Patients’ experience of lung cancer care coordination: a quantitative exploration

2018 ◽  
Vol 27 (2) ◽  
pp. 485-493 ◽  
Author(s):  
Gemma K. Collett ◽  
Ivana Durcinoska ◽  
Nicole M. Rankin ◽  
Prunella Blinman ◽  
David J. Barnes ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Care Coordination ◽  
Cancer Care ◽  
Patients Experience

Examining patient burden and drivers of delayed care in patients undergoing surgical treatment of primary lung cancer.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 153-153
Author(s):  
Caleb Barnhill ◽  
Charles Hillenbrand ◽  
Stephen Kaplan ◽  
Madhan Kuppusamy ◽  
Michal Hubka
Keyword(s):  
Lung Cancer ◽  
Surgical Treatment ◽  
Care Coordination ◽  
Cancer Care ◽  
Medical Center ◽  
Primary Lung Cancer ◽  
Cancer Center ◽  
Healthcare Team ◽  
The Impact ◽  
Travel Burden

153 Background: Patients’ geographic location can impact access to specialty care and affect the appropriateness and timeliness of evaluation leading to primary surgical treatment of lung cancer. Cancer care coordination has long been speculated to lead to greater efficiency in oncologic care, yet objective measures demonstrating the utility of such healthcare team members is lacking. We aimed to study the impact of patients’ residence on healthcare encounters, travel burden and the distribution of physiologic and oncologic workup leading to delays in care at a specialty cancer center. Methods: We conducted a single center retrospective cohort study of 103 patients undergoing workup of primary lung cancer between January 2015 and August 2017. The shortest route between patient residence and treating medical center was measured in miles and classified as: urban ( < 40 miles); rural (40.1 – 100 miles); and regional (100.1 – 1,000 miles). Average total miles traveled (i.e. travel burden), total number of healthcare encounters, and the distribution of physiologic and oncologic evaluations as drivers of delay in care were examined. Results: Patients were categorized as urban n = 80 (77.7%); rural n = 12 (11.7%); and regional n = 11 (10.7%). Median travel burden (urban = 100 miles [interquartile range, IQR 56-216.8]; rural = 385.7 [127.1 – 769]; regional = 780 [560 – 1936]; p < 0.001) and median total healthcare encounters (urban = 7 [6-9]; rural = 9 [7-9.5]; regional = 10 [7-12]; p = 0.3) increased with greater distance of patient residence from treating medical center. Additional necessary physiologic workup was associated with delayed care and greater burden in the rural and regional patients compared to those residing in urban locations (urban = 21% increase; rural = 152%; regional = 162%). Additional oncologic workup was associated with delayed care in the regional group only (49% increase). These trends remained even when controlling for clinical stage. Conclusions: These findings demonstrate the need for better cancer care coordination for rural and regional lung cancer patients to improve efficiency, appropriateness and timeliness of care while decreasing patient-related burdens.

The Effect of a Lung Cancer Care Coordination Program on Timeliness of Care

2013 ◽  
Vol 14 (5) ◽  
pp. 527-534 ◽  
Author(s):  
Susan Alsamarai ◽  
Xiaopan Yao ◽  
Hilary C. Cain ◽  
Bryan W. Chang ◽  
Herta H. Chao ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Care Coordination ◽  
Cancer Care ◽  
Timeliness Of Care

scholarly journals The Anatomy and Physiology of Teaming in Cancer Care Delivery: A Conceptual Framework

2020 ◽  
Author(s):  
Dana Verhoeven ◽  
Veronica Chollette ◽  
Elizabeth H Lazzara ◽  
Marissa L Shuffler ◽  
Raymond U Osarogiagbon ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Conceptual Framework ◽  
Care Coordination ◽  
Cancer Care ◽  
Care Delivery ◽  
Treatment Options ◽  
Multimodality Treatment ◽  
Clinical Team ◽  
Coordinated Care ◽  
Treatment Regimens

Abstract Care coordination challenges for patients with cancer continue to grow as expanding treatment options, multimodality treatment regimens, and an aging population with comorbid conditions intensify demands for multidisciplinary cancer care. Effective teamwork is a critical, yet understudied, cornerstone of coordinated cancer care delivery. For example, comprehensive lung cancer care involves a clinical “team-of-teams”—or clinical multiteam system (MTS)—coordinating decisions and care across specialties, providers, and settings. The teamwork processes within and between these teams lay the foundation for coordinated care. While the need to work as a team and coordinate across disciplinary, organizational, and geographic boundaries increases, evidence identifying and improving the teamwork processes underlying care coordination and delivery among the multiple teams involved remains sparse. This commentary synthesizes MTS structure characteristics and teamwork processes into a conceptual framework called the cancer Multiteam System (cMTS) Framework to advance future cancer care delivery research addressing evidence gaps in care coordination. Included constructs were identified from published frameworks, discussions at the 2016 NCI-ASCO Teams in Cancer Care Workshop, and expert input. A case example in lung cancer provided practical grounding for framework refinement. The cMTS framework identifies team structure variables and teamwork processes affecting cancer care delivery, related outcomes, and contextual variables hypothesized to influence coordination within and between the multiple clinical teams involved. We discuss how the framework might be used to identify care delivery research gaps, develop hypothesis-driven research examining clinical team functioning, and support conceptual coherence across studies examining teamwork, care coordination, and their impact on cancer outcomes.

scholarly journals Improving the Quality of Lung Cancer Care in Ontario: The Lung Cancer Disease Pathway Initiative

2013 ◽  
Vol 8 (7) ◽  
pp. 876-882 ◽  
Author(s):  
William K. Evans ◽  
Yee C. Ung ◽  
Nathalie Assouad ◽  
Anna Chyjek ◽  
Carol Sawka
Keyword(s):  
Lung Cancer ◽  
Cancer Care ◽  
Cancer Disease

115 The role of the lung cancer care coordinator

Lung Cancer ◽  
2014 ◽  
Vol 83 ◽  
pp. S42
Author(s):  
A. Moore ◽  
J. Love ◽  
A. Hyde ◽  
S. Berwick
Keyword(s):  
Lung Cancer ◽  
Cancer Care ◽  
Care Coordinator

scholarly journals Typical Time to Treatment of Patients With Lung Cancer in a Multisite, US-Based Study

2016 ◽  
Vol 12 (6) ◽  
pp. e643-e653 ◽  
Author(s):  
Regina M. Vidaver ◽  
Marianna B. Shershneva ◽  
Scott J. Hetzel ◽  
Timothy R. Holden ◽  
Toby C. Campbell
Keyword(s):  
Lung Cancer ◽  
Cancer Care ◽  
Disease Incidence ◽  
The United States ◽  
Small Cell ◽  
Time Intervals ◽  
Time To Treatment ◽  
Specialist Referral ◽  
Patient Reported ◽  
Typical Time

Introduction: The importance of high-quality, timely lung cancer care and the need to have indicators to measure timeliness are increasingly discussed in the United States. This study explored when and why delays occur in lung cancer care and compared timeliness between two states with divergent disease incidence. Methods: Patients with small-cell or non–small-cell lung cancer were recruited through cancer centers, outpatient clinics, and community approaches, and interviewed over the phone. Statistical analysis of patient-reported dates included descriptive statistics and comparing time intervals between states and across the sites with Mann-Whitney U tests. Additionally, data from patients with longer timelines were qualitatively analyzed to identify possible reasons for delays. Results: On the basis of the dates reported by 275 patients, the median time from first presentation to a clinician to treatment was 52 days; 29% of patients experienced a wait of 90 days or more. Median times for key intervals were 36.5 days from abnormal radiograph to treatment, 9.5 days from initial presentation to specialist referral, 15 days from patient informed of diagnosis to first therapy, and 16 days from referral to treatment to first therapy. More than one quarter of patients perceived delays in care. No significant differences in length of time intervals were identified between states. Monitoring of small nodules, missed diagnosis, and other reasons for longer timelines were documented. Conclusion: Results defined typical time to treatment of patients with lung cancer across a variety of health systems and should facilitate establishing metrics for determining timeliness of lung cancer care.

Abstract 2552: Adapting a novel cancer care delivery model: identifying barriers unique to care coordination for LGBTQ cancer survivors

2021 ◽  
Author(s):  
Nicolas Francone ◽  
Jonathan Alhalel ◽  
Will Dunne ◽  
Sankirtana Danner ◽  
Nihmotallahi Adebayo ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Care Coordination ◽  
Cancer Care ◽  
Care Delivery ◽  
Delivery Model ◽  
Care Delivery Model

Effect of an antiracism intervention on disparities in time to lung cancer surgery.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 101-101
Author(s):  
Jacob Newton Stein ◽  
Samuel Cykert ◽  
Christina Yongue ◽  
Eugenia Eng ◽  
Isabella Kathryn Wood ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Racial Disparities ◽  
Cancer Care ◽  
Retrospective Cohort ◽  
Early Stage ◽  
Lung Cancer Surgery ◽  
Cancer Surgery ◽  
Early Stage Lung Cancer ◽  
Black Patients ◽  
White Patients

101 Background: Racial disparities are well described in the management of early-stage lung cancer, with Black patients less likely to receive potentially curative surgery than non-Hispanic Whites. A multi-site pragmatic trial entitled Accountability for Cancer Care through Undoing Racism and Equity (ACCURE), designed in collaboration with community partners, eliminated racial disparities in lung cancer surgery through a multi-component intervention. The study involved real-time electronic health record (EHR) monitoring to identify patients not receiving recommended care, a nurse navigator who reviewed and addressed EHR alerts daily, and race-specific feedback provided to clinical teams. Timeliness of cancer care is an important quality metric. Delays can lead to disease progression, upstaging, and worse survival, and Black patients are more likely to experience longer wait times to lung cancer surgery. Yet interventions to reduce racial disparities in timely delivery of lung cancer surgery have not been well studied. We evaluated the effect of ACCURE on timely receipt of lung cancer surgery. Methods: We analyzed data of a retrospective cohort at five cancer centers gathered prior to the ACCURE intervention and compared results with prospective data collected during the intervention. We calculated mean time from clinical suspicion of lung cancer to surgery and evaluated the proportion of patients who received surgery within 60 days stratified by race. We performed a t-test to compare mean days to surgery and chi2 for the delivery of surgery within 60 days. Results: 1320 patients underwent surgery in the retrospective arm, 160 were Black. 254 patients received surgery in the intervention arm, 85 were Black. Results are summarized in Table. Mean time to surgery in the retrospective cohort was 41.8 days, compared with 25.5 days in the intervention cohort (p<0.01). In the retrospective cohort, 68.8% of Black patients received surgery within 60 days versus 78.9% of White patients (p<0.01). In the intervention, the difference between Blacks and Whites with respect to surgery within 60 days was no longer significant (89.41% of Black patients vs 94.67% of White patients, p=0.12). Conclusions: Racial disparities exist in the delivery of timely lung cancer surgery. The ACCURE intervention improved time to surgery and timeliness of surgery for Black and White patients with early-stage lung cancer. A combination of real-time EHR monitoring, nurse navigation, and race-based feedback markedly reduced racial disparities in timely lung cancer care. [Table: see text]

Sign in / Sign up

Export Citation Format

Share Document