Management of Cancer Specialized Hospital An Example of JFCR Ota.pdf · 9 . Our hospital set the...

© 2014 JAPANESE FOUNDATION FOR CANCER RESEARCH

Management of Cancer Specialized Hospital An Example of JFCR

Executive Director Takahiro, Ota

September 1st, 2014


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The Characteristics of Cancer Institute Hospital of JFCR


・Land Area； 20,000 m2

・Total Floor Area； 78,000 m2

・700 beds, 12th Floor

・Employee： 1,705

・Operation Room； 20 Room

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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）


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)


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

Presenter

Presentation Notes

We have No. 1 position in terms of number of cases for stomach cancer, breast cancer, cervical cancer, ovarian cancer, uterine cancer, colon cancer, and endoscopic treatment of stomach cancer. Almost all other cancer has within 5th position in Japan.


Residence of New Patients (Oct.2010～Dec.2010)

6

90％ of the patients are

from Tokyo and neighboring area.

(Kanagawa, Saitama, and Chiba)


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


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Key Factor of Success for Cancer Screening Center


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

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Presenter

Presentation Notes

Our hospital set the ideal vision of cancer care as from screening and its early detection till palliative care. Some hospitals refuse to accept incurable patients after all the kinds of treatment were tried, and those patients are sometimes called cancer refugee in Japan. However, our hospital are proud to provide continuous treatment as palliative care to those patients. Not so many major hospitals provides cancer cares from A to Z, from cancer screening to palliative care.


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Infrastructures and Systems for Hospital Management


Information Technology

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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

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Multi-Disciplinary Treatment

12

Experts from different fields collaboratively work together to bring the best outcome for each patient.


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


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Reformation Activites


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


16

Financial Management


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）


Revenue-Cost Structure 18

Actions are being taken to maximize the revenue and minimize the cost.


19

International Activities


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


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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]


Tele-Pathology Advisory Service

22

Peking Univ. Shenzhen Hospital

Pathology Slides

Send Digital Data

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


International Relationships

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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

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