Ambulatory Care Excellence (ACE): Charting a New Path in Ambulatory Care Model and Coordination

This is the fifth blog post in a 6-part series recognizing the achievements of the 2025 ACCC Innovator Award winners before their in-depth sessions at the ACCC 42nd National Oncology Conference. Learn more about the innovations being recognized this year and those who pioneered them by joining ACCC in Denver, Colorado, from October 15-17, 2025. 

With an estimated 19 million of the 23 million chemotherapy visits that take place every year occurring in ambulatory oncology settings, it is vital to fully understand and optimize the structural factors that affect the quality of patient care in these settings. Among the most prominent challenges in delivering ambulatory care are financial pressures and a shrinking workforce, underscoring the need for system interventions for quality improvement. 

Understanding the severity of these challenges, Fox Chase Cancer Center designed the Ambulatory Care Excellence (ACE) Model to improve efficiency, coordination, and patient outcomes in ambulatory cancer care while ensuring top-of-license scope of work for clinicians. The program addressed inefficiencies in patient access, clinic workflows, and care coordination, earning a 2025 Association of Cancer Care Centers (ACCC) Innovator Award in the process. 

In anticipation of the ACCC 42nd National Oncology Conference this fall, ACCCBuzz spoke to Anna Liza Rodriguez, MSN, MHA, RN, OCN, NEA-BC, chief nursing officer and vice president of nursing and patient care services; Tara DelGrippo, MSN, RN, OCN, NE-BC, clinical director of ambulatory care; and Sarah Porzig, MSN, RN, OCN, clinical manager of ambulatory care, to learn more about the Fox Chase Cancer Center program. 

ACCCBuzz: How long has Fox Chase Cancer Center been an ACCC member?  

Rodriguez: We have been a member since 1990.  

ACCCBuzz: What do you enjoy most about being an ACCC member? Are there specific programs, resources, or tools that you use at your cancer program? 

Rodriguez: I have found ACCC’s resources for financial navigation and financial toxicity to be really helpful—not just here at Fox Chase, but at other cancer centers I’ve worked with, as well. I also really enjoy looking at the work of past ACCC Innovators to learn about best practices at other programs and whether those are strategies we can replicate at our own cancer center to enhance our offerings. We also appreciate the opportunity to contribute our own findings and insights to the community, whether it be through ACCCeXchange or Oncology Issues. 

ACCCBuzz: What makes your cancer center unique? 

Rodriguez: Fox Chase Cancer Center is one of the only freestanding academic cancer hospitals in the nation, and we are in the process of earning our seventh magnet redesignation—the most of any NCI-designated comprehensive cancer center. We are also one of the few cancer centers in the world awarded Planetree International’s gold certification for our person-centered care.  

DelGrippo: Our location in the community allows us to bring high-quality care to patients close to home, rather than forcing them to commute to a major city. For the 13 years I’ve been at Fox Chase, I have witnessed a community that is nothing like I’ve seen before. Our culture is incredibly welcoming and has not changed despite our growing presence as an NCI-designated cancer center.  

Porzig: Fox Chase is unique in the level of priority it places on its nursing staff; we really feel that we are important to the cancer center, and that was something we kept in mind during the ACE redesign. When I started here 20 years ago, I was part of the graduate nurse program, along with 7 other women who are still on staff. I think that speaks volumes about how valued nurses are at Fox Chase. People come here and stay, not only because of the care we’re able to give to patients, but because of the support we feel from the cancer center itself. 

Rodriguez: There truly is a community feel in all of our interactions with patients. At Fox Chase, they don’t have to choose between feeling like family and having access to cutting-edge research and phase 1 clinical trials. Our outcomes from a quality standpoint are remarkable, and we’re outpacing many of our peers—not just in the region, but compared to other NCI-designated centers as well. 

ACCCBuzz: It can be challenging for administrators and C-suite members to share a common language with clinicians and others who provide direct patient care. Can you share any tips you used to obtain buy-in and support for your innovation? 

Rodriguez: We were experiencing a lot of confusion and work redundancies in our clinics because we had not clearly defined the roles of certain staff members, like nurses and medical assistants [MAs]. There was definitely an opportunity to improve care coordination as well, since we didn’t have a particular person whose job it was to facilitate transitions of care. My colleagues that executed the ACE redesign noted at the outset of this project that we needed to have the right people on staff to deliver care effectively. 

The individuals we first needed to obtain buy-in from were our CEO, CFO, and COO, and we made a point to explain what the return on the upfront investment of resources would be. This allowed us to show that, even though we’d be spending a lot of time, money, and resources in the beginning, this expenditure would make us more efficient, open slots in the clinic, and increase satisfaction for both physicians and nurses. Framing our innovation this way demonstrated the value of the work we set out to do and the benefit it would bring to our center. 

Porzig: We’re lucky that our C-suite has been extremely supportive, and that in part comes from the benchmarking data we’ve provided from our service lines. Before the redesign, we had no method for providers to justify adding additional staff. Now that we have built this system, we can input the number of providers and the number of clinic sessions and generate how many staff members we need to accommodate the workload, which has greatly increased our ability to get buy-in from the C-suite. 

As for the clinic staff, nurses, and medical assistants, getting their buy-in was a lot easier because they’ve been asking for this prep time to improve care coordination. In the past, they weren’t able to follow their patients outside of live clinic sessions because they were not always stationed in the same disease site. Now our nurses and medical assistants stay with 1 disease site team with added prep and care coordination time so they can see patient status and close the loop with them. 

DelGrippo: It’s always important to show positive financial gain when you’re asking for more resources, because your C-suite will ask you, “Where are we going to reap the benefits? How are you going to control your costs?” But there are a lot of other benefits that came out of our program, such as decreasing our orientation time and precepting time, because we’re no longer orienting clinical staff to multiple disease sites. We’ve also seen an increase in provider satisfaction, so there is a lot less turnover and lower vacancy rates. 

ACCCBuzz: ACCC President Una Hopkins, DNP, MSN, FNP-BC, NE-BC, RN, FACCC, centered her theme on Designing Oncology Care to Meet the Needs of a Growing Patient Population. A key component of that theme is Workforce Empowerment and Enablement, which was key to your innovation. Can you share any insights you’ve learned in this area? 

Rodriguez: The foundation of this work is empowering our staff and enabling them to practice at top of license—not just nurses, but physicians and advanced practice providers. Our institution invested in our MAs by paying for their medical assistant certification training and their certification fees, which allowed us to upskill these staff members so they can do a lot more tasks relevant to their higher certification level. 

DelGrippo: Being inclusive of the staff who perform this work was key to our innovation. We started with a staff survey and more of a lean methodology process. We didn’t start with a solution, but with a problem. We engaged our staff with focus groups, surveys, interactive design sessions, and empathy mapping to discuss care coordination and distribution of tasks. Nursing staff, medical assistants, and interdisciplinary care team leaders were involved in this dialogue, and the theme that kept reemerging was a lack of time. A lack of time with the patient, time to complete their work, time to prepare for their in-person clinic. That was the main hurdle to overcome with this project and the staffing design. It seems like a simple change, but giving our staff the extra time to be successful in their roles and do meaningful work has made a huge difference—both in staff satisfaction and revenue for our cancer center. Keeping this problem at the forefront of our innovation helped us drive the change we wanted to create.