management of cancer specialized hospital an example of jfcr ota.pdf · 9 . our hospital set the...
TRANSCRIPT
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
Management of Cancer Specialized Hospital An Example of JFCR
Executive Director Takahiro, Ota
September 1st, 2014
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
2
The Characteristics of Cancer Institute Hospital of JFCR
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
・Land Area; 20,000 m2
・Total Floor Area; 78,000 m2
・700 beds, 12th Floor
・Employee: 1,705
・Operation Room; 20 Room
3
THE CANCER INSTITUTE HOSPITAL
1908 JFCR founded ( 1st Japanese Organization Specialized in Cancer) 1934 Institute and Hospital of JFCR established in Otsuka 2005 JFCR Relocation Project to Ariake completed 2011 Ministry of Health, Labour, and Welfare designated JFCR as an advanced
・In-Hospital Cancer Registration ;8,620(2010) ・Outpatient;395,363 ・Inpatient;215,094 ・Cancer Surgery ;7,449 ・Patient for Radiation ;1,613 ・Patient for Chemotherapy;28,609 ・ESD and EMR for Upper GI;596 ・ESD and EMR for Lower GI ;474 ・International Clinical Trial;21
◇HISTORY
◇Performance(2013)
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
Number of Inpatients by Disease
4
55
843
1,725
30
619
1,633
2,048
844 987 1,321
1,509
2,751
637 279
0
500
1,000
1,500
2,000
2,500
3,000
Number of Inpatients FY2013 (Person)
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
Ranking of the Top 5 Japan’s Hospitals in Cancer Surgery in 2012 Asahi Shimbun Publications Inc. Feb 2014
5 *Total of Cervical, Uterine, and Ovarian Cancer
Surveyed in 2012
CIH: Cancer Institute Hospital Diagnosis / Rank 1st 2nd 3rd 4th 5th
Stomach CIH National Cancer Center Shizuoka Cancer Center National Cancer Center East Niigata Cancer Center 502 376 355 286 247
Breast CIH St. Luke’s International Hospital St. Marianna University School of Medicine Sagara Hospital National Cancer Center
1135 776 663 603 582
Gynecology CIH Kyoto University Hospital - 2nd Place
Hyogo Cancer Center - 2nd Place Keio University Hospital The Jikei University Hospital
Kashiwa 293 182 182 180 162
Colon CIH Shizuoka Cancer Center Osaka Medical College Hospital Toranomon Hospital - 4th Place Komagome Hospital - 4th Place
602 493 466 392 392
Head and Neck CIH National Cancer Center East Aichi Cancer Center Hospital Saitama Medical University International Medical Center
Tokyo Medical and Dental University Hospital Faculty of
Dentistry 507 370 268 257 213
Endoscopic Treatment (Stomach)
Shizuoka Cancer Center CIH National Cancer Center Sendai Kousei Hospital Toranomon Hospital
367 363 361 296 288
Hepato-Biliary- Pancreas
Tokyo Women's Medical University Hospital CIH Nihon University Itabashi
Hospital National Cancer Center Shizuoka Cancer Center
316 302 271 262 254
Radiotherapy Shizuoka Cancer Center National Cancer Center East CIH National Cancer Center Komagome Hospital 1885 1871 1689 1501 1327
Colonoscopic Treatment
Showa University Northen Yokohama Hospital Kishiwada Tokushukai Hospital Kagawa University Hospital CIH Saiseikai Nakatsu Hospital
393 309 282 278 265
Esophagus National Cancer Center East Keiyukai Sapporo Hospital Juntendo University Hospital CIH National Cancer Center 145 135 134 118 109
Endoscopic Treatment (Esophagus)
National Cancer Center National Cancer Center East Osaka Medical Center for
Cancer and Cardiovascular Diseases
Keiyukai Sapporo Hospital CIH
175 168 129 120 118
Lung National Cancer Center Himeji Medical Center National Cancer Center East Juntendo University Hospital CIH 480 356 323 293 290
Thyroid Kuma Hospital Ito Hospital Noguchi Hospital Tsuchiya General Hospital CIH 1213 1129 512 230 218
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
Residence of New Patients (Oct.2010~Dec.2010)
6
90% of the patients are
from Tokyo and neighboring area.
(Kanagawa, Saitama, and Chiba)
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
Palliative Care and Pain Control
7
Palliative Care
Palliative Therapy,
Cancer Pain Service
Psycho-Oncologist,
Clinical Psychologist
Specialized Certified
Nurse
Dietitians
Regional Care
Network
Volunteers
It begins from the point of diagnosis through the end of life. We have 25-bedded palliative care ward, as well as 2 teams of “palliative care team” which covers the enter hospital. It’s a comprehensive care, including medical treatment, nursing, social welfare
and psychological care: Palliative care team consists of doctor, psycho-oncologist, specialized nurse, dietitians, etc.
Surgery Radiation
Chemo-therapy
Palliative Care
Palliative Care as the 4th column of cancer treatment
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
8
Key Factor of Success for Cancer Screening Center
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
The Ideal Vision of Cancer Care contributed to consolidated credential for each value chain
The Cancer Institute Hospital provides the consistent cancer care system, which contribute to have a consolidated cancer screening.
Cancer Treatment Process
Screening Treatment Palliative Care Outpatient Care
The Cancer Institute Hospital of JFCR
Major Hospitals
Continuous Treatment
• Critical to establish the consistent cancer care system from cancer screening to palliative care
in Japan
► Surgical Treatment
► Radiation Therapy
► Chemotherapy
9
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
10
Infrastructures and Systems for Hospital Management
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
Information Technology
11
Physiology diagnostic machines including electrocardiogram etc.
Endoscopy picturizing machine
Endoscopy division Endoscopy filing system (Olympus)
Physiology diagnostic division Physiology filing system (Nihon Kohden)
Dietary division Dietary system (Fujitsu)
Cancer Screening Center system Cancer Screening Center System (Fujitsu)
Rehabilitation division Rehabilitation system (Fujitsu)
OR/ Anesthesiology division OR/ Anesthesiology system (Nihon Kohden)
ICU/ HCU division ICU system (Nihon Kohden)
Medication division Medication information system (Fujitsu)
Speciality treatments and divisions Electronic Medical Records system (Fujitsu)
Conference Conference system (Fujitsu)
Logistics division Logistics system (Fujitsu)
Personnel division Personnel/ payroll system (Fujitsu)
Accounting division Charitable corporation accounting system (Fujitsu)
Financial division Management support system (Fujitsu)
Administrative division Medical accounting system (Fujitsu)
Outpatients accounting Automatic accounting machine (ALMEX)
Outpatients reception PHS system (Matsushita)
Engineer support system (Fujitsu)
Diagnostic imaging division
Images management system (Fuji film medical)
Radiation oncology division
Radiation oncology system (Yokogawa electric)
Ward Urine collecting machine system (Fujikougaku)
Ward Nursing system (Fujitsu) Blood transfusion division Blood transfusion system (Fujitsu)
Pathology division Pathology/ cytodiagnosis system (Fujitsu)
Diagnostic division Specimen/ bacteria diagnostic system (Fujitsu)
Clinical trials division Clinical trials system (Fujitsu)
Patients-centered team approach by sharing information within
divisions and throughout the hospital
Ward nursing notes with wireless LAN
Risk management with barcode attached on patients’ wrists.
Radiation oncology machine
Various diagnostics machines
Various picturizing machines including CT, MRI, Ultrasound, etc.
Automatic accounting machine
Return visit reception machine
Patients call PHS
Various operations/ anesthesiology/ ICU machines
1,000 terminals for EMR are deployed. It makes speedy and definite treatment possible by quick referring appropriate medical information.
High-definition interpretation display
Hardware: 70 servers, 750 desktop PCs, 300 laptop PCs, 300 printers
Diagnostic imaging division
11
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
Multi-Disciplinary Treatment
12
Experts from different fields collaboratively work together to bring the best outcome for each patient.
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
Internal Decision Making Meetings
13
Board Meeting
Management Meeting
Healthcare Unit
Board of Trustee
Research Unit
Management Strategy Unit
Hospital Management
Meeting
Cancer Clinical
Treatment
Non-Cancer Sections
Central Diagnostic and
Treatment Sections
Central Diagnostic and
Treatment Sections
Nursing
Pharmacy
Clinical Trial and Research
・Held 2 / year ・Held 1/month ・Financial disposition ・Reorganization ・Approval of budget
・Held 2 /week ・Held every week ・Daily operation
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
14
Reformation Activites
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
Organize the Operational Reforms Task Force 220 Change Leaders (Reform promoters) assigned All 1700 members of the JFCR to participate in the campaign
Operational Reform
The next management activities depth and widen are followed by these management reformation activities
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
16
Financial Management
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
P&L by Department
17
Annual budget is drawn up every year, and the budget and the actual is monitored. Revenue, cost, and the profit is monitored by department monthly.
(2013)
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
Revenue-Cost Structure 18
Actions are being taken to maximize the revenue and minimize the cost.
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
19
International Activities
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
Number of International Patients
20
99
191
259 312
267 264 311
416
488
0
100
200
300
400
500
600
2005 2006 2007 2008 2009 2010 2011 2012 2013
International Patient
Language Assisted Patients
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
21
Steps toward the First Appointment
Inquiry Decision by Doctor
Arrangement of Appointment
First Consultation
1 2 3 4
International Center will support the whole process. The fee for step 1 to 3 is for FREE.
Call: +81-3-3570-0383 E-mail: [email protected]
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
Tele-Pathology Advisory Service
22
Peking Univ. Shenzhen Hospital
Pathology Slides
Send Digital Data
Neighboring Hospital
Neighboring Hospital
Neighboring Hospital
Neighboring Hospital
Pathology Slides
Pathology Slides
Digital Data
The Cancer Institute Hospital of JRCR
Digital Data
JFCR provides remote pathology consultation service to Peking University Shenzhen Hospital, and the neighboring hospitals.
JFCR receive digital pathology slides and send back the pathological advice.
Patient
Information
Patient
Information
Pathology Report
Patient
Information
© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH
International Relationships
23
Sister Relationship Peking University Shenzhen Hospital, China
Massachusetts General Hospital, USA
Other Medical Institution MD Anderson Cancer Center, USA
Memorial Sloan Kettering Cancer Center, USA
Rockland Hospital, India
Gading Pluit Hospital, Indonesia
China-Japan Friendship Hospital, China
Shanghai Senmao Clinic, China
Bangkok Hospital, Thailand
Parkway Hospitals, Singapore
Kazakh Research Institute of Oncology and Radiology, Kazakhstan
The Regional Clinical Centre for Oncology in Khabarovsk, Russia