Summary of limitations identified from workflow assessment and proposed intervention(s)
| Limitation . | Proposed intervention . |
|---|---|
| Phase 1 (<3 mo) | |
| Lack of organization and standardization in charting resulting in incompleteness and inefficiency in registry data entry | • Create a pediatric oncology summary sheet (POSH) for chemotherapy protocols and other outcomes to incorporate into the medical record and facilitate standardized documentation |
| Lack of data security | • Create password-protected Excel spreadsheet with a standardized approach to data entry while issues regarding a more secure database are being resolved |
| Offsite storage of data from the clinic | • Provide data clerks with a laptop to facilitate data collection • Develop a system for backing up data |
| Timing of when data are collected during the patient admission could contribute to incompleteness and decrease efficiency | • Explore alternative workflows to data collection (ie, discharge huddle, discharge/transition checklist) |
| Phase 2 (3-6 mo) | |
| Lack of prioritization of the pediatric cancer registry by the medical residents | • Provide training for medical residents and data clerks regarding appropriate documentation • Incorporate charting into resident evaluation |
| Need for larger team buy-in and communication | • Create a multidisciplinary committee that includes physicians, nurses, data clerks, pharmacists, social workers, and a medical record keeper • Initiate a huddle to reconcile missing information and gather information about discharge and follow-up plan • Ensure completion of POSH and pass off to data clerk for registry entry |
| Need for synchronized data collection | • Ensure compliance with current process across all hospitals (ie, TASH, Jimma, Mekelle) |
| Phase 3 (6-12 mo) | |
| Lack of data security and unsynchronized registry data | • Initiate database with single local server with security housed in Ethiopia • Explore different databases to find ideal solution |
| Transport of medical chart to and from medical centers is the responsibility of the parents, leading to high rate of missing charts | • Designate individual responsible for transporting patient chart between locations to prevent parents/family from possibly losing medical charts during transportation |
| Limitation . | Proposed intervention . |
|---|---|
| Phase 1 (<3 mo) | |
| Lack of organization and standardization in charting resulting in incompleteness and inefficiency in registry data entry | • Create a pediatric oncology summary sheet (POSH) for chemotherapy protocols and other outcomes to incorporate into the medical record and facilitate standardized documentation |
| Lack of data security | • Create password-protected Excel spreadsheet with a standardized approach to data entry while issues regarding a more secure database are being resolved |
| Offsite storage of data from the clinic | • Provide data clerks with a laptop to facilitate data collection • Develop a system for backing up data |
| Timing of when data are collected during the patient admission could contribute to incompleteness and decrease efficiency | • Explore alternative workflows to data collection (ie, discharge huddle, discharge/transition checklist) |
| Phase 2 (3-6 mo) | |
| Lack of prioritization of the pediatric cancer registry by the medical residents | • Provide training for medical residents and data clerks regarding appropriate documentation • Incorporate charting into resident evaluation |
| Need for larger team buy-in and communication | • Create a multidisciplinary committee that includes physicians, nurses, data clerks, pharmacists, social workers, and a medical record keeper • Initiate a huddle to reconcile missing information and gather information about discharge and follow-up plan • Ensure completion of POSH and pass off to data clerk for registry entry |
| Need for synchronized data collection | • Ensure compliance with current process across all hospitals (ie, TASH, Jimma, Mekelle) |
| Phase 3 (6-12 mo) | |
| Lack of data security and unsynchronized registry data | • Initiate database with single local server with security housed in Ethiopia • Explore different databases to find ideal solution |
| Transport of medical chart to and from medical centers is the responsibility of the parents, leading to high rate of missing charts | • Designate individual responsible for transporting patient chart between locations to prevent parents/family from possibly losing medical charts during transportation |
Our team presented these recommendations to physicians and other hospital stakeholders to guide future endeavors.