The impact of a single disease site treatment facility on prostate cancer care in a community-hospital based radiation oncology practice

2008 ◽  
Vol 26 (15_suppl) ◽  
pp. 6626-6626 ◽  
Author(s):  
A. A. Konski ◽  
A. Howald ◽  
R. Starkey ◽  
P. Engstrom
Keyword(s):  
Prostate Cancer ◽  
Radiation Oncology ◽  
Cancer Care ◽  
Community Hospital ◽  
Treatment Facility ◽  
Disease Site ◽  
Oncology Practice ◽  
The Impact

Use of the Internet to connect radiation oncologists and medical oncologists with disease site-specific experts: 3-year outcomes of chartrounds.com.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 241-241 ◽  
Author(s):  
Patricia H. Hardenbergh ◽  
Brigitta Gehl ◽  
Kimberly Anne Lyons-Mitchell
Keyword(s):  
Radiation Oncology ◽  
Cancer Care ◽  
Medical Oncology ◽  
Tumor Board ◽  
Site Specific ◽  
Radiation Oncologists ◽  
Medical Oncologists ◽  
Tumor Boards ◽  
Disease Site ◽  
The Impact

241 Background: The purpose of this project is to improve the quality of cancer care by connecting disease site-specific experts with community oncologists through web-based technology. Methods: Chartrounds.com is a conferencing web-site developed to allow community oncologists to present real cases to disease site specialists in oncology on a scheduled basis. Chartrounds was developed initially for radiation oncologists and subsequently has expanded to include multidisciplinary tumor boards and medical oncology specific sessions. Presently 43 disease site expert oncologists including surgeons, medical oncologists and radiation oncologists from 38 academic institutions in the US host sessions. Feedback reports following the completion of each session were designed to assess the impact of the project. Results: Since its inception in December 2010, 43 disease site-specialists have lead 366 sessions, connecting 3,793 participating oncologists from all 50 US states and 24 countries.Broken down by specialty, 348 radiation oncology sessions have linked 3,632 participants, 14 medical oncology specific and multidisciplinary tumor board sessions have included 161 participants. On a 5 point Likert scale with 5 representing the greatest possible impact, the mean response to feedback questions is as follows: session quality: 4.7 for radiation oncology, 4.6 for multidisciplinary; time used effectively: 4.6 for radiation oncology, 4.5 for multidisciplinary; discussions relevant to daily practice: 4.6 for radiation oncology, 4.6 for multidisciplinary; session is likely to result in a change of practice: 4.0 for radiation oncology, 4.0 for multidisciplinary. Chartrounds sessions qualify for 1 CME credit and is approved for a practice quality improvement project by the American Board of Radiology. Conclusions: Chartrounds.com is impacting oncology practices which results in changes in community practice. Future directions of this project include providing chartrounds sessions for oncology nurses and providing a library of video recorded archived sessions. This work has been funded by the Improving Cancer Care Grant of the ASCO Conquer Cancer Foundation.

Proposed Agenda for the Measurement of Quality-of-Care Outcomes in Oncology Practice

1999 ◽  
Vol 17 (8) ◽  
pp. 2614-2614 ◽  
Author(s):  
Jeanne S. Mandelblatt ◽  
Patricia A. Ganz ◽  
Katherine L. Kahn
Keyword(s):  
Breast Cancer ◽  
Quality Of Care ◽  
Outcome Measures ◽  
Cancer Care ◽  
The United States ◽  
Leadership Role ◽  
Institute Of Medicine ◽  
Oncology Practice ◽  
The Impact

ABSTRACT: Cancer is an important disease, and health care services have the potential to improve the quality and quantity of life for cancer patients. The delivery of these services also has recently been well codified. Given this framework, cancer care presents a unique opportunity for clinicians to develop and test outcome measures across diverse practice settings. Recently, the Institute of Medicine released a report reviewing the quality of cancer care in the United States and called for further development and monitoring of quality indicators. Thus, as we move into the 21st century, professional and regulatory agencies will be seeking to expand process measures and develop and validate outcomes-oriented measures for cancer and other diseases. For such measures to be clinically relevant and feasible, it is key that the oncology community take an active leadership role in this process. To set the stage for such activities, this article first reviews broad methodologic concerns involved in selecting measures of the quality of care, using breast cancer to exemplify key issues. We then use the case of breast cancer to review the different phases of cancer care and provide examples of phase-specific measures that, after careful operationalization, testing, and validation, could be used as the basis of an agenda for measuring the quality of breast cancer care in oncology practice. The diffusion of process and outcome measures into practice; the practicality, reliability, and validity of these measures; and the impact that these indicators have on practice patterns and the health of populations will be key to evaluating the success of such quality-of-care paradigms. Ultimately, improved quality of care should translate into morbidity and mortality reductions.

Quantifying the impact of the COVID-19 pandemic on gastrointestinal cancer care delivery.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 30-30
Author(s):  
Nicholas Perkons ◽  
Casey Kim ◽  
Chris Boedec ◽  
Charles John Schneider ◽  
Ursina R. Teitelbaum ◽  
...  
Keyword(s):  
Healthcare Utilization ◽  
Radiation Oncology ◽  
Cancer Care ◽  
Hospital Admissions ◽  
Care Delivery ◽  
Morbidity And Mortality ◽  
Specific Effects ◽  
Chemotherapy Infusion ◽  
Future Work ◽  
The Impact

30 Background: Changes in healthcare utilization and delivery during the first months of the COVID-19 pandemic have altered the presentation, treatment, and management of patients with gastrointestinal (GI) malignancies. We hypothesize this has contributed to diagnostic and treatment delays that will increase disease morbidity and mortality. Methods: We performed a retrospective cohort study comparing healthcare utilization of patients with diagnosed GI malignancy (ICD10:C15-C26) during and prior to the COVID-19 pandemic within our health system. Deidentified patient encounter parameters were collected for the first 20 weeks of both 2019 and 2020, including the number of: new patient visits (NPVs), hospital admissions, and specialty encounters. Difference-in-difference analyses adjusted for week-specific and year-specific effects quantified the impact of the COVID-19 pandemic on care delivery, with week 11 of 2020 marking the start of the pandemic period. Results: The 2019 and 2020 cohorts of patients had similar demographic compositions on the basis of sex and ethnicity (2019: n = 23,536, 56.8% M, 70.4/16.3/1.9% White/Black/Hispanic; 2020: n = 25,773, 57.0% M, 70.3/16.3/2.0% White/Black/Hispanic). Across all GI malignancies, the COVID-19 pandemic period was associated with a significant decrease in NPVs (-50.0/week, -45% from 2019, p < 1e-3). Colorectal cancer (CRC) had the largest decrease in NPVs among GI malignancies (-25.3/week, -53% from 2019, p < 1e-4). Of note, there was a parallel decrease in colonoscopies during this time (-682/week, -91% from 2019, p < 1e-11). For patients with diagnosed GI malignancies, the COVID-19 pandemic was associated with statistically significant declines in hospital admissions (-31.7/week, -37% from 2019, p < 1e-5), radiology encounters (-177/week, -38% from 2019, p < 1e-6), radiation oncology encounters (-18.2/week, -12% from 2019, p < 0.01), chemotherapy infusion visits (-62.2/week, -17% from 2019, p < 1e-4), and surgery encounters (-71.1/week, -15.7% from 2019, p < 0.01). Subgroup analyses revealed these reductions were most significant in patients with CRC (radiology encounters, surgery encounters, hospital admissions), anal cancer (radiation oncology encounters), and pancreatic cancer (chemotherapy infusion visits). Conclusions: These data demonstrate that the COVID-19 pandemic is associated with significant disruptions to care delivery. While these effects were appreciated broadly across GI malignancies, CRC—diagnosed and managed by periodic screening—has been affected most acutely. The precipitous drop in screening colonoscopies likely contributed to the decline in NPVs, specialty encounters and hospital admissions. These findings underscore the importance of reinstating regular GI cancer screening and management. Future work will assess the impact of these and other changes to cancer care delivery on long term morbidity and mortality.

Establishing the need for provider education on cancer and nutrition (PECAN): Survey results on nutrition practices at a large community oncology practice.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 49-49
Author(s):  
Karen Smith ◽  
Lance Ortega ◽  
Lalan S. Wilfong ◽  
Sabrina Q. Mikan ◽  
John F. Sandbach ◽  
...  
Keyword(s):  
Nutrition Education ◽  
Cancer Care ◽  
Screening Tool ◽  
Community Practice ◽  
Provider Education ◽  
Provider Type ◽  
Large Community ◽  
Nutrition Practices ◽  
Oncology Practice ◽  
The Impact

49 Background: Oncology providers and patients benefit from evidence-based nutritional resources to support cancer care. For patients, proper nutrition care can prevent inappropriate weight loss, improve treatment tolerance, and improve quality of life. Recent literature has noted the lack of both adequate dietitian resources at outpatient centers and comprehensive nutrition guidelines in cancer care. At a large community practice with 210 locations across Texas and Oklahoma, a survey was developed and administered to assess nutrition practices. Methods: Clinic directors in the practice completed a survey to assess for the presence or absence of a malnutrition screen; how nutrition concerns are addressed; and the availability of a dietitian. Results: A total of 26 responses detailed the nutrition processes at 50 unique locations. At 37 (74%) locations, a malnutrition screening tool was utilized and of these, 30 (81%) locations reported utilizing the Malnutrition Screening Tool (MST), a brief, validated tool for outpatient settings including oncology. Seven (19%) sites did not specify what tool was used. Of the clinics that reported completing a malnutrition screen for patients, the screen was completed by the advanced practice provider (APP)/physician in 18 (49%) clinics, a nurse in 4 (11%) clinics, a dietitian in 4 (11%) clinics and a medical assistant in 1 (3%) clinic. At 10 sites more than one provider type was responsible for completing the screen. Nutrition issues were addressed by physicians, APPs, and nurses in 15 (50%), 35 (70%), and 9 (14%) sites respectively (see table). Twenty-two locations (44%) reported referring patients to a dietitian and 10 sites (20%) had a dietitian available in clinic. Forty-one (82%) clinics employed more than one method for addressing nutrition issues. Sixteen of 26 respondents (62%) reported that increased dietitian access would be helpful; this included respondents whose locations already had a dietitian available. Conclusions: Overall, 74% of reporting locations used a malnutrition screening tool and 20% had access to a dietitian on site. Forty-four percent of sites referred to a dietitian if there was a need. This indicates that multiple providers are involved in the nutritional care of oncology patients. In response to these findings, the multidisciplinary PECAN Taskforce was created to develop comprehensive malnutrition screening, implement a referral process for all at-risk patients, enhance nutrition education, and expand dietitian services. Further study will measure the impact of expanded nutrition access on patient outcomes.[Table: see text]

Embedding Supervised Exercise Training for Men on Androgen Deprivation Therapy Into Standard Prostate Cancer Care: A Feasibility and Acceptability Study

2021 ◽  
Author(s):  
Sophie Reale ◽  
Rebecca Turner ◽  
Eileen Sutton ◽  
Liz Steed ◽  
Stephanie Taylor ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Exercise Training ◽  
Androgen Deprivation Therapy ◽  
Cancer Care ◽  
Professional Training ◽  
Androgen Deprivation ◽  
Face To Face ◽  
Supervised Exercise ◽  
Rate Maximum ◽  
The Impact

Abstract Lifestyle interventions involving exercise training offset the adverse effects of androgen deprivation therapy in men with prostate cancer (PCa). Yet provision of integrated exercise pathways in cancer care is sparse. This study assessed the feasibility and acceptability of an embedded supervised exercise training intervention into standard PCa care in a single-arm, multicentre prospective cohort study. Feasibility included recruitment, retention, adherence, fidelity and safety. Acceptability of behaviourally informed healthcare and exercise professional training was assessed qualitatively. Despite the imposition of lockdown for the COVID-19 pandemic, referral rates into and adherence to, the intervention was high. Of the 45 men eligible for participation, 79% received the intervention. Patients completed a mean of 27 minutes of aerobic exercise per session (SD=3.48), at 77% heart rate maximum (92% of target dose), and 3 sets of 10 reps of 3 resistance exercises twice weekly for 12 weeks, without serious adverse event. The intervention was delivered by healthcare and exercise professionals with moderate to high fidelity and the intervention was deemed highly acceptable to patients. The impact of societal changes due to the pandemic on the delivery of this face-to-face intervention remain uncertain but positive impacts of embedding exercise provision into PCa care warrant long-term investigation.

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