UCSF Sustainability Stories


Deborah Fleischer, Green Impact, August 2012


San Francisco General Hospital:  Four Lessons Learned from Colorectal Cancer Screenings

WasteWhat do you think of when you hear save resources, reduce waste and be more efficient?  While you might think we are speaking about going green, for San Francisco General Hospital, it refers to improving quality of care, being more efficient and reducing wait times for a colonoscopy.  The hospital has successfully reduced the wait time for a colonoscopy from 125 days to an average of 26 days over three years and reduced clinic wait time from 345 days to 130 days over 5 years.  This is consistent with the theme of “Choosing Wisely” highlighted in the Spring 2012 edition of the Department of Medicine’s Frontiers in Medicine.

UCSF Sustainability Manager Gail Lee and I had the opportunity to speak with Dr. Lukejohn Day, who has helped to develop a new model to increase colorectal cancer screening rates at San Francisco General Hospital.  While the hospital’s main goal is to improve quality of care, there are some interesting lessons learned that translate to UCSF’s broader goal of promoting LivingGreen.

By promoting teamwork, garnering input from all staff, creating a colonoscopy education class, involving nursing staff, streamlining patient access to care and going to electronic, paperless documentation, Day has seen a range of benefits, including increased provider satisfaction, improved communication and accountability, reduction in unnecessary referrals, 50 percent reduction in wait time, increased clinic capacity and elimination of a huge amount of paper.

And while it is difficult to put a dollar value on this model of efficiency, I offer the following four lessons learned from the hospital’s success:

1.  Look for opportunities to cut out inefficiencies in your systems.  Where is paper needlessly wasted?  Where can time and resources be saved?

2.  Identify clear metrics for tracking your success.  General Hospital has identified a range of metrics to track success in the GI Clinic, including wait time, referral review time, scheduling time, volume, no-shows, patient wait time and patient satisfaction.  What metrics can you identify to track your success?

3.  Create a culture of teamwork and ask all staff for input and ideas.  Day stressed that part of their process was to create a culture of teamwork where individuals are encouraged to speak up about opportunities to be more efficient.  How can you inspire your staff to try new things?  Ask your staff, what can we do better and encourage them to speak up.

4.  Efficiencies are good for the environment.  A major force driving Day is his desire to provide high quality care to patients at the County hospital and reduce wait times.  “It is about quality of service and doing things better and safer,”  stressed Day.  By streamlining processes and centralizing key processes, it is also possible to save money and resources.  While it is hard to measure the savings from elimination of piles paper forms, reducing waste is the right thing to do.  Good for the planet and good for patients.