The hidden cancer one clinician caught – and the process improvements she says matter most

LAKE MARY, Fla. — Shana Vongkhankeo, APRN, a family medicine nurse practitioner at AdventHealth Lake Mary Health Park, didn’t expect to find something serious during a routine physical for a teenage patient. But within minutes, she noticed an unusual thyroid enlargement – a small detail that ultimately led to a life-saving cancer diagnosis. Discoveries like these demonstrate why being fully present with patients and committing to continual process improvement matter just as much as clinical expertise.

1. Q: You say that process improvement is one of your key passions. Can you share a specific example of how this focus has directly benefited a patient?

A: Process improvement has always been a passion, and I’ve seen how it can even save lives. Recently, a mother and her teenage daughter came in for a routine physical. I noticed the daughter’s thyroid was enlarged, so I suggested an ultrasound. Unfortunately, the results indicated cancer, requiring surgery. After that quick diagnosis, the care team ensured she had a seamless care journey, promptly coordinating to have her thyroid removed.

I was really touched by the family’s response. The mother hugged me and expressed how grateful she was that I noticed the issue, questioning how long her daughter’s condition might have gone unnoticed. Thanks to the team’s commitment to process improvement principles, primary care was integrated with specialty services, which allowed us to fast-track her diagnostic imaging and referral – saving precious time for a smoother recovery and better outcome.

2. Q: If you had to translate your approach with process improvement into practical advice, what are the top three principles anyone, regardless of their role, can apply today?

A:

• Be fully present: Embrace the moment you're in and bring the needs of whomever you're working with and your shared goals into focus. Make eye contact and engage actively. This helps people feel heard and cared for.
• Prioritize timeliness and ease: Being organized can be a service to not only yourself, but also to others. Things like quick responses, clear timelines and thoughtful communication go a long way in making things easier for you and your collaborators - whether that's a patient, a colleague or a client.
• Maintain a work-life balance: It's hard to help others if you're not helping yourself. To achieve this, focus on efficiency and proficiency in your work processes. When you're feeling whole yourself, you can be of better service to others.

3. Q: Can you tell us about your care delivery experience and how your role connects to AdventHealth's mission and brand promise?

A: I absolutely love my role at AdventHealth. Sometimes, I interact with patients whose needs go beyond physical health; they may require spiritual or emotional support. Providing that wholistic care has been rewarding.

My time in the emergency room taught me to recognize critical situations and ask the right questions. These triage skills are invaluable in family medicine, where I can build relationships and see how my decisions positively impacts patients.

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