Increasing access to care for young adults with cancer: Results of a quality-improvement project using a novel telemedicine approach to supportive group psychotherapy

2016 ◽  
Vol 15 (2) ◽  
pp. 176-180 ◽  
Author(s):  
Laura Melton ◽  
Benjamin Brewer ◽  
Elissa Kolva ◽  
Tanisha Joshi ◽  
Michelle Bunch

AbstractObjective:Young adults with cancer experience high levels of psychological distress. Group interventions for cancer patients have been effective in reducing levels of psychological distress but suffer from high levels of attrition and serve a limited geographic area. In a quality-improvement project, we converted an existing in-person support group to a telemedicine format in the hopes of improving attendance and reducing geographic disparities in access to care.Method:Eight young adults (18–40 years) with cancer were recruited from across Colorado. Participants received a tablet equipped with Wi-Fi and downloaded an HIPAA-compliant video-conferencing application. Participants attended six weekly supportive psychotherapy sessions.Results:Participants found the group to be beneficial: the technology worked, they enjoyed the group format, and they would recommend it to others. The novel treatment interface allowed for low attrition rates due to the flexibility of a patient's location during the intervention. It allowed for provision of services to a geographically diverse population of medically ill young adults, as participants lived an average of 148 miles from the cancer center (range = 25–406 miles).Significance of results:Internet-based mental health care is an area of growing interest for providers, but few studies have evaluated its efficacy in patients with cancer, and even fewer in young adults with cancer. Incorporating technological advances into clinical practice will increase access to care, reduce geographic health disparities, and provide more consistent services.

2020 ◽  
Vol 66 (2) ◽  
pp. S36
Author(s):  
Sarah Pitts ◽  
Carly Milliren ◽  
Grace Berg ◽  
Danielle McPeak ◽  
Amy DiVasta

2019 ◽  
Vol 10 (6) ◽  
pp. S24
Author(s):  
F. Gomes ◽  
K. Baker ◽  
J. Bruce ◽  
M. Eaton ◽  
J. Woods ◽  
...  

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S236-S236
Author(s):  
Laura Perez ◽  
Rebecca Castro ◽  
Steven E Wolf ◽  
Jong Lee

Abstract Introduction Our Burn Center provides care to persons living in southeast area of our State. Patients residing in this area sometimes have low socioeconomic status (SES), and are often unable to return to burn clinic for continued care due to transportation barriers. Typically driving distance is over 80 miles involving ferry access, taking two or more hours each way. The aim of this quality improvement project was to examine the feasibility of a free transportation program for low SES patients who have barriers to transportation. Methods Our first step was to assess transportation needs. We started with a patient survey in clinic to determine if patients would be interested in free transportation and if the service would increase access to care. Survey with six questions was used to assess needs. Results We surveyed ten patients during burn clinic to determine if transportation would increase access to care. Nine patients responded positively and found transportation would be beneficial. One responded that he would not use it as he would use clinic appointment as opportunity to vacation in the area. Funding was secured from our School of Medicine. Community transportation providers were contacted and pricing was obtained. Transportation van was contracted with existing vender. Transportation is now available to patients with burn clinic appointments. We hope to expand to other clinics in the hospital in the future. The Transportation program will assist patients with access to care, compliance, decrease non-emergent Emergency Department visits and 30-day readmissions. Conclusions Transportation assistance for socioeconomically disadvantaged burn patients to follow up in clinic is needed. Nine out of ten patients surveyed were willing to use free transportation. We obtained funding to start a free transportation program once a month. This project began in October 2019. We have begun a once-a-month transportation assistance service to determine ridership and continued need. Twice monthly assistance may be needed and will be assessed over time. Our goal is ultimately to expand the program to include other clinics. Applicability of Research to Practice Free transportation program can assist patients with access to care, compliance, and decrease non-emergent Emergency Department visits and 30-day readmissions.


PEDIATRICS ◽  
2016 ◽  
Vol 139 (1) ◽  
pp. e20160258 ◽  
Author(s):  
Rachel Thienprayoon ◽  
Kelly Porter ◽  
Michelle Tate ◽  
Marshall Ashby ◽  
Mark Meyer

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 21-21
Author(s):  
Deepthi Kodali ◽  
Melinda Sanders ◽  
Robert James Dowsett ◽  
Jeffrey Spiro ◽  
Upendra P. Hegde

21 Background: Although traditionally linked to smoking and alcohol, high-risk (HR) human papilloma virus (HPV) associated head and neck cancers are becoming increasingly common in non-smokers. HR HPV causes approx. 70% of all oropharyngeal squamous cell carcinomas (OPSCC) and they have better outcomes when compared with smoking associated OPSCC. An accurate HPV assessment in OPSCC is important due to its relevance in treatment and follow up. This Quality Improvement project was designed to evaluate frequency of HPV testing with p16 immunochemistry (IHC) staining in patients with OPSCC at a University-based cancer center. Methods: All cases diagnosed with OPSCC or those with high suspicion for OPSCC between 2008 and 2017 were obtained from Department of Pathology. Patients with biopsies from sites other than oropharynx as well as those with biopsies performed at outside hospitals were excluded. All pathology reports were reviewed to identifyfrequency of p16 IHC staining. Results: A list of 127 cases was obtained from Pathology. Of these, 26 non-OPSCC and external hospital slides were excluded, making sample size (n) 101. HR HPV testing by p16 IHC staining was performed in 42 of 101 patients (41.5%) and not performed in 59 (58.5%). 38 of 42 patients tested were positive for HR HPV (90.5%). There was an overall upward trend in the frequency of HPV testing over the 10 years. Conclusions: HR HPV testing was done only in 41.5% of eligible patients suggesting a deficiency in testing for this biomarker. Various causes for this lack of testing were identified, most common one being inadequacy of tissue specimen. 90.5% of eligible patients tested were positive for HR-HPV, highlighting the strong association between HPV and OPSCC. Based on importance of testing HR HPV in OPSCC and need for aligning with American Society of Clinical Pathology guidelines, corrective actions were proposed by meeting with pathologists and otolaryngologists.


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