May 16, 2008
Small changes lead to big results in the SCTO

Two years ago, the MGH Center for Sarcoma and Connective Tissue Oncology (SCTO) was experiencing problems in two practice areas: long patient wait times and appointments running over their allotted time. On average, patients were waiting up to an hour to see a physician, and sessions often ran late. These delays were due to the complex and coordinated care requirements of SCTO patients, who often see two to four multidisciplinary providers during each of their MGH visits.

Because the SCTO team is dedicated to providing the very best MGH experience to all of its patients, center staff sought strategies to improve these areas. Francis Hornicek, MD, PhD, co-director of the SCTO, contacted MGH Ambulatory Consulting (AC) to explore ways to address these problems.

Working with AC staff, including Christine Primiano, MS, MBA, director; Ali Spray, practice consultant; Liz Fearing, corporate team leader for MGH/MGPO Ambulatory Care Systems; and Deidre Donovan, application analyst, the SCTO team began analyzing the issues and piloting process changes. Steps included standardizing administrative operations, applying the computerized scheduling program in new ways and engaging the entire team toward a common vision. Support from department leaders, including David Gaynor, executive director of MGH Orthopaedics, and Harry Rubash, MD, chief of MGH Orthopaedic Surgery, was also crucial in the effort's success. By implementing these changes, the center experienced dramatically different results in just one year — patient wait times decreased to an average of 20 minutes, and sessions ran long only 44 percent of the time and for no more than 30 minutes.

Recently, AC had the opportunity to present this success story at the Institute for Healthcare Improvement's (IHI) ninth annual International Summit in Texas. Based in Cambridge, Mass., the IHI is a nonprofit organization dedicated to the improvement of health care systems and operations.

For more information about AC, contact Primiano at

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