Reducing Bottlenecks to Improve the Efficiency of the Lung Cancer Care Delivery Process: A Process Engineering Modeling Approach to Patient-Centered Care

2017 ◽  
Vol 42 (1) ◽  
Author(s):  
Feng Ju ◽  
Hyo Kyung Lee ◽  
Xinhua Yu ◽  
Nicholas R. Faris ◽  
Fedoria Rugless ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Care ◽  
Care Delivery ◽  
Patient Centered Care ◽  
Process Engineering ◽  
Patient Centered ◽  
Modeling Approach ◽  
Centered Care ◽  
Engineering Modeling

scholarly journals Unique Challenges for Otolaryngology Patients During the COVID-19 Pandemic

2020 ◽  
pp. 019459982095483
Author(s):  
Melissa Ghulam-Smith ◽  
Yeyoon Choi ◽  
Heather Edwards ◽  
Jessica R. Levi
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Intimate Contact ◽  
Respiratory Mucosa ◽  
Increased Risk ◽  
Centered Care ◽  
Upper Respiratory

The coronavirus disease 2019 (COVID-19) pandemic has drastically altered health care delivery and utilization. The field of otolaryngology in particular has faced distinct challenges and an increased risk of transmission as day-to-day procedures involve intimate contact with a highly infectious upper respiratory mucosa. While the difficulties for physicians have been thoroughly discussed, the unique challenges of patients have yet to be considered. In this article, we present challenges for patients of otolaryngology that warrant thoughtful consideration and propose solutions to address these challenges to maintain patient-centered care both during and in the aftermath of the COVID-19 pandemic.

Patterns of care in ALK+ or ROS1+ non-small cell lung cancer (NSCLC) in community systems.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 232-232
Author(s):  
Benjamin Philip Levy ◽  
Breanne Y Farris ◽  
Rebecca R Crawford ◽  
Jeffrey D. Carter ◽  
Tamar Sapir
Keyword(s):  
Lung Cancer ◽  
Targeted Therapies ◽  
Treatment Options ◽  
Patient Centered Care ◽  
Molecular Testing ◽  
Distress Screening ◽  
Patient Centered ◽  
Treatment Practices ◽  
Molecular Tests ◽  
Centered Care

232 Background: For patients who have ALK or ROS1+ NSCLC, targeted therapies have greatly improved treatment options, though challenges personalizing care have hindered effective integration. In a quality improvement (QI) program conducted in 2 community oncology systems, practices involving the use of targeted therapies for NSCLC were assessed. Methods: Between 01-04/2020, retrospective EMR audits of 100 patients with ALK or ROS1+ NSCLC were analyzed for demographics, molecular testing, disease characteristics, treatment history, and shared decision-making (SDM). Surveys were administered to evaluate healthcare professionals’ (HCP; N = 47) challenges and barriers. HCP teams participated in audit-feedback sessions and developed action plans for resolving identified gaps. Results: 64% of HCPs indicated high confidence in utilizing molecular tests to inform treatment and properly sequencing targeted therapies; however, the EMR audit demonstrated challenges efficiently integrating guideline-aligned testing into practice. The mean time from diagnosis to molecular testing results was 22 days and documentation of testing for genetic aberrations other than ALK/ROS1 during work-up were low (Table). Delays in receiving molecular testing results may have presented challenges aligning treatment practices to guidelines as some patients were not receiving frontline targeted therapies (31% ALK+, 24% ROS1+). Additionally, EMR audits suggested sub-optimal use of distress screening (37%), tobacco counseling (38%), quality of life screening (60%), and engagement/documentation of various aspects of SDM (Table) for patient-centered care. Importantly, given the role internalized stigma can play in lung cancer, only 59% of those surveyed indicated that they routinely use tools to identify patients affected by stigma. During audit-feedback sessions, teams identified increased documentation, improved molecular testing/collaboration with pathology team, and provision of patient-centered care, including reduction of smoking-associated stigma as action items. Conclusions: These findings reveal important performance gaps in providing targeted and patient-centered treatment for NSCLC in community settings. These findings may be relevant for future QI programs. [Table: see text]

scholarly journals Patient-centered care, collaboration, communication, and coordination: a report from AMIA's 2013 Policy Meeting

2014 ◽  
Vol 22 (e1) ◽  
pp. e2-e6 ◽  
Author(s):  
Patti Flatley Brennan ◽  
Rupa Valdez ◽  
Greg Alexander ◽  
Shifali Arora ◽  
Elmer V Bernstam ◽  
...  
Keyword(s):  
Research Agenda ◽  
Care Delivery ◽  
Data Access ◽  
Patient Centered Care ◽  
Policy Framework ◽  
Patient Centered ◽  
Research Perspectives ◽  
Centered Care ◽  
Major Shift ◽  
Communication And Coordination

Abstract In alignment with a major shift toward patient-centered care as the model for improving care in our health system, informatics is transforming patient–provider relationships and overall care delivery. AMIA's 2013 Health Policy Invitational was focused on examining existing challenges surrounding full engagement of the patient and crafting a research agenda and policy framework encouraging the use of informatics solutions to achieve this goal. The group tackled this challenge from educational, technical, and research perspectives. Recommendations include the need for consumer education regarding rights to data access, the need for consumers to access their health information in real time, and further research on effective methods to engage patients. This paper summarizes the meeting as well as the research agenda and policy recommendations prioritized among the invited experts and stakeholders.

scholarly journals Patient-centered care pathways: what does it mean? An integrative conceptual framework to meet the need of an international consensus: a qualitative systematic review protocol

2021 ◽  
Author(s):  
Jean-Baptiste Gartner ◽  
Kassim Said Abasse ◽  
Ghita Ben Zagguou ◽  
Frédéric Bergeron ◽  
Paolo Landa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Care Delivery ◽  
Care Pathway ◽  
Patient Centered Care ◽  
Patient Centered ◽  
International Consensus ◽  
Patient Journey ◽  
Centered Care ◽  
Health Care Delivery Systems

Background: Faced with increased expectations regarding the quality and safety of health care delivery systems, a number of stakeholders are increasingly looking for more qualitative and efficient ways to deliver care. This study is conducted to provide a clear definition of the patient-centered care pathway and its characteristics to meet the need for an international consensus. Methods: This qualitative systematic review aims to perform a systematic synthesis of published evidence concerning (1) the definition of the patient trajectory, patient pathway or patient journey and (2) their characteristics. With a consulting librarian, a comprehensive and systematic search in three databases was conducted (PUBMED, Embase, ABI/Inform), from 1995 to 2020 without language criteria. Eligibility criteria guiding data selection will follow the PICo mnemonic criteria consisting of (1) Population : all types of patients managed by health care delivery systems for an acute or chronic condition regardless of age or condition, (2) Phenomena : studies that contribute to the definition and conceptualization of the concepts of care trajectory, care pathway and patient journey resulting in a theoretical and conceptual contribution, and (3) Context : health care providers include all providers of primary, secondary, tertiary, and quaternary care in any geographic area. Two reviewers will independently screen, select, extract data and make a critical assessment of the methodology used with the JBI Qualitative Assessment and Review Instrument (JBI QARI).Discussion: This systematic review will provide much-needed knowledge regarding patient-centered pathways. The results will benefit clinicians, decision makers, and researchers by giving them a clear and integrated definition and understanding of the patient-centered care pathways and their characteristics to finally meet the need for an international consensus.

scholarly journals Multimorbidity: An Issue of Growing Importance for Oncologists

2011 ◽  
Vol 7 (6) ◽  
pp. 371-374 ◽  
Author(s):  
Christine S. Ritchie ◽  
Elizabeth Kvale ◽  
Michael J. Fisch
Keyword(s):  
Cancer Care ◽  
Patient Centered Care ◽  
Care Plan ◽  
Patient Centered ◽  
Centered Care ◽  
The Impact

Recognition of the impact of multiple co-occurring conditions on a patient's cancer care plan and development of strategies to address the challenges associated with multimorbidity will enable oncologists to provide higher quality, patient-centered care.

scholarly journals Experiences of Patient-Centered Care Among Japanese and Australian Cancer Outpatients: Results of a Cross-Sectional Study

2021 ◽  
Vol 8 ◽  
pp. 237437352110076
Author(s):  
Mariko L Carey ◽  
Megumi Uchida ◽  
Alison C Zucca ◽  
Toru Okuyama ◽  
Tatsuo Akechi ◽  
...  
Keyword(s):  
Side Effects ◽  
Care Delivery ◽  
International Comparisons ◽  
Patient Centered Care ◽  
Cross Sectional Study ◽  
Patient Centered ◽  
Cross Sectional ◽  
Centered Care ◽  
Improvement Interventions ◽  
Quality Improvement Interventions

There have been few international comparisons of patient-centered cancer care delivery. This study aimed to compare the experiences of patient-centered care (PCC) of Japanese and Australian radiation oncology patients. Participants were adults with cancer attending a radiotherapy appointment at a Japanese or Australian clinic. Participants completed a survey asking about 10 indicators of PCC. Overall, 259 Japanese and 285 Australian patients participated. Compared with Japanese participants, Australian participants were significantly more likely to report receiving information about: what the treatment is, and the short-term and long-term side effects of treatment. A higher proportion of Australian participants reported being asked whether they wanted a friend or family member present at the consultation. There were no differences in the frequency with which Japanese and Australian participants were asked by their clinicians about whether they were experiencing physical side effects or emotional distress. International differences highlight the (1) need to exercise caution when generalizing from one country to another; and (2) the importance of context in understanding PCC delivery and the subsequent design of quality improvement interventions.

scholarly journals French Health professionals’ attitudes about patient empowerment in the cancer care pathway

2019 ◽  
Vol 7 (4) ◽  
pp. 41
Author(s):  
Elise Verot ◽  
Véronique Régnier-Denois ◽  
Dominique Feld ◽  
Romain Rivoirard ◽  
Franck Chauvin
Keyword(s):  
Nursing Care ◽  
Health Professionals ◽  
Cancer Care ◽  
Care Pathway ◽  
Patient Empowerment ◽  
Patient Centered Care ◽  
Care Providers ◽  
Patient Centered ◽  
Centered Care ◽  
New Form

Objective: France is experiencing a shift in health policy. The purpose of this article is to describe how cancer care health professionals define patient empowerment, describe modalities of care of the cancer patient treated by intravenous means and identify avenues for reflection on the specific challenges facing patient-centered care, from the perspective of changes in practices in the cancer care pathway.Methods: 19 individual, semi-structured interviews with health professionals working in cancer care facilities were analyzed in a qualitative study, using the Theoretical Domain Framework linked to the COM-B model.Results: The organization of care is governed by three factors. First of all, the cancer care system focuses on the strictly curative aspect of this disease. All devices lead to management centered on the pathology, and not on the patient as a whole. Secondly, the fact that the patient suffers from cancer modifies the attitudes and representations of caregivers towards the patient. Cancer introduces a relational bias in each of the stakeholders. Thirdly, the current organization of nursing care maintains paternalistic and prescriptive care in the cancer care pathway. Only new nursing jobs (coordinating nurses or pivot nurses) suggest the possibility of switching to patient-centered care. The analysis from TDF linked to the COM-B model shows that the strategy of implementing a new tool to measure the level of patient engagement, in routine nursing care, must focus on the reflective opportunity and motivation of the stakeholders.Conclusions: Caregivers should be acculturated to patient empowerment. TDF linked to the COM-B model can make it possible to think about how to prepare and adapt this change in practice at several sites of cancer treatment. Training adapted to the context to familiarize current caregivers with this new form of care is currently being implemented. To succeed, acculturating current health care providers to this new form of care, while offering them a tool to objectively assess the level of patient empowerment would undoubtedly foster their involvement in supporting patient empowerment, while allowing them to evaluate the time required to integrate this type of care.

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