Seventeen years of progress for supportive care services: A resurvey of National Cancer Institute–designated comprehensive cancer centers

2014 ◽  
Vol 13 (4) ◽  
pp. 917-925 ◽  
Author(s):  
Sheila L. Hammer ◽  
Karen Clark ◽  
Marcia Grant ◽  
Matthew J. Loscalzo
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
National Cancer Institute ◽  
Advisory Council ◽  
Current Status ◽  
Distress Screening ◽  
Cancer Centers ◽  
Care Services ◽  
Comprehensive Cancer Centers ◽  
Question Survey

AbstractObjective:We replicated a 1994 study that surveyed the state of supportive care services due to changes in the field and the increased need for such services. We provide an updated assessment, comparing the changes that have occurred and describing the current status of supportive care services in comprehensive cancer settings.Method:We used Coluzzi and colleague's 60-question survey from their 1995 Journal of Clinical Oncology article to frame the 98-question survey employed in the current study. Medical and palliative care directors for the 2011 National Cancer Institute (NCI) comprehensive cancer centers were surveyed regarding their supportive care services and their subjective review of the overall effectiveness of the services provided.Results:We achieved a 76% response rate (n = 31). The data revealed increases in the number of cancer beds in the hospitals, the degree of integration of supportive care services, the availability of complementary services, and the number of pain and palliative care services offered. There was also an overall shift toward centers becoming more patient centered, as 65% reported now having a patient and family advisory council. Our findings revealed a growing trend to offer distress screening for both outpatients and inpatients. Medical and palliative care directors' evaluations of the supportive care services they offered also significantly improved. However, the results revealed an ongoing gap in services for end-of-life care and timely referrals for hospice services.Significance of results:Overall, both the quantity and quality of supportive care services in the surveyed NCI-designated cancer centers has improved.

Screening for Palliative Care Needs: Pilot Data From German Comprehensive Cancer Centers

2021 ◽  
pp. OP.20.00698
Author(s):  
Carmen Roch ◽  
Maria Heckel ◽  
Birgitt van Oorschot ◽  
Bernd Alt-Epping ◽  
Mitra Tewes
Keyword(s):  
Palliative Care ◽  
Human Resources ◽  
Structural Characteristics ◽  
Physical Symptoms ◽  
Screening Tools ◽  
Current Status ◽  
Care Needs ◽  
Cancer Centers ◽  
Comprehensive Cancer Centers ◽  
Palliative Care Needs

PURPOSE: Guidelines recommend several screening tools to identify patients with complex palliative needs. This diversity and lack of structural recommendations offer a wide scope for implementing screening. Against this background, the current status of implementation at German Comprehensive Cancer Centers (CCCs) funded by the German Cancer Aid has not yet been investigated. METHODS: e-mail survey of the 17 hospital sites of the 13 CCCs. The questionnaire asked for structural characteristics of the centers as well as preconditions of the screening process. Structurally established screening procedures (one item) and standardized workflows, modes of performance, screening tools (four items), modes of training how to screen, and responsibilities (two items) were assessed. RESULTS: In a 2-month period, 15 hospital sites responded; seven hospital sites conducted a palliative care needs (PCN) screening. Only one hospital site carried out PCN screening in almost all oncology departments, but only with the distress thermometer. Other hospital sites determined palliative needs by assessing physical symptoms using the Integrated Palliative Care Outcome Scale or the Minimal Documentation System, and two hospital sites combined tools to determine both physical and psychological stress. The type of screening varied from paper-pencil–based to tablet computer–based documentation. The main barriers to implementation were identified as a lack of human resources and a lack of structural conditions. CONCLUSION: There is a lack of consensus among palliative care specialists and oncologists in the CCCs supported by the German Cancer Aid in PCN screening as well as of structured guidelines and the professional association. Structural requirements should be adapted to these needs, which include both technical and human resources. A combined psycho-oncologic and palliative care screening might help to formulate best practice recommendations.

Supportive care in cancer organization in France: State of the art.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19640-e19640
Author(s):  
Florian Scotte ◽  
Christian Herve ◽  
Roland Bugat ◽  
Fadila Farsi ◽  
Moise Namer ◽  
...  
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
Cancer Centers ◽  
Treatment Side Effects ◽  
Comprehensive Cancer Centers ◽  
Medical Oncologists ◽  
French Speaking ◽  
The Mean ◽  
Pain Care ◽  
Mean Time

e19640 Background: Second Cancer Act was defined in France in December 2009 including enhancement of supportive care in Cancer (SCC). How are supportive care organized in France? Are patients informed about supportive treatment side effects? Methods: The AFSOS (French Speaking Association for Supportive Care in Cancer) conducted this observational study to evaluate practices, organizations and informations given to patients (pts) about SCC. Among 1621 french medical doctors (MD) caring cancer pts who were sent an adhoc questionnaire, 20% (330 MD including 44% medical oncologists) answered. Results: Three different organizations were described: Single MD, transversal team and specific structure specialized in global care (specifically developed in comprehensive cancer centers-CCC). Psycho-oncology, palliative care, nutrition and pain care were the four main items considered as supportive care. During their disease, 68% of pts are receiving SCC, presented by their MD (88%) or nurse devoted to announcement of disease and SCC information (57%). Supportive care is more dispensed during palliative period (90%) than at diagnosis (44%). Patients information is rather supplied during palliative care (85%) than at diagnosis (52%) using a specific questionnaire for outpatient (20%) or specific supportive care session (17%). 71% of cancer department have a cross team to provide supportive care, with specific SCC team particularly in CCC (62%; p=0.01)). 37% have inpatient specific units. Only 40% have a specific organization in home care connection, more in CCC than in public or private centers (respectively 69%, 45%, 20%; p=0.01). 73% use specific financial valorization of CSC activity. Adverse events information is dispensed to 54% of the pts for erythropoiesis stimulating agents (ASE), 74% for biphosphonates and 94% for opioids treatments, rather by medical oncologist than other specialists (p=0.01). Conclusions: Specific organization developed especially in comprehensive cancer centers seems to facilitate SCC organization and information to pts. In the mean time, recommendations include this information, involvement in supportive care team and methods have to be enhanced. Further results compared with patient point of views are expected.

Reducing patient suffering and preventing readmissions via supportive care screening: The James Cancer Hospital supportive-care screening model.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 33-33
Author(s):  
Sharla Wells-Di Gregorio ◽  
Alexandra Zaleta ◽  
Emily Porensky ◽  
Lisa Graham ◽  
Kelly McDowell ◽  
...  
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
Phase Ii ◽  
Hospital Admissions ◽  
Physical Symptoms ◽  
Distress Screening ◽  
Care Clinic ◽  
Screening Model ◽  
Care Services ◽  
Cancer Hospital

33 Background: Hospital admissions create physical, financial and emotional stress for oncology patients. Hospital avoidable readmissions are considered a marker of poorer quality patient care. To reduce readmissions, cancer hospitals must understand modifiable readmission risk factors AND establish screening systems to triage at-risk patients to outpatient palliative/supportive care services. The James Cancer Hospital is in Phase II development of a model to reduce patient suffering and readmission via the James Supportive Care Screening (JSCS), a 48-item validated clinical-research instrument. Methods: In 2013, the James Cancer Hospital began implementation of Supportive Care Screening to meet Standard 3.2 (Psychosocial Distress Screening) of the Commission on Cancer. The JSCS asks patients to rate distress in six palliative care domains including emotional concerns, physical symptoms, social/practical problems, spiritual problems, cognitive concerns, and healthcare decision-making/communication issues. Between January 2011 and December 2013, one-thousand and one patients completed the JSCS in the Outpatient Palliative Care clinic. During this period, 57 patients had at least one readmission. Hierarchical linear regression was used to predict the number of future readmissions with JSCS subscales as independent variables. Results: The overall model predicting readmissions was significant, F(7,959) = 37.074, p<.001. Time to readmission, physical symptoms, emotional concerns, spiritual concerns, and social concerns were significant predictors of patient readmission. We are currently examining palliative care outcomes in these domains and have found that outpatient palliative care significantly reduces suffering related to physical and emotional distress. Conclusions: Supportive care screening, can serve to reduce oncology readmissions and prevent patient suffering in six key palliative domains. During Phase II of the James Supportive Care Screening Model, we have identified several problem areas targeted to reduce readmissions and improve patient self-reported outcomes.

Early palliative care: current status of integration within German comprehensive cancer centers

2017 ◽  
Vol 25 (8) ◽  
pp. 2577-2580 ◽  
Author(s):  
Julia Berendt ◽  
Stephanie Stiel ◽  
Friedemann Nauck ◽  
Christoph Ostgathe
Keyword(s):  
Palliative Care ◽  
Current Status ◽  
Cancer Centers ◽  
Early Palliative Care ◽  
Comprehensive Cancer Centers

Survey of the provision of supportive care services at National Cancer Institute-designated cancer centers.

1995 ◽  
Vol 13 (3) ◽  
pp. 756-764 ◽  
Author(s):  
P H Coluzzi ◽  
M Grant ◽  
J H Doroshow ◽  
M Rhiner ◽  
B Ferrell ◽  
...  
Keyword(s):  
Supportive Care ◽  
National Cancer Institute ◽  
Cancer Control ◽  
The United States ◽  
Cancer Therapies ◽  
Industry Funding ◽  
Private Industry ◽  
Cancer Society ◽  
Cancer Centers ◽  
Care Services

PURPOSE The purpose of this survey was to determine the scope of supportive care services (SCS) designed to promote quality of life during cancer therapies at National Cancer Institute (NCI)-designated cancer centers. METHODS A survey was mailed to the medical directors and nursing directors of 52 NCI-designated comprehensive (n = 26), clinical (n = 11), and planning cancer centers (n = 15) in the United States. Only one survey was completed from each institution. Survey questions identified services provided such as pain management, terminal care, psychosocial programs, and spiritual care. RESULTS Thirty-nine questionnaires were received for a total response rate of 75%. Of the respondents, 45% were comprehensive cancer centers, 24% clinical cancer centers, and 29% planning centers. One center did not identify their NCI designation. Sixty-one percent of the centers reported research programs in supportive care. Outside funding was reported in 51% of the respondents, with 39% having American Cancer Society (ACS) or National Institutes of Health (NIH) funding and 28% having private industry funding. Overall SCS self-ratings improved from a 21% rating of excellent to very good 5 years ago to the current 54% rating. CONCLUSION Survey results provide data on SCS across a representative sample of NCI cancer centers and can be used to develop standards for future cancer control programs.

The availability/accessibility gap of palliative care and supportive care services at 40 National Cancer Institute-designated cancer centers.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 122-122
Author(s):  
Kathryn Hutchins ◽  
Geoffrey Hamlyn ◽  
Abby Johnston ◽  
Rishonda Thomas ◽  
James Tian ◽  
...  
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
Cancer Education ◽  
Quantitative Measure ◽  
Complete Information ◽  
Cancer Center ◽  
Cancer Centers ◽  
Care Services ◽  
Palliative Care Services ◽  
Genetic Assessment

122 Background: All NCI-designated, comprehensive cancer centers report having consultative palliative care services alongside six other supportive care services. Inaccuracies in the understanding of these services among frontline office staff may undermine their accessibility to patients. We investigated how easily new patients could access these services when first contacting a major cancer center. Methods: We used a ‘mystery shopper’ format to simulate calls made by a family member of a recently diagnosed patient. We used a standardized call script, describing a female patient, age 58, recently diagnosed with inoperable liver cancer. We called each center four times on different days and evaluated quantitative and qualitative components. Descriptive statistics were calculated for each quantitative measure. Results: We placed 160 calls to 40 NCI-designated cancer centers. 38.2% of callers were unable to receive complete information about supportive care services. Overall, only 37.6% of callers (60.8% of those reaching someone who could answer questions) were told all 7 supportive care services were offered. In 9.5% of calls, call recipients gave an answer other than “yes” to whether the cancer center offered palliative care. Callers were told regarding palliative care: that it was for end of life patients only (2 calls), that there weren’t doctors who focused on symptom management (3), its availability depends on review of medical records (2), or that the call recipient was unsure either of the availability of palliative care (10), or did not know what the term meant (2). Availability responses other than “yes” were obtained in the following frequencies: multidisciplinary approach (14.6%), patient navigation (12.1%), genetic assessment (9.5%), psychological services (7.6%), and cancer education services (6.4%). Conclusions: Despite the stated availability of seven key supportive care services, accessibility was limited in one-third of calls. In about 10% of cases where a person was reached, the call recipient was unable to confirm that palliative care was offered. Further research is needed to close the availability vs. accessibility gap in oncology palliative and supportive care.

A survey of National Cancer Institute-designated comprehensive cancer centers’ oral health supportive care practices and resources in the USA

2007 ◽  
Vol 15 (4) ◽  
pp. 357-362 ◽  
Author(s):  
Joel B. Epstein ◽  
Ira R. Parker ◽  
Matthew S. Epstein ◽  
Anurag Gupta ◽  
Susan Kutis ◽  
...  
Keyword(s):  
Oral Health ◽  
Supportive Care ◽  
National Cancer Institute ◽  
Cancer Centers ◽  
Comprehensive Cancer Centers ◽  
The Usa ◽  
Care Practices

Symptom Assessment and Early Access to Supportive and Palliative Care for Patients With Advanced Solid Tumors in Mexico

2019 ◽  
Vol 35 (1) ◽  
pp. 40-45 ◽  
Author(s):  
Mirza Jacqueline Alcalde-Castro ◽  
Enrique Soto-Perez-de-Celis ◽  
Alfredo Covarrubias-Gómez ◽  
Sofía Sánchez-Román ◽  
Paulina Quiróz-Friedman ◽  
...  
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
Solid Tumors ◽  
Advanced Cancer ◽  
Symptom Assessment ◽  
First Year ◽  
Advanced Solid Tumors ◽  
Care Clinic ◽  
Care Services ◽  
Oncology Care

Background: Early specialized palliative care improves quality of life of patients with advanced cancer, and guidelines encourage its integration into standard oncology care. However, many patients fail to obtain timely palliative/supportive care evaluations, particularly in limited-resource settings. We aimed to determine the proportion of patients with advanced cancer who received an assessment of symptoms and were referred to supportive and palliative care services during the first year after diagnosis in a Mexican hospital. Methods: Individuals with newly diagnosed advanced solid tumors and 1 year of follow-up at the oncology clinics in the Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran in Mexico City from October 2015 to April 2016 were included in this retrospective study. Results: Seventy-seven patients were included. Forty-two (54.5%) were referred to the various supportive care services during the first year after diagnosis, and 23 (29.8%) were referred to the palliative care clinic. The most commonly assessed symptoms by oncologists were pain (77.9%), anorexia (74.0%), fatigue (68.8%), and nausea (55.8%), while depression/anxiety were evaluated in 10 (12.9%) patients. The oncologist offered to clarify treatment goals in 39 (50.6%) cases and evaluated the understanding of diagnosis/illness and prognosis in 22 (28.5%). Conclusion: Palliative and supportive care services were widely underutilized, which may be related to a lack of standardized symptom assessments and poor end-of-life communication. Novel strategies are needed to improve the implementation of tools for systematic symptom assessment and to optimize the integration of supportive care interventions into oncology care in developing countries.

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