Differences in approach of cancer specialists toward AYA cancer care

2021 ◽  
Author(s):  
Kimikazu Matsumoto ◽  
Kazuhito Yamamoto ◽  
Seiichiro Ozono ◽  
Hiroya Hashimoto ◽  
Keizo Horibe
Keyword(s):  
Cancer Care ◽  
Cancer Specialists

Distributed Cognition for Improving Cancer Care Coordination

2018 ◽  
Vol 7 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Brian Hazlehurst ◽  
Gurvaneet Randhawa ◽  
Paul N. Gorman ◽  
Yan Xiao
Keyword(s):  
No Value ◽  
Cancer Care ◽  
Distributed Cognition ◽  
Care Process ◽  
Cancer Therapies ◽  
Treatment Technologies ◽  
Cancer Specialists ◽  
The Many ◽  
Effective Use ◽  
Improve Patient

Our health care system uses sophisticated cancer therapies, treatment technologies and facilities, and has dedicated and talented cancer specialists. Effective use of these innovations requires coordination of many diffuse components. For example, transitions between steps of care involve multiple actors and institutions, with distinct sets of information, procedures, policies, practices and knowledge. As Taplin and Rodgers note (2010:108), “[i]t takes the entire care process to achieve optimal cancer care. Screening is of no value without a diagnosis, and diagnosis does not improve outcome without access to comprehensive and effective treatment. This seems obvious but the care process is not studied that way.” In cancer care, coordinating across the many providers and with the patient and family members, is challenging. A human factors and systems-based approach to improving that coordination has potential to improve patient outcomes.

Identifying challenges to breast cancer care coordination at urban community-based primary care clinics.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 83-83
Author(s):  
Tamara Hamlish ◽  
Zakiya N Moton ◽  
Zuoli Zhang ◽  
Dana Sohmer ◽  
Olufunmilayo I. Olopade ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Care Coordination ◽  
Cancer Care ◽  
Medical Records ◽  
Primary Care Providers ◽  
Primary Care Visit ◽  
Patient Centered ◽  
Care Continuum ◽  
Cancer Specialists

83 Background: Primary care providers (PCPs) are well positioned to play a significant role in improving cancer care in the U.S. and achieving the Institute of Medicine (IOM) recommendation for patient-centered, coordinated, comprehensive cancer care across the care continuum. This is particularly important in underserved communities where fragmented care contributes to widening disparities in cancer mortality. However, PCPs can face considerable challenges delivering cancer care. This research examines challenges to breast cancer survivorship (BCS) care coordination at federally qualified health centers (FQHCs). Methods: We conducted a chart review at five Chicago FQHCs to assess BCS-related follow-up care provided by PCPs. We reviewed patient electronic medical records for documentation of breast cancer-related health information by the PCP and for documentation from cancer specialists, including consultant notes, pathology reports, and treatment histories. Based on BC ICD -9 codes we identified 109 patients who had a BC diagnosis within five years and a primary care visit at one of the five FQHCS within 2 years. Results: The patient population was primarily comprised of African Americans (81%), with 16% Hispanic, and 4% Asian or non-Hispanic White. Mean age at diagnosis was 55 years with 30% diagnosed < 50 years. Medicaid (59%) was the most common health insurance. More than half of the patients had ≥1 chronic disease. Critical clinical BC information was missing from patient medical records, including BC pathology (65%), mammogram (60%), last clinical breast examination (49%), and cancer specialist notes (45%). Documentation of family history and genetic counseling were missing from 76% and 98% of the records, respectively. Conclusions: Our data indicate that PCPs at FQHCs currently have a limited role in delivering IOM recommended patient-centered, coordinated, comprehensive cancer care across the care continuum. The research results underscore a need for improvement in two key areas: 1) support for PCPs to build capacity in BCS care and 2) enhanced communication and care coordination between cancer specialists and PCPS in order to make PCPs an active part of the BCS care team.

Results of a feasibility analysis of quality indicators for outpatient cancer care.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6623-6623
Author(s):  
Kerstin Hermes ◽  
Walter Baumann ◽  
Andreas Zimmermann ◽  
Stephan H. Schmitz
Keyword(s):  
Quality Of Care ◽  
Quality Indicators ◽  
Cancer Care ◽  
High Standard ◽  
Feasibility Analysis ◽  
Internal Quality ◽  
Quality Reporting ◽  
The Rich ◽  
Cancer Specialists

6623 Background: Quality indicators are increasingly used for measuring quality of care, for internal quality assurance, confidential benchmarking processes and anonymous quality reporting. The WINHO quality indicators project aims to develop and examine process quality measures for outpatient cancer care in Germany. This project is fully funded by the German Cancer Aid (Deutsche Krebshilfe). Currently, a set of 46 quality indicators exists. To gain better insights into what data can be retrieved from patient records and documentation systems in oncology practices, a feasibility analysis was conducted prior to data collection. Methods: 2176 questionnaires focusing on different aspects of the feasibility of quality indicators were sent to 295 doctors of WINHO partner practices. 1089 questionnaires were answered. Hence, for each of the 46 WINHO quality indicators 20 to 27 answers are available. Results: Although about 80% of the data required for the indicators are documented in patient charts, less than 30% of the data can be retrieved electronically. Particularly, data for indicators of the quality of pain management, holistic and palliative care often cannot be retrieved easily. By contrast, data on basal documentation, therapy planning and implementation are easier to obtain from patient charts. As a result, these indicators experience better evaluations by the office-based oncologists regarding frequency of occurrence, acceptance and reliability. However, high standard deviations show that documentation habits vary considerably within the group of office-based cancer specialists. Conclusions: Despite the large amount of data documented by oncologists in everyday practice, the information required to measure quality of care with indicators is complicated by low retrievability of data. Facilitating improved documentation and IT systems in oncology practices would ease the collection and examination of the rich information documented by office-based oncologists.

scholarly journals Gap between desired and self-determined roles of general practitioners: a multicentre questionnaire study in Japan

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Takashi Chinen ◽  
Yusuke Sasabuchi ◽  
Kazuhiko Kotani ◽  
Hironori Yamaguchi
Keyword(s):  
Palliative Care ◽  
General Practitioners ◽  
Cancer Care ◽  
Primary Care Physicians ◽  
Survivorship Care ◽  
Web Based ◽  
Care Continuum ◽  
Cancer Care Continuum ◽  
Cancer Specialists

Abstract Background Primary care physicians have diverse responsibilities. To collaborate with cancer specialists efficiently, they should prioritise roles desired by other collaborators rather than roles based on their own beliefs. No previous studies have reported the priority of roles such clinic-based general practitioners are expected to fulfil across the cancer care continuum. This study clarified the desired roles of clinic-based general practitioners to maximise person-centred cancer care. Methods A web-based multicentre questionnaire in Japan was distributed to physicians in 2019. Physician roles within the cancer care continuum were divided into 12 categories, including prevention, diagnosis, surgery, follow-up with cancer survivors, chemotherapy, and palliative care. Responses were evaluated by the proportion of three high-priority items to determine the expected roles of clinic-based general practitioners according to responding physicians in similarly designated roles. Results Seventy-eight departments (25% of those recruited) from 49 institutions returned questionnaires. Results revealed that some physicians had lower expectations for clinic-based general practitioners to diagnose cancer, and instead expected them to provide palliative care. However, some physicians expected clinic-based general practitioners to be involved in some treatment and survivorship care, though the clinic-based general practitioners did not report the same priority. Conclusion Clinic-based general practitioners prioritised involvement in prevention, diagnoses, and palliative care across the cancer continuum, although lower expectations were placed on them than they thought. Some additional expectations of their involvement in cancer treatment and survivorship care were unanticipated by them. These gaps represent issues that should be addressed.

scholarly journals A European Society of Breast Cancer Specialists (EUSOMA) előírásainak megfelelő emlőrákellátás minőségbiztosítási elemzése az Országos Onkológiai Intézetben

2016 ◽  
Vol 157 (42) ◽  
pp. 1674-1682 ◽  
Author(s):  
Mihály Újhelyi ◽  
Dávid Pukancsik ◽  
Péter Kelemen ◽  
Ákos Sávolt ◽  
Mária Gődény ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Indicators ◽  
European Society ◽  
Cancer Care ◽  
Critical Mass ◽  
Breast Cancer Mortality ◽  
Breast Cancer Care ◽  
Minimum Standards ◽  
Cancer Specialists ◽  
Diagnostic Modalities

Introduction: The European Society of Breast Cancer Specialists has created quality indicators for breast units to establish minimum standards and to ensure specialist multimodality care with the conscious aim of improving outcomes and decreasing breast cancer mortality. Aim: The aim of this study was to analyse the breast cancer care in the National Institute of Oncology according to the European Society of Breast Cancer Specialists requirements and in a large number of cases in order to present representative clinico-pathological data on the incidence of breast cancer in Hungary. Method: According to the European Society of Breast Cancer Specialists uniformed criteria clinico-pathological data of multimodality treated breast cancer cases were retrospectively analysed between June 1, 2011 and May 31, 2012. Results: During the period of interest 906 patients underwent breast surgery for malignant or benign lesions. According to the European Society of Breast Cancer Specialists quality indicators the breast cancer care of the National Institute of Oncology is eligible. Conclusions: The diagnostic modalities and multimodality care of breast cancer of the National Institute of Oncology breast unit meets the critical mass and minimum standards of the European Society of Breast Cancer Specialists criteria. Orv. Hetil., 2016, 157(42), 1674–1682.

scholarly journals Consultative workshop proceedings of the Canadian Team to Improve Community-Based Cancer Care Along the Continuum

2017 ◽  
Vol 24 (2) ◽  
pp. 135 ◽  
Author(s):  
E. Grunfeld ◽  
B. Petrovic ◽  
For the CanIMPACT Investigators
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Providers ◽  
Cancer Care ◽  
Primary Care Providers ◽  
Care Providers ◽  
Community Based ◽  
Nurse Navigator ◽  
Cancer Specialists ◽  
The Continuum

The multidisciplinary pan-Canadian canimpact (Canadian Team to Improve Community-Based Cancer Care Along the Continuum) group is studying how to improve cancer care for patients in the primary care setting. A consultative workshop hosted by the team took place on 31 March and 1 April 2016 in Toronto, Ontario. The workshop included 74 participants from 9 provinces, with representation from primary care, cancer specialties, international liaisons, knowledge users, researchers, and patients. On the agenda were presentations from canimpact phase 1 projects includingqualitative studies on the perspectives of survivors and health care providers about continuity and coordination of care;an environmental scan and systematic review of existing initiatives designed to improve care integration;population-based administrative health database analyses related to breast cancer diagnosis, treatment, and survivorship; anda qualitative study on the experiences, desired roles, and needs of primary health care providers with respect to personalized medicine.In addition, there were presentations on two possible intervention approaches, including nurse navigation and the eConsult system. Based on the information presented, participants worked in small groups to develop recommendations for phase 2, which will involve development and evaluation of an intervention to improve the integration of care between primary care providers and cancer specialists. After a process of deliberation and voting, workshop participants recommended testing the implementation of eConsult in the oncology setting to determine whether it improves relationships, communication, knowledge sharing, and connections between family doctors and cancer specialists; and, to improve system navigation, evaluating eConsult in existing nurse navigator programs, if feasible.

Clinicians’ perspectives on strategies to improve cross-institutional collaboration and coordination of pancreatic cancer care for rural patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13532-e13532
Author(s):  
Matthew DePuccio ◽  
Natasha A Kurien ◽  
Angela Sarna ◽  
Ann Scheck McAlearney ◽  
Aslam Ejaz
Keyword(s):  
Pancreatic Cancer ◽  
Decision Making ◽  
Cancer Patients ◽  
Cancer Care ◽  
High Volume ◽  
Institutional Collaboration ◽  
Phone Calls ◽  
Tumor Boards ◽  
Cancer Specialists ◽  
The Impact

e13532 Background: Rural pancreatic cancer patients often lack access to high-volume pancreatic cancer specialists. This lack of access can result in fragmented cancer care—when patients receive care at multiple institutions—and necessitates that specialists engage in cross-institutional collaboration. In the context of fragmented pancreatic cancer care, the strategies specialists use to facilitate collaboration across institutions are poorly understood. Methods: We conducted semi-structured interviews with cancer specialists (medical, surgical, and radiation oncologists) from a high-volume pancreas cancer center (n = 9) and rural community cancer centers (n = 11) to examine specialists’ coordination practices related to treating and co-managing pancreatic cancer patients across their respective institutions. Using qualitative methods, two of the co-authors independently coded the interview transcripts to identify themes related to cross-institutional coordination practices, noting improvement opportunities and facilitative strategies. Results: Cancer specialists described multiple practices to coordinate cross-institutional care including one-on-one phone calls and using a shared electronic medical record or secure email to exchange clinical notes. In recognizing the limitations of these practices, specialists acknowledged the need to develop and implement communication systems that could facilitate real-time discussions and information sharing between high-volume and rural specialists to coordinate diagnostic and treatment plans. Cross-institutional virtual tumor boards were viewed as a potentially useful approach to foster shared clinical decision-making and treatment plan development across institutions, but specialists perceived that logistical, institutional, and technological challenges could limit the use of this approach. Regardless, specialists indicated that cross-institutional virtual tumor boards could help disseminate treatment recommendations as well as identify barriers to care for mutually-shared rural cancer patients. Specialists also indicated that a dedicated patient navigator could help facilitate cross-institutional coordination by bridging communication between specialists while also assisting cancer patients with issues related to housing, transportation, scheduling, and treatment finances. Conclusions: It is important for cancer specialists treating rural cancer patients to have strategies that support efficient communication and decision-making. Cross-institutional virtual tumor boards and dedicated patient navigators are two such strategies that may help facilitate collaboration between high-volume and rural cancer specialists. Future research should examine the impact of these strategies on patients receiving cancer care at multiple institutions.

Cancer support nurses: a co-ordinating role in cancer care

1998 ◽  
Vol 7 (2) ◽  
pp. 125-128 ◽  
Author(s):  
McILLMURRAY ◽  
CUMMINGS ◽  
HOPKINS ◽  
McCANN
Keyword(s):  
Cancer Care ◽  
Cancer Support
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