The Cancer Emergency Department—The Ohio State University James Cancer Center Experience

Biological products may be used to diagnose, prevent, treat, and cure diseases and medical conditions, including cancer. Biosimilar agents, approved under an abbreviated 351(k) pathway, continue to increase in number and market share for biologic agents, especially for cancer care. Although biosimilars offer the potential for improved access to care, their introduction to the marketplace has created significant disruption. It is imperative that health systems providing care to patients with cancer develop a well-defined process to address the challenges associated with biosimilars. This descriptive article outlines pharmacy considerations for biosimilars and describes the current practices at The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at The Ohio State University. Biosimilars have and will continue to significantly impact oncology care. Organizations must understand the clinical, operational, and financial challenges associated with the use of these products.

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LPTO-10. ASSESSMENT OF LEPTOMENINGEAL CARCINOMATOSIS DIAGNOSIS AND OUTCOMES FROM 2005 TO 2015 AT THE OHIO STATE UNIVERSITY

Neuro-Oncology Advances ◽

10.1093/noajnl/vdz014.033 ◽

2019 ◽

Vol 1 (Supplement_1) ◽

pp. i8-i8

Author(s):

Nicole Williams ◽

Hannah Rinehardt ◽

Evan Morgan ◽

Mahmoud Kassem ◽

Marilly Palettas ◽

...

Keyword(s):

Leptomeningeal Carcinomatosis ◽

Ohio State University ◽

Diagnostic Methods ◽

Detection Methods ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Primary Cancer ◽

State University ◽

Csf Cytology ◽

The Ohio State University

Abstract BACKGROUND: Leptomeningeal carcinomatosis (LMC) is a complication of solid tumor malignancies where tumors metastasize to the leptomeninges. LMC complicates 4–15% of malignancies with incidence increasing as survival of patients with advanced cancer improves. Diagnostic methods include magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) cytology. We assessed detection methods, incidence, and outcomes of LMC at The Ohio State University Comprehensive Cancer Center from 2005–2015. METHODS: This was a single-institution retrospective study of 160 patients with confirmed diagnosis of LMC. Patients with hematologic and central nervous system malignancies were excluded. Descriptive statistics were used to summarize demographic and clinical characteristics. Overall survival (OS) was defined as time from LMC diagnosis to death or last known follow-up, and was generated using Kaplan-Meier methods. RESULTS: Median age of LMC diagnosis was 55.8 years (range: 48, 62.5). 69 (43%) patients had primary breast cancer, 41 (26%) had lung cancer, and 17 (11%) had melanoma. 73 patients (46%) presented with stage IV disease at initial diagnosis of the primary cancer, 41 (26%) with stage III disease, and 26 (16%) with stage II disease. Median time from diagnosis of primary cancer to diagnosis of LMC was 2 years (range: 0, 31.2). 158 (99%) patients had metastases at the time of LMC diagnosis, predominantly in bone (36%) or brain (36%). Median OS was 1.9 months (CI: 1.3, 2.5). 160 (100%) patients had an MRI of the brain or spine and 155 (97%) had MRI findings consistent with LMC. 75 (47%) patients underwent lumbar puncture, and 39 (52%) had CSF cytology positive for malignancy. CONCLUSIONS: Despite treatment, prognosis remains poor and confirmation of diagnosis can be challenging. This study highlights the need for novel therapeutics and improved diagnostic techniques for patients with LMC.

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The Ohio State University Comprehensive Cancer Center

10.32388/r9dm84 ◽

2020 ◽

Author(s):

Keyword(s):

Ohio State University ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

State University ◽

The Ohio State University

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QIM19-143: Reducing Risk of IV Chemotherapy Administration Errors Utilizing Pump Integration Technology

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2018.7149 ◽

2019 ◽

Vol 17 (3.5) ◽

pp. QIM19-143

Author(s):

Robert C. Stillman ◽

Emily Konerman

Keyword(s):

Patient Safety ◽

Medical Center ◽

Ohio State University ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

State University ◽

Cancer Hospital ◽

The Ohio State University ◽

Smart Pump ◽

Research Institute

Background: The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solve Research Institute is a 356-bed cancer care hospital that is part of The Ohio State University Medical Center. In addition to the inpatient beds, the hospital services 175 ambulatory infusion chairs. Each month, we administer over 6,000 chemotherapy infusions on an IV pump. Smart IV pumps in tandem with hospital information technology infrastructure integrate IV drug administration pump data with the electronic medical record (EMR) and computerized physician order entry to decrease risk of error and increase patient safety. The closed loop system transmits the medication infusion rate and the prescribed dose to the smart pump to deliver the medication. The smart pump in turn transmits the dose and volume delivered to the EMR to accurately capture what the patient received. The ability to wirelessly transmit clinical information from the EMR to automatically program the IV pump with specific data was implemented in March 2018 as part of a system-wide safety initiative to enhance patient safety via the reduction of error during medication administration. Methods: IV pump integration has been in use since March 2018; the organization has robust data on the use of smart pump technology that allowed for comparison of data pre- and postimplementation of pump integration. This includes: total suite usage, count of basic infusions, severe harm averted, total good catches, and event-reporting data. Post-integration, the overall compliance of utilizing pump integration (sending an order from the EMR to the smart IV pump) is also continuously monitored. Results: The implementation of pump interoperability resulted in a safer delivery of infused medications (Figure 1). The use of “basic Infusion” or unprotected infusion function decreased while our use of the appropriate safeguarded pump program increased. The compliance at the medical center increased from about 86% to almost 94%. With increased usage of the pump interoperability, the potential for severe harm as well as human programming errors decreased significantly. Conclusion: The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solve Research Institute is able to deliver infused medications via a smart pump in a safer, more automated system with the implementation of pump integration. We are able to reduce the “human factor” in medication delivery by reducing keystrokes and opportunities for manual programming errors. Pre-integration data cannot be isolated for the cancer hospital only, from our post-implementation data we can infer that our chemotherapy infusions are subsequently safer for our patients.

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Use of a Professional Practice Model to Illuminate the Importance of Relationships

Creative Nursing ◽

10.1891/1078-4535.20.2.127 ◽

2014 ◽

Vol 20 (2) ◽

pp. 127-136 ◽

Cited By ~ 4

Author(s):

Linda Johnson ◽

Jamie Ezekielian

Keyword(s):

Professional Practice ◽

Ohio State University ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

State University ◽

Practice Model ◽

Nurse Satisfaction ◽

Primary Nursing ◽

The Ohio State University ◽

Frontline Leaders

At the Ohio State University Comprehensive Cancer Center—James Cancer Hospital and Solove Research Institute (OSUCCC—James), implementation of relationship-based care (RBC) and primary nursing (PN) along with enculturation of the James Nursing professional practice model (PPM), have improved patient and nurse satisfaction. This article describes the importance of relationships with self, colleagues, patients and families, and the community. Best practices and outcomes are shared to inspire others who seek to transform professional practice environments and organizational cultures by focusing on patients and families and engaging frontline leaders in the change process.

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NCMP-07. TREATMENT-INDUCED CEREBRAL NECROSIS IN GLIOMAS: THE OHIO STATE UNIVERSITY COMPREHENSIVE CANCER CENTER (OSUCCC) EXPERIENCE

Neuro-Oncology ◽

10.1093/neuonc/noaa215.519 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii124-ii124

Author(s):

Appaji Rayi ◽

Iyad Alnahhas ◽

Joshua Palmer ◽

Raju Raval ◽

Wayne Slone ◽

...

Keyword(s):

Promoter Hypermethylation ◽

Ohio State University ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Idh Mutation ◽

State University ◽

Grade Ii ◽

Previously Treated ◽

The Ohio State University ◽

Cerebral Necrosis

Abstract INTRODUCTION Treatment-induced cerebral necrosis (TN) is a challenging complication encountered in neuro-oncology. Diagnosis and treatment of TN remains poorly defined. METHODS In this single institution, retrospective study, consecutive patients with gliomas and TN between 01/01/2012 and 04/20/2020 at the OSUCCC were identified. Details of the tumor treatment, molecular markers, radiological and pathological findings of TN, as well as treatment, recurrence rate and management upon recurrence were collected. RESULTS Of the 53 patients analyzed, 37 had glioblastoma, 7 had anaplastic oligodendroglioma and 9 had grade II or III astrocytoma. MGMT promoter hypermethylation was present in 31/50 (59%) and IDH mutation in 17/53 (32%). Diagnosis of TN was based on histology in 43/53 (81%) or clinical/radiographic features in 10/53 (19%). Worsening of focal weakness (36%), seizures (9%) or being (30%) were common presentations at TN diagnosis. Patient with right compared to left hemisphere involvement were more symptomatic at TN diagnosis. (p=0.049). Bevacizumab (BEV) (51%), resection (28%), steroids only (9%) or Laser Interstitial Thermal Therapy (6%) were used to treat TN. Steroids were weaned off in 20/27 (74%) after receiving BEV. Among all treatments, BEV was significantly associated with a better outcome (resolution or partial improvement of enhancement in 84.6%) (p=0.0006, Bonferroni corrected p< 0.005). TN Recurrence occurred in 36%, 70% and 100% of the patients treated with BEV, resection and LITT respectively. The median duration to TN recurrence was 10 weeks (range: 3–70 weeks). Initial treatment used for TN, MGMT methylation and IDH mutation status did not predict TN recurrence. (p=0.074; p=0.819; p=0.607 respectively). CONCLUSIONS BEV appears to be a superior treatment to control TN overall. Recurrence of TN in patients previously treated with BEV was 36%. There was no difference in the risk of developing recurrent TN based on MGMT or IDH status.

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Five Decades of Research Experience in Speech Anatomy and Physiology

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp1.sig5.4 ◽

2016 ◽

Vol 1 (5) ◽

pp. 4-12

Author(s):

David P. Kuehn

Keyword(s):

Ohio State University ◽

State University ◽

Research Experience ◽

University Of Iowa ◽

University Of Illinois ◽

Anatomy And Physiology ◽

The Ohio State University ◽

Speech Science ◽

The University ◽

East Carolina University

This report highlights some of the major developments in the area of speech anatomy and physiology drawing from the author's own research experience during his years at the University of Iowa and the University of Illinois. He has benefited greatly from mentors including Professors James Curtis, Kenneth Moll, and Hughlett Morris at the University of Iowa and Professor Paul Lauterbur at the University of Illinois. Many colleagues have contributed to the author's work, especially Professors Jerald Moon at the University of Iowa, Bradley Sutton at the University of Illinois, Jamie Perry at East Carolina University, and Youkyung Bae at the Ohio State University. The strength of these researchers and their students bodes well for future advances in knowledge in this important area of speech science.

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Cardiology Fellowship Education in the Era of High-density Training, Data Tracking, and Quality Measures

The American Heart Hospital Journal ◽

10.15420/ahhj.2011.9.2.99 ◽

2011 ◽

Vol 9 (2) ◽

pp. 99

Author(s):

Alex J Auseon ◽

Albert J Kolibash ◽

◽

Keyword(s):

Ohio State University ◽

Training Data ◽

State University ◽

Training Requirements ◽

Healthcare Environment ◽

Medical Centers ◽

Work Hour ◽

The Ohio State University ◽

Data Tracking

Background:Educating trainees during cardiology fellowship is a process in constant evolution, with program directors regularly adapting to increasing demands and regulations as they strive to prepare graduates for practice in todays healthcare environment.Methods and Results:In a 10-year follow-up to a previous manuscript regarding fellowship education, we reviewed the literature regarding the most topical issues facing training programs in 2010, describing our approach at The Ohio State University.Conclusion:In the midst of challenges posed by the increasing complexity of training requirements and documentation, work hour restrictions, and the new definitions of quality and safety, we propose methods of curricula revision and collaboration that may serve as an example to other medical centers.

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