scholarly journals Spotlight on International Quality: COVID-19 and Its Impact on Quality Improvement in Cancer Care

2021 ◽  
pp. 1513-1521
Author(s):  
Douglas W. Blayney ◽  
Giovanni Bariani ◽  
Devika Das ◽  
Shaheenah Dawood ◽  
Michael Gnant ◽  
...  

This report from ASCO's International Quality Steering Group summarizes early learnings on how the COVID-19 pandemic and its stresses have disproportionately affected cancer care delivery and its delivery systems across the world. This article shares perspectives from eight different countries, including Austria, Brazil, Ghana, Honduras, Ireland, the Philippines, South Africa, and the United Arab Emirates, which provide insight to their unique issues, challenges, and barriers to quality improvement in cancer care during the pandemic. These perspectives shed light on some key recommendations applicable on a global scale and focus on access to care, importance of expanding and developing new treatments for both COVID-19 and cancer, access to telemedicine, collecting and using COVID-19 and cancer registry data, establishing measures and guidelines to further enhance quality of care, and expanding communication among governments, health care systems, and health care providers. The impact of the COVID-19 pandemic on cancer care and quality improvement has been and will continue to be felt across the globe, but this report aims to share these experiences and learnings and to assist ASCO's international members and our global fight against the pandemic and cancer.

Author(s):  
Manali I. Patel ◽  
Richard Snyder ◽  
Otis Brawley

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.


2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Diego Sadler ◽  
◽  
Jeanne M. DeCara ◽  
Joerg Herrmann ◽  
Anita Arnold ◽  
...  

Abstract Background Re-allocation of resources during the COVID-19 pandemic has resulted in delays in care delivery to patients with cardiovascular disease and cancer. The ability of health care providers to provide optimal care in this setting has not been formally evaluated. Objectives To assess the impact of COVID-19 resource re-allocation on scheduling, testing, elective procedures, telemedicine access, use of new COVID-19 therapies, and providers’ opinions on healthcare policies among oncology and cardiology practitioners. Methods An electronic survey was conducted by a cardio-oncology collaborative network through regional and state chapters of the American College of Cardiology, American Society of Clinical Oncology, and the International Cardio-Oncology Society. Descriptive statistics were reported by frequency and proportion for analyses, and stratified categorically by geographic region and specialty. Results One thousand four hundred fifteen providers (43 countries) participated: 986 cardiologists, 306 oncologists, and 118 trainees/internal medicine. 63% (195/306) of oncologists vs 92% (896/976) of cardiologists reported cancellations of treatments/elective procedures (p = 0.01). 46% (442/970) of cardiologists and 25% (76/303) of oncologists modified the scope of their practice (p = < 0.001). Academic physicians (74.5%) felt better supplied with personal protective equipment (PPE) vs non-academic (74.5% vs 67.2%; p = 0.018). Telemedicine was less common in Europe 81% (74/91), and Latin America 64% (101/158), than the United States, 88% (950/1097) (p = < 0.001). 95% of all groups supported more active leadership from medical professional societies. Conclusions These results support initiatives to promote expanded coverage for telemedicine, increased access to PPE, better testing availability and involvement of medical professional societies to help with preparedness for future health care crisis.


2017 ◽  
Vol 34 (4) ◽  
pp. 261-271 ◽  
Author(s):  
Catherine M. Laing ◽  
Nancy J. Moules ◽  
Andrew Estefan ◽  
Mike Lang

The purpose of this philosophical hermeneutic study was to understand the effects on health care providers (HCPs) of watching digital stories made by (past and present) pediatric and adolescent/young adult (AYA) oncology patients. Twelve HCPs participated in a focus group where they watched digital stories made by pediatric/AYA oncology patients and participated in a discussion related to the impact the stories had on them personally and professionally. Findings from this research revealed that HCPs found digital stories to be powerful, therapeutic, and educational tools. Health care providers described uses for digital stories ranging from education of newly diagnosed families to training of new staff. Digital stories, we conclude, can be an efficient and effective way through which to understand the patient experience, implications from which can range from more efficient patient care delivery to decision making. Recommendations for incorporating digital storytelling into healthcare delivery are offered.


2020 ◽  
Author(s):  
Fatima Y. AL Hashmi ◽  
Abeer Al Zuabi ◽  
Ibrahim Y. Hachim ◽  
Guido H.H. Mannaerts ◽  
Omar Bekdache

Background Since its emergence in December 2019, the Novel Coronavirus (COVID-19) pandemic resulted in a profound impact on the health care system worldwide. We propose herein to evaluate the impact of implementing conservative management as an alternative approach to surgical appendectomy in the treatment of proven acute appendicitis during COVID19 pandemic. Methods Our study is a prospective multicenter study that includes a cohort of 160 patients admitted to the surgical departments in both Tawam Hospital and Sheikh Shakhbout Medical City, Abu Dhabi, UAE, for the period from February 2020 till July 2020. Results Our results showed that 56 of our patients (35%) were treated conservatively, while the other 104 (65%) underwent operative management. There was a significant decrease in length of hospital stay (LOS) (2.32 days) among the first group compared to the second (2.8 days). Also, short term follow-up showed that 90% of those patients did not require further operative intervention or developed any serious complications. Out of the 110 patients that were swapped for COVID19, nine (8.18%) were confirmed to be positive. Our protocol was to avoid surgical management for COVID19 positive patients unless indicated. This resulted in (8/9) of COVID19 positive patients to be treated conservatively. Follow up was achieved by using telemedicine-based follow-up with the aim of empowering social distancing and reducing risk of viral exposure to patients as well as the health care providers. In conclusion, our results showed that the implementation of conservative management in treating patients with acute appendicitis who were COVID19 positive is a safe and feasible approach that maybe essential in reducing viral transmission risks as well as avoiding operative risks on COVID19 positive patients.


2020 ◽  
pp. 15-17
Author(s):  
Alan H Rosenstein

Healthcare is a complex multidimensional system that depends upon effective communication and collaboration amongst all members of the health care team as the key ingredient for best patient care. In the current health care environment all health care providers are feeling the growing pressures on care delivery and the changing health dynamics which in many instances has negatively impacted their attitudes and behaviors toward medical care. Nursing is a key part of this process. In order to provide best patient care, affiliated organizations need to recognize how important staff satisfaction and engagement is to care continuity and provide the necessary resources and support to maintain staff physical, emotional, and behavioral well- being. The aim of the article is to review key literature findings to help organizations recognize the causes and consequences of stress and burnout and the importance of providing the appropriate support and resources to help nurses succeed.


2020 ◽  
Author(s):  
Diego Sadler ◽  
Jeanne M. DeCara ◽  
Joerg Herrmann ◽  
Anita Arnold ◽  
Arjun K. Ghosh ◽  
...  

Abstract BackgroundRe-allocation of resources during the COVID-19 pandemic has resulted in delays in care delivery to patients with cardiovascular disease and cancer. The ability of health care providers to provide optimal care in this setting has not been formally evaluated.ObjectivesTo assess the impact of COVID-19 resource re-allocation on scheduling, testing, elective procedures, telemedicine access, use of new COVID-19 therapies, and providers’ opinions on healthcare policies among oncology and cardiology practitioners.MethodsAn electronic survey was conducted by a cardio-oncology collaborative network through regional and state chapters of the American College of Cardiology , American Society of Clinical Oncology, and the International Cardio-Oncology Society. Descriptive statistics were reported by frequency and proportion for analyses, and stratified categorically by geographic region and specialty.Results1,415 providers (43 countries) participated: 986 cardiologists, 306 oncologists, and 118 trainees/internal medicine. 63% (195/306) of oncologists vs 92% (896/976) of cardiologists reported cancellations of treatments/elective procedures (p=0.01). 46% (442/970) of cardiologists and 25% (76/303) of oncologists modified the scope of their practice (p=<0.001). Academic physicians (74.5%) felt better supplied with personal protective equipment (PPE) vs non-academic (74.5% vs 67.2%; p=0.018). Telemedicine was less common in Europe 81% (74/91), and Latin America 64% (101/158), than the United States, 88% (950/1,097) (p=<0.001). 95% of all groups supported more active leadership from medical professional societies.ConclusionsThese results support initiatives to promote expanded coverage for telemedicine, increased access to PPE, better testing availability and involvement of medical professional societies to help with preparedness for future health care crisis.Appendix: Link to the Survey: https://www.surveymonkey.com/r/C8ZDYNW


1998 ◽  
Vol 16 (4) ◽  
pp. 1628-1630 ◽  

In his Presidential address on May 17, 1996, Dr John Glick proposed the formation of the American Federation of Clinical Oncologic Societies (AFCOS), a coalition of all professional clinical oncology societies. AFCOS was intended to address heightened concerns about changes in the health care delivery system and the impact that they may have on quality patient care. AFCOS places primary emphasis on educating patients, their families, health care providers, payors, legislators, regulators, and the general public about what constitutes quality care, advocating access to and coverage for such care, including clinical trials, and supporting and promoting patient-oriented research. Several meetings of the coalition have resulted in the development of a consensus statement on quality cancer care, which the Journal of Clinical Oncology is pleased to publish in this edition. The consensus statement was the product of collaboration among the Federation's nine member societies as well as national patient advocacy groups represented by the Cancer Leadership Council.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18559-e18559
Author(s):  
Dhanya Kumar ◽  
Sana Khateeb ◽  
Manali I. Patel

e18559 Background: The SARS‐CoV‐2/COVID‐19 pandemic greatly impacted the health of many patients with cancer. We conducted in-depth interviews with patients across the United States to better understand the effect of the COVID-19 pandemic on their cancer care, emotional and mental health, and to solicit suggestions for how health care providers could mitigate these concerns. Methods: We contacted respondents from the Impact of COVID-19 on Cancer parent study. The parent study used a snowball sampling approach to survey patients nationally regarding cancer delays between April 2020 and October 2020. We invited all respondents who volunteered for future studies to participate in a 40-minute interview regarding their experiences and suggestions for how health care providers could mitigate COVID19-related concerns. Interviews were conducted between August 2020 and October 2020, recorded, transcribed and analyzed using qualitative thematic content analysis. Results: A total of 34 participants were contacted and consented to participate in this study. Four overarching themes were identified: (1) significant concern regarding infection risk; (2) concerns regarding care changes, such as delays, worsening cancer outcomes; (3) concern regarding loss of employment, health insurance, and transportation on cancer treatment, affordability, and prognosis; and (4) worsening emotional and mental health due to social isolation. Suggestions for the clinical team included: 1) specific and direct guidance from health care providers on how to mitigate infection risk; 2) screening for and access to mental health services; 3) continuation of cancer treatment, surveillance, and clinical trials without delays and 4) allowing caregivers to attend appointments. Conclusions: In this national qualitative study of patients with cancer, participants identified that COVID-19 and modifications to their cancer care worsened their emotional and mental health with growing concerns about the impact of the virus and socioeconomic status on their cancer outcomes. Specific suggestions for health care providers, such as anticipatory guidance, access to mental health services, and expanded visitation should be considered to improve patient experiences with care during the pandemic.


2019 ◽  
Vol 14 (6) ◽  
pp. 941-953 ◽  
Author(s):  
Kianoush Kashani ◽  
Mitchell Howard Rosner ◽  
Michael Haase ◽  
Andrew J.P. Lewington ◽  
Donal J. O'Donoghue ◽  
...  

AKI is a global concern with a high incidence among patients across acute care settings. AKI is associated with significant clinical consequences and increased health care costs. Preventive measures, as well as rapid identification of AKI, have been shown to improve outcomes in small studies. Providing high-quality care for patients with AKI or those at risk of AKI occurs across a continuum that starts at the community level and continues in the emergency department, hospital setting, and after discharge from inpatient care. Improving the quality of care provided to these patients, plausibly mitigating the cost of care and improving short- and long-term outcomes, are goals that have not been universally achieved. Therefore, understanding how the management of AKI may be amenable to quality improvement programs is needed. Recognizing this gap in knowledge, the 22nd Acute Disease Quality Initiative meeting was convened to discuss the evidence, provide recommendations, and highlight future directions for AKI-related quality measures and care processes. Using a modified Delphi process, an international group of experts including physicians, a nurse practitioner, and pharmacists provided a framework for current and future quality improvement projects in the area of AKI. Where possible, best practices in the prevention, identification, and care of the patient with AKI were identified and highlighted. This article provides a summary of the key messages and recommendations of the group, with an aim to equip and encourage health care providers to establish quality care delivery for patients with AKI and to measure key quality indicators.


2016 ◽  
Vol 12 (11) ◽  
pp. 1115-1122 ◽  
Author(s):  
Allison Magnuson ◽  
James Wallace ◽  
Beverly Canin ◽  
Selina Chow ◽  
William Dale ◽  
...  

We present the case of a 92-year-old man, MH, who was given a diagnosis of colorectal cancer. His primary care physician, surgeon, geriatric oncologist, and family members all played important roles in his care. MH’s case is an example of a lack of explicit shared goal setting by the health care providers with the patient and family members and how that impeded care planning and health. This case demonstrates the importance of explicitly discussing and establishing shared goals in team-based cancer care delivery early on and throughout the care process, especially for older adults. Each individual member’s goals should be understood as they fit within the overarching shared team goals. We emphasize that shared goal setting and alignment of individual goals is a dynamic process that must occur several times at critical decision points throughout a patient’s care continuum. Providers and researchers can use this illustrative case to consider their own work and contemplate how shared goal setting can improve patient-centered care and health outcomes in various team-based care settings. Shared goal setting among team members has been demonstrated to improve outcomes in other contexts. However, we stress, that little investigation into the impact of shared goal setting on team-based cancer care delivery has been conducted. We list immediate research goals within team-based cancer care delivery that can provide a foundation for the understanding of the process and outcomes of shared goal setting.


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