resources were used more effectively. Additionally, Dr. Lone leveraged nurse practitioners (NPs) to manage follow-ups and survivorship visits, which alleviated pressure on physicians and improved patient flow.
To support these advancements, Dr. Lone employed Lean and Six Sigma methodologies to identify inefficiencies and develop standardized processes. This approach focused on minimizing waste and fostering a culture of continuous improvement. "Implementing Lean and Six Sigma methodologies to develop standard processes, identify and minimize waste, and strive for continuous improvement," he noted, was a cornerstone of his strategy, reflecting his commitment to creating sustainable, scalable systems. Dr. Lone also highlighted the importance of embedding nurses in scheduling teams and creating specialty Medical Officer of the Day (MOD) roles, which effectively bridged the gap between clinical and administrative functions.
Collaboration across departments was another key component of Dr. Lone's success. He emphasized the importance of fostering open communication and ensuring that every team member felt heard. "Promote open and candid communication," he shared, while also advocating for a "just culture" that encourages learning from mistakes without fear of blame. Dr. Lone stressed that "gathering regular feedback from teams" was equally vital to keeping everyone engaged and aligned with shared goals. By bringing all stakeholders to the table and aligning their objectives with organizational priorities, he cultivated an environment of trust and shared accountability.
These collaborative strategies not only streamlined operations but also enhanced patient care by creating a unified approach across departments. Through his initiatives, Dr. Lone demonstrated the transformative power of multidisciplinary teamwork in driving operational efficiency while preserving the quality of care.
Metrics That Drive Continuous Improvement
A comprehensive and data-driven approach is central to how Dr. Lone measures the success of his initiatives, ensuring continuous improvement in oncology operations. One of his primary methods involves establishing baseline metrics before implementing any initiative and then assessing improvements against those benchmarks. "Develop specific key performance indicators (KPI) and measure those at monthly/quarterly intervals, check a positive/negative trend," he explains, emphasizing the importance of tracking progress systematically.
Several specific metrics guide this evaluation process. For example, the team monitors the median "days to seen" for newly diagnosed patients, measuring the time from the first call to the scheduled appointment. Patient feedback through Press Ganey surveys is another essential tool, offering insights into satisfaction and areas for improvement. Additional indicators include the likelihood of recommending City of Hope to family and friends, the weekly number of follow-up appointments handled by Physician Assistants, and physician template utilization. These metrics not only highlight operational efficiency but also ensure that patient care standards remain a priority. By combining milestones, KPIs, and regular trend analysis, Dr. Lone and his team ensure that every initiative is both impactful and sustainable.
A Vision for Timely Cancer Care
Leveraging innovative strategies and technology, Dr. Lone aims to reduce delays further in cancer care delivery. One of his key priorities is streamlining the patient intake process to ensure that individuals are quickly connected with the appropriate specialists or physicians. This would create a more seamless transition from diagnosis to treatment, addressing a critical pain point in the patient's journey. Additionally, he emphasizes the potential of technology and data analytics to predict patient demand and optimize resource allocation, enabling the timely availability and transfer of medical information across healthcare systems.
Telehealth consultations feature prominently in City of Hope's vision. Dr. Lone believes, "This approach could reduce wait times for initial consultations and follow-up appointments," particularly benefiting patients in remote or underserved areas. Addressing healthcare inequities is equally vital to his plans. He advocates for reallocating resources to serve underprivileged communities, noting the importance of launching education and prevention programs tailored to these populations. By aligning policy reforms with these innovations, Lone's forward-thinking initiatives aim to create a more inclusive and efficient cancer care model that benefits both patients and healthcare systems.
Dr. Lone and his team's leadership at City of Hope stand as a powerful example of how strategic foresight combined with meticulous execution can drive meaningful transformation in healthcare. By significantly reducing waiting times for cancer patients, the team demonstrated the profound influence that targeted leadership can have on improving system efficiency and patient outcomes.
His commitment to fostering an inclusive culture that values continuous improvement and innovation has created a blueprint for healthcare systems worldwide. Through the integration of data-driven methodologies and leading-edge treatments, such as CAR T cell therapy, Lone and colleagues have helped position City of Hope as a pioneer in oncology care. His forward-thinking approach points toward a future where timely and effective healthcare is the norm, setting a new standard for patient care and operational excellence within the industry.
Disclaimer: The medical information provided in this article is for educational purposes only and is not intended as a substitute for professional advice, diagnosis, or treatment. Please consult a qualified healthcare provider for any questions regarding medical condition.
