scholarly journals Defining current gaps in quality measures for cancer immunotherapy: consensus report from the Society for Immunotherapy of Cancer (SITC) 2019 Quality Summit

2020 ◽  
Vol 8 (1) ◽  
pp. e000112 ◽  
Author(s):  
Sara Pai ◽  
David Blaisdell ◽  
Rachel Brodie ◽  
Robert Carlson ◽  
Heidi Finnes ◽  
...  
Keyword(s):  
Cancer Immunotherapy ◽  
Cancer Care ◽  
Expert Panel ◽  
Care Delivery ◽  
Quality Measures ◽  
Quality Measure ◽  
Long Term Outcome ◽  
Quality Cancer Care ◽  
National Quality ◽  
Immunotherapy Of Cancer

BackgroundQuality measures are important because they can help improve and standardize the delivery of cancer care among healthcare providers and across tumor types. In an environment characterized by a rapidly shifting immunotherapeutic landscape and lack of associated long-term outcome data, defining quality measures for cancer immunotherapy is a high priority yet fraught with many challenges.MethodsThus, the Society for Immunotherapy of Cancer convened a multistakeholder expert panel to,first, identify the current gaps in measures of quality cancer care delivery as it relates to immunotherapy and to,second, advance priority concepts surrounding quality measures that could be developed and broadly adopted by the field.ResultsAfter reviewing the existing quality measure landscape employed for immunotherapeutic-based cancer care, the expert panel identified four relevant National Quality Strategy domains (patient safety, person and family-centered care, care coordination and communication, appropriate treatment selection) with significant gaps in immunotherapy-based quality cancer care delivery. Furthermore, these domains offer opportunities for the development of quality measures as they relate to cancer immunotherapy. These four quality measure concepts are presented in this consensus statement.ConclusionsThis work represents a first step toward defining and standardizing quality delivery of cancer immunotherapy in order to realize its optimal application and benefit for patients.

Challenges and Opportunities in Delivering High-Quality Cancer Care: A 2016 Update

2016 ◽  
pp. e294-e300
Author(s):  
Patricia A. Ganz ◽  
Michael J. Hassett ◽  
David C. Miller
Keyword(s):  
Cancer Care ◽  
Care Delivery ◽  
Quality Measurement ◽  
Quality Measures ◽  
The United States ◽  
Institute Of Medicine ◽  
Patients With Cancer ◽  
Quality Cancer Care ◽  
Challenges And Opportunities ◽  
Quality Improvement Collaboratives

Herein, both the rationale and scope of current initiatives aimed at improving the quality of cancer care delivery in the United States are described. First, we discuss a recent report from the Institute of Medicine that issued a strong call for both the development of quality measures in oncology and implementation of a learning health care system in which data and experience from clinical practice can inform continuous improvements in cancer care. Second, we review the multiple, diverse initiatives that are underway to identify, test, and validate quality measures for the entire spectrum of cancer care. Finally, we discuss regional quality improvement collaboratives as one successful approach to creating a cycle of quality measurement, identification of best practices, and implementation of changes in practice patterns that ultimately yield improved care and outcomes for patients with cancer.

Improving the quality of oral cancer drug delivery across a health system.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 184-184
Author(s):  
Katherine Enright ◽  
Rosemary Ku ◽  
Daniela Gallo-Hershberg ◽  
Aliya Pardhan ◽  
Leta Marie Forbes
Keyword(s):  
Patient Education ◽  
Cancer Care ◽  
Care Delivery ◽  
Treatment Plan ◽  
Quality Measures ◽  
Patient Specific ◽  
Cancer Drug ◽  
Use Of Technology ◽  
Adherence Monitoring

184 Background: Oral systemic therapy (ST) presents unique care delivery challenges. Gaps in patient education and monitoring for patients on oral ST delivery are well documented and can result in decreased adherence or increased toxicity. Within Ontario, cancer care is provincially coordinated through Ontario Health- Cancer Care Ontario (OH-CCO), but locally implemented by 14 Regional Cancer Programs (RCPs). Using a centrally coordinated, but regionally implemented quality improvement (QI) approach, we aimed to improve the quality of oral ST delivery across Ontario by enabling the use of patient specific monitoring plans to optimize treatment adherence and toxicity management. Methods: Between 2018 and 2020 a 2 year focused QI project was undertaken. A suite of 19 quality measures were developed to measure different quality domains for oral ST delivery including treatment plan documentation, patient education, toxicity/adherence monitoring and toxicity outcomes. In year 1, all regions used the suite of quality measures to establish baseline performance and develop a QI plan using rapid cycle improvement methodology to improve performance in at least 1 domain based on regional gaps and priorities. Projects were implemented and evaluated during year 2. OH-CCO provided QI coaching through dissemination of standardized QI tools, a monthly discussion forum and project specific feedback. At the end of year 2, a post-implementation evaluation was performed for each region. Results: 15 centers participated, representing all RCPs across Ontario. The participating centers implemented QI projects focused on treatment plan documentation (N = 3), patient education (N = 10) and toxicity/adherence management (N = 5), with some focusing on multiple domains. All centers reported an improvement in at least 1 domain (see Table). Key enablers identified include engagement with a multi-disciplinary team and the use of technology, while barriers include lack of onsite dispensing pharmacy. Future work will continue to focus on quality of oral ST delivery and better pharmacy integration. Conclusions: Through a centrally coordinated, locally implemented QI project, improvement in quality of oral ST care was achieved across Ontario. This model of QI focus has the potential to be adaptable across health systems. [Table: see text]

Successful Strategies to Address Disparities: Insurer and Employer Perspectives

2020 ◽  
pp. 292-300
Author(s):  
Manali I. Patel ◽  
Richard Snyder ◽  
Otis Brawley
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Low Income ◽  
Cancer Care ◽  
Care Delivery ◽  
The United States ◽  
Cancer Disparities ◽  
Care Providers ◽  
High Quality ◽  
Quality Cancer Care

Disparities in cancer have been documented for decades and continue to persist despite clinical advancements in cancer prevention, detection, and treatment. Disparate cancer outcomes continue to affect many populations in the United States and globally, including racial and ethnic minorities, populations with low income and education, and residents of rural areas or low socioeconomic neighborhoods, among others. Addressing cancer disparities requires approaches that are multilevel. Addressing social determinants of health, such as removing obstacles to health (e.g., poverty, discrimination, access to housing and education, jobs with fair pay, and health care) can reduce cancer disparities. However, to achieve cancer health equity, multilevel approaches are required to ensure that access to high-quality cancer care and equitable receipt of evidence-based services can reduce cancer disparities. Policy, health system interventions, and innovative delivery and health care coverage approaches by private and public payers, employer-based payers, and labor union organizations can assist in ensuring access to and receipt of high-quality cancer care while addressing the high costs of care delivery. Partnerships among patients, caregivers, employers, health care providers, and health care payers can make impactful changes in the way in which cancer care is delivered and, in turn, can assist in reducing cancer disparities.

scholarly journals American Society of Clinical Oncology Road to Recovery Report: Learning From the COVID-19 Experience to Improve Clinical Research and Cancer Care

2021 ◽  
Vol 39 (2) ◽  
pp. 155-169
Author(s):  
Nathan A. Pennell ◽  
Melissa Dillmon ◽  
Laura A. Levit ◽  
E. Allyn Moushey ◽  
Ajjai S. Alva ◽  
...  
Keyword(s):  
Clinical Research ◽  
Cancer Care ◽  
Care Delivery ◽  
Well Being ◽  
Lessons Learned ◽  
Scientific Integrity ◽  
High Quality ◽  
Quality Cancer Care ◽  
American Society ◽  
Made In

This report presents the American Society of Clinical Oncology’s (ASCO’s) evaluation of the adaptations in care delivery, research operations, and regulatory oversight made in response to the coronavirus pandemic and presents recommendations for moving forward as the pandemic recedes. ASCO organized its recommendations for clinical research around five goals to ensure lessons learned from the COVID-19 experience are used to craft a more equitable, accessible, and efficient clinical research system that protects patient safety, ensures scientific integrity, and maintains data quality. The specific goals are: (1) ensure that clinical research is accessible, affordable, and equitable; (2) design more pragmatic and efficient clinical trials; (3) minimize administrative and regulatory burdens on research sites; (4) recruit, retain, and support a well-trained clinical research workforce; and (5) promote appropriate oversight and review of clinical trial conduct and results. Similarly, ASCO also organized its recommendations regarding cancer care delivery around five goals: (1) promote and protect equitable access to high-quality cancer care; (2) support safe delivery of high-quality cancer care; (3) advance policies to ensure oncology providers have sufficient resources to provide high-quality patient care; (4) recognize and address threats to clinician, provider, and patient well-being; and (5) improve patient access to high-quality cancer care via telemedicine. ASCO will work at all levels to advance the recommendations made in this report.

Transforming Cancer Care: Are Transdisciplinary Approaches Using Design-Thinking, Engineering, and Business Methodologies Needed to Improve Value in Cancer Care Delivery?

2014 ◽  
Vol 10 (2) ◽  
pp. e51-e54 ◽  
Author(s):  
Manali I. Patel ◽  
David Moore ◽  
Douglas W. Blayney ◽  
Arnold Milstein
Keyword(s):  
Cancer Care ◽  
Design Thinking ◽  
Care Delivery ◽  
High Quality ◽  
Quality Cancer Care

Although design-thinking and engineering methodologies have not been used in cancer care delivery transformation, there are opportunities for these methodologies to improve interventions aimed at delivering high-quality cancer care.

Application of quality indicators in breast cancer care using linked national registry and administrative claims data

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6565-6565
Author(s):  
A. Meguerditchian ◽  
A. Stewart ◽  
N. Watroba ◽  
J. Roistacher ◽  
M. Cropp ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Care ◽  
Claims Data ◽  
Quality Measures ◽  
Registry Data ◽  
Breast Cancer Surgery ◽  
Birth Date ◽  
Administrative Claims ◽  
Cancer Data ◽  
National Quality

6565 Background: The National Quality Forum (NQF) recently approved quality measures for cancer care. These are intended for application through cancer registries. Variably complete cancer registry data on outpatient care may limit application of these measures. Administrative claims matched to registries may provide more complete data. This study tested the ability to match claims with the National Cancer Data Base (NCDB) registry and to apply NQF breast cancer measures in a limited pilot in one region. Methods: Claims data from one regional payer in Western New York (WNY) were matched with registry data from the 3 WNY hospitals participating in the NCDB for 2001–2003. NQF measures for hormone therapy (HT), radiation (RT) with breast conserving surgery (BCS) and chemotherapy (CT) were applied independently using registry and claims data. Results: 480 women with this payer had claims for breast cancer surgery at the NCDB hospitals and 439 (91%) matched NCDB based on birth date, date of treatment and reporting hospital. Among these, 17 had duplicate or incomplete records. Among 422 analytic cases the median age was 54 and stage was 0 –9%; I –49%; II –33%; III –7%; IV –2%. Claims identified CT, HT and RT in substantially more cases than identified by the registry ( Table 1 ). Claims also provided information not collected by registry including specific drugs used and duration of therapy. Conclusions: Matching NCDB with payer claims is possible based on limited identifiers, and quality measures can be applied using claims. Registry data in WNY NCDB hospitals did not capture some RT, HT and CT identified by claims. Though in aggregate the registries in WNY shows substantially lower treatment rates than national NCDB averages, this study demonstrates that claims enhance registry data. Linkage of claims with NCDB may be a robust tool to apply quality measures of cancer care. No significant financial relationships to disclose. [Table: see text]

Effect of a gastrointestinal multidisciplinary clinic on the quality of pancreatic cancer care delivery at a community cancer center.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 378-378
Author(s):  
Laurence E. McCahill ◽  
Gerald P. Wright ◽  
Sunil Konduri ◽  
Mary May ◽  
Coralyn Martinez ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cancer Care ◽  
Care Delivery ◽  
Clinical Stage ◽  
Quality Measures ◽  
Cancer Center ◽  
R0 Resection ◽  
Value Assessment ◽  
Periampullary Neoplasms

378 Background: Healthcare reform calls for measurements of value in services received. The 2002 IOM report Crossing the Quality Chasm emphasized deficits in efficiency, effectiveness, and patient centeredness. In 2009, a pancreatic cancer panel proposed 43 measures for high quality pancreatic cancer care. We incorporated these composite measures into a unique program of multidisciplinary (MD) care, nurse navigation (NN), and quality monitoring. Methods: A MD gastrointestinal cancer program was initiated in Jan 2010. Key components included a treatment planning conference followed immediately by a MD clinic. A GI NN coordinated staging, clinical evaluation, and treatment initiation. Patients with suspected /newly diagnosed pancreatic or periampullary neoplasms were included. We evaluated our quality of cancer care and outcomes proposed by the pancreatic cancer quality expert panel. Results: A total of 76 patients with pancreatic neoplasms were evaluated over 18 months, 55 subjects had confirmed malignancies. Of these, 20 were clinical Stage I/II, 15 stage III and 20 Stage IV. Quality measures in Table 1 focus on quality measures. 25 patients underwent resection. Mean OR time was 424 min, mean EBL 843 mL, morbidity 30%, mortality 4%, R0 resection rate 76%, mean nodes evaluated 24, and mean hospital LOS 10 days. Complete adherence with guidelines occurred in all 30 non-operative patients and 22 of 25 patients who undergoing resection. Overall compliance for all pancreatic cancer care guidelines was 99.7%. Conclusions: Comprehensive MD pancreatic cancer evaluation and care is feasible in a community cancer. We believe this study establishes new benchmarks of quality and value assessment for pancreatic cancer programs. [Table: see text]

Sign in / Sign up

Export Citation Format

Share Document