Areas for quality improvement in pediatric supportive oncology services.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 146-146
Author(s):  
Jennifer Reichek ◽  
Christine B. Weldon ◽  
Eugene Suh ◽  
Julia Rachel Trosman ◽  
Stacy D. Sanford ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Pediatric Cancer ◽  
Cancer Care ◽  
Care Delivery ◽  
Institute Of Medicine ◽  
Supportive Services ◽  
Care Community ◽  
Pediatric Cancer Patients ◽  
Survey Results ◽  
Supportive Oncology

146 Background: In 2013, the Institute of Medicine report recommended that supportive oncology services be initiated at time of diagnosis. Providers of pediatric cancer care in the Chicagoland community, supported by The Coleman Foundation, sought to define areas for quality improvement of supportive oncology delivery to children. Methods: Focus groups and surveys with clinicians providing pediatric cancer care and supportive services at 14 sites were used to prioritize areas needing improvement. Results: 100% (14/14) of sites participated. Of the eligible sites, 6 were pediatric cancer treatment sites and 8 cancer care community organizations. Sites demonstrated consistent agreement for 8 of the 12 areas of focus for improvement. Over 50% of sites reported areas of focus (table) as important or very important. Conclusions: Sites identified the need for quality improvement in delivery of psychosocial, survivorship and palliative care for pediatric cancer patients. Survey results demonstrate a need for collaboration and efforts to guide care delivery improvement across sites. [Table: see text]

Areas for quality improvement in pediatric supportive oncology services.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e22022-e22022
Author(s):  
Jennifer Reichek ◽  
Christine B. Weldon ◽  
Rani Ganesan ◽  
Eugene Suh ◽  
Dipti Dighe ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Pediatric Cancer ◽  
Cancer Care ◽  
Care Delivery ◽  
Institute Of Medicine ◽  
Supportive Services ◽  
Care Community ◽  
Pediatric Cancer Patients ◽  
Survey Results ◽  
Supportive Oncology

e22022 Background: In 2013, the Institute of Medicine report recommended that supportive oncology services be initiated at time of diagnosis. Providers of pediatric cancer care in the Chicagoland community, supported by The Coleman Foundation, sought to define areas for quality improvement of supportive oncology delivery to children. Methods: Focus groups and surveys with clinicians providing pediatric cancer care and supportive services at 14 sites were used to prioritize areas needing improvement. Results: 100% (14/14) of sites participated. Of the eligible sites, 6 were pediatric cancer treatment sites and 8 cancer care community organizations. Sites demonstrated consistent agreement for 8 of the 12 areas of focus for improvement. Over 50% of sites reported areas of focus (table) as important or very important. Conclusions: Sites identified the need for quality improvement in delivery of psychosocial, survivorship and palliative care for pediatric cancer patients. Survey results demonstrate a need for collaboration and efforts to guide care delivery improvement across sites. [Table: see text]

Multi-institution quality improvement in supportive oncology: Results of the Coleman Supportive Oncology Collaborative (CSOC).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6606-6606
Author(s):  
Paramjeet Khosla ◽  
Julia Rachel Trosman ◽  
Betty Roggenkamp ◽  
Teresa Lillis ◽  
Joanna Martin ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Care Delivery ◽  
Safety Net ◽  
Training Methods ◽  
Institute Of Medicine ◽  
Quality Improvements ◽  
Exact Test ◽  
Oncology Care ◽  
Supportive Oncology ◽  
Oncology Practice

6606 Background: The Institute of Medicine and Commission on Cancer recommend systematic delivery of supportive oncology care for cancer patients. The CSOC is focused on quality improvement (QI) of supportive care across Chicago cancer centers (Weldon ASCO ’17). Supportive oncology includes distress, practical, family, physical, nutrition, pain, fatigue and care concerns. To support QI, cross-institution teams developed unique, relevant tools, methods, care delivery processes, patient handouts and online training. Methods: Ten centers (5 academic, 1 VA, 1 public, 2 safety net, 1 community) implemented supportive oncology screening and care delivery quality improvements. Centers collected data for relevant Quality Oncology Practice Initiative (QOPI) metrics. Analyses used simple frequencies and Fishers exact test. Results: Five of six QOPI measures were improved at statistically significant levels from 2014 to 2017, p < .00001. Improvements are more modest in 2016 & 2017 as 4 of the centers started this QI in 2017. Conclusions: The CSOC achieved significant improvements in supportive oncology screening and identifying and addressing patients’ needs and concerns. Additional work is needed to improve these measures to achieve the best quality of cancer care possible for every patient based on their needs and concerns. [Table: see text]

Multi-institution quality improvement in supportive oncology: Results of the Coleman Supportive Oncology Collaborative (CSOC).

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 33-33
Author(s):  
Julia Rachel Trosman ◽  
Betty Roggenkamp ◽  
Paramjeet Khosla ◽  
Teresa Lillis ◽  
Joanna Martin ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Care Delivery ◽  
Safety Net ◽  
Training Methods ◽  
Institute Of Medicine ◽  
Quality Improvements ◽  
Exact Test ◽  
Oncology Care ◽  
Supportive Oncology ◽  
Oncology Practice

33 Background: The Institute of Medicine and Commission on Cancer recommend systematic delivery of supportive oncology care for cancer patients. The CSOC is focused on quality improvement (QI) of supportive care across Chicago cancer centers (Weldon ASCO ’17). Supportive oncology includes distress, practical, family, physical, nutrition, pain, fatigue and care concerns. To support QI, cross-institution teams developed unique, relevant tools, methods, care delivery processes, patient handouts and online training. Methods: Ten centers (5 academic, 1 VA, 1 public, 2 safety net, 1 community) implemented supportive oncology screening and care delivery quality improvements. Centers collected data for relevant Quality Oncology Practice Initiative (QOPI) metrics. Analyses used simple frequencies and Fishers exact test. Results: Five of six QOPI measures were improved at statistically significant levels from 2014 to 2017, p < .00001. Improvements are more modest in 2016 & 2017 as 4 of the centers started this QI in 2017. Conclusions: The CSOC achieved significant improvements in supportive oncology screening and identifying and addressing patients’ needs and concerns. Additional work is needed to improve these measures to achieve the best quality of cancer care possible for every patient based on their needs and concerns. [Table: see text]

scholarly journals Playful strategies to foster the well-being of pediatric cancer patients in the Brazilian Unified Health System: a design thinking approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leandro Miletto Tonetto ◽  
Valentina Marques da Rosa ◽  
Priscila Brust-Renck ◽  
Megan Denham ◽  
Pedro Marques da Rosa ◽  
...  
Keyword(s):  
Health System ◽  
Cancer Patients ◽  
Pediatric Cancer ◽  
Cancer Care ◽  
Design Thinking ◽  
Care Delivery ◽  
Well Being ◽  
Subjective Well Being ◽  
Unified Health System ◽  
Pediatric Cancer Patients

Abstract Background Cancer care can negatively impact children’s subjective well-being. In this research, well-being refers to patients’ self-perception and encompasses their hospital and care delivery assessment. Playful strategies can stimulate treatment compliance and have been used to provide psychosocial support and health education; they can involve gamification, virtual reality, robotics, and healthcare environments. This study aims to identify how playfulness, whenever applicable, can be used as a strategy to improve the subjective well-being of pediatric cancer patients in the Brazilian Unified Health System. Methods Sixteen volunteers with experience in pediatric oncology participated in the study. They were physicians, psychologists, child life specialists, and design thinking professionals. They engaged in design thinking workshops to propose playful strategies to improve the well-being of pediatric cancer patients in the Brazilian Unified Health System. Data collection consisted of participatory observations. All activities were video recorded and analyzed through Thematic Analysis. The content generated by the volunteers was classified into two categories: impact of cancer care on children’s self-perception and children’s perceptions of the hospital and the care delivery. Results Volunteers developed strategies to help children deal with time at the hospital, hospital structure, and care delivery. Such strategies are not limited to using playfulness as a way of “having fun”; they privilege ludic interfaces, such as toys, to support psychosocial care and health education. They aim to address cancer and develop communication across families and staff in a humanized manner, educate families about the disease, and design children-friendly environments. Volunteers also generated strategies to help children cope with perceptions of death, pain, and their bodies. Such strategies aim to support understanding the meaning of life and death, comprehend pain beyond physicality, help re-signify cancer and children’s changing bodies, and give patients active voices during the treatment. Conclusions The paper proposes strategies that can improve the well-being of pediatric cancer patients in the Brazilian Unified Health System. Such strategies connect children’s experiences as inpatients and outpatients and may inform the implementation of similar projects in other developing countries.

Raising all boats in supportive oncology: Initial impact of the Coleman Supportive Oncology Collaborative (CSOC).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18205-e18205
Author(s):  
Christine B. Weldon ◽  
James Gerhart ◽  
William Dale ◽  
Urjeet Patel ◽  
Paramjeet Khosla ◽  
...  
Keyword(s):  
Care Delivery ◽  
Safety Net ◽  
Screening Tools ◽  
Institute Of Medicine ◽  
Exact Test ◽  
Care Processes ◽  
Ongoing Work ◽  
Implementation Period ◽  
Supportive Oncology ◽  
The Impact

e18205 Background: The Institute of Medicine (IOM) and Commission on Cancer (CoC) recommend systematic delivery of supportive oncology and survivorship care to all cancer patients. CSOC aims to improve the quality of supportive care across Chicago-area providers. Methods: 35 CSOC participating institutions (cancer centers, support centers, hospice) formed care delivery design teams Distress, Survivorship & Palliative. Teams collaboratively developed solutions to supportive oncology gaps: patient screening tools, care delivery processes, provider training, and quality metrics to assess supportive oncology quality and the CSOC impact. Six implementation centers (2 safety-net, 3 academic & 1 public) reviewed charts at baseline (2014 diagnoses) and after the initial implementation period (2015 diagnoses), compared by frequencies and Fisher’s exact test. Results: Eight metrics contained patient data at 2 time points; improvements were seen in 7/8 metrics. Conclusions: CSOC developed supportive oncology screening, and care processes aligned with IOM and CoC standards. Significant improvements were shown after implementation across diverse settings. Ongoing work will further evaluate the impact of CSOC efforts on patient care. [Table: see text]

Quality improvement and implementation science in cancer care: Identifying areas of synergy and opportunities for further integration.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 29-29
Author(s):  
Devon Check ◽  
Leah L. Zullig ◽  
Melinda Davis ◽  
Angela M. Stover ◽  
Louise Davies ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Implementation Science ◽  
Cancer Care ◽  
Performance Monitoring ◽  
Care Delivery ◽  
Evidence Based ◽  
Theoretical Frameworks ◽  
Randomized Design ◽  
Stakeholder Input ◽  
The Impact

29 Background: Efforts to improve cancer care delivery have been driven by two approaches: quality improvement (QI) and implementation science (IS). QI and IS have developed independently but have potential for synergy. To inform efforts to better align these fields, we examined 20 cancer-related QI and IS articles to identify differences and areas of commonality. Methods: We searched PubMed for cancer care studies that used IS or QI methods and were published in the past 5 years in one of 17 leading journals. Through consensus-based discussions, we categorized studies as QI if they evaluated efforts to improve the quality, value, or safety of care, or IS if they evaluated efforts to promote the adoption of evidence-based interventions into practice. We identified the 10 most frequently cited studies from each category (20 total studies), characterizing and comparing their objectives, methods – including use of theoretical frameworks involvement of stakeholders – and terminology. Results: All IS studies (10/10) and half (5/10) of QI studies addressed barriers to uptake of evidence-based practices. The remaining five QI studies sought to improve clinical outcomes, reduce costs, and/or address logistical issues. QI and IS studies employed common approaches to change provider and/or organizational practice (e.g., training, performance monitoring/feedback, decision support). However, the terminology used to describe these approaches was inconsistent within and between IS and QI studies. Fewer than half (8/20) of studies (4 from each category) used a theoretical or conceptual framework and only 4/20 (2 from each category) consulted key stakeholders in developing their approach. Most studies (10/10 IS and 6/10 QI) were multi-site, and most were observational, with only 4/20 studies (2 from each category) using a randomized design to evaluate their approach. Conclusions: Cancer-related QI and IS studies had overlapping objectives and used similar approaches but used inconsistent terminology. The impact of IS and QI on cancer care delivery could be enhanced by greater harmonization of language and by promoting rigor through the use of conceptual frameworks and stakeholder input.

scholarly journals Using Quality Improvement Methods and Time-Driven Activity-Based Costing to Improve Value-Based Cancer Care Delivery at a Cancer Genetics Clinic

2016 ◽  
Vol 12 (3) ◽  
pp. e320-e331 ◽  
Author(s):  
Ryan Y.C. Tan ◽  
Marie Met-Domestici ◽  
Ke Zhou ◽  
Alexis B. Guzman ◽  
Soon Thye Lim ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Cancer Care ◽  
Cancer Genetics ◽  
Care Delivery ◽  
Genetic Counselor ◽  
Activity Based Costing ◽  
Improvement Project ◽  
Personnel Costs ◽  
Number Of Patients ◽  
The Impact

Purpose: To meet increasing demand for cancer genetic testing and improve value-based cancer care delivery, National Cancer Centre Singapore restructured the Cancer Genetics Service in 2014. Care delivery processes were redesigned. We sought to improve access by increasing the clinic capacity of the Cancer Genetics Service by 100% within 1 year without increasing direct personnel costs. Methods: Process mapping and plan-do-study-act (PDSA) cycles were used in a quality improvement project for the Cancer Genetics Service clinic. The impact of interventions was evaluated by tracking the weekly number of patient consultations and access times for appointments between April 2014 and May 2015. The cost impact of implemented process changes was calculated using the time-driven activity-based costing method. Results: Our study completed two PDSA cycles. An important outcome was achieved after the first cycle: The inclusion of a genetic counselor increased clinic capacity by 350%. The number of patients seen per week increased from two in April 2014 (range, zero to four patients) to seven in November 2014 (range, four to 10 patients). Our second PDSA cycle showed that manual preappointment reminder calls reduced the variation in the nonattendance rate and contributed to a further increase in patients seen per week to 10 in May 2015 (range, seven to 13 patients). There was a concomitant decrease in costs of the patient care cycle by 18% after both PDSA cycles. Conclusion: This study shows how quality improvement methods can be combined with time-driven activity-based costing to increase value. In this paper, we demonstrate how we improved access while reducing costs of care delivery.

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 ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
United Arab Emirates ◽  
Health Care Providers ◽  
Cancer Care ◽  
Care Delivery ◽  
Global Scale ◽  
The Philippines ◽  
Care Providers ◽  
The Impact

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.

Effective Communication for Newly Diagnosed Pediatric Patients With Cancer: Considerations for the Patients, Family Members, Providers, and Multidisciplinary Team

2019 ◽  
pp. 573-581 ◽  
Author(s):  
Sarah Dobrozsi ◽  
Amy Trowbridge ◽  
Jennifer W. Mack ◽  
Abby R. Rosenberg
Keyword(s):  
Communication Skills ◽  
Pediatric Cancer ◽  
Multidisciplinary Team ◽  
Cancer Care ◽  
Care Delivery ◽  
Effective Communication ◽  
Well Being ◽  
Medical Team ◽  
High Quality ◽  
Personalized Care

Hearing that a child has been diagnosed with cancer is invariably difficult for both patients and their caregivers. Effective communication among patients, caregivers, and medical teams is necessary not only to deliver information and facilitate cancer care delivery but also to support patient and family coping and well-being. In this review, we focus on early communication in pediatric oncology care to (1) highlight the importance of communication between clinicians and patients and within the medical team and (2) describe resources and opportunities for clinicians to improve communication skills. For example, communication between patients and the medical team has several core functions, including the development of shared knowledge and decision-making and the formation of a therapeutic relationship. High-quality communication, regardless of the news being shared, supports and facilitates patient and parent adjustment to diagnosis, hope, and trust. Communication within the medical team supports the delivery of high-quality, personalized care. Despite these critical roles of communication in pediatric cancer care and evidence suggesting communication skills can be learned, formal training is limited. Resources include educational efforts, practical tools, and specific strategies to enhance systematic multidisciplinary team communication. Taken together, continued recognition of the importance of communication in pediatric cancer care has the potential to improve patient, family, and clinician experiences.

Tobacco use among pediatric cancer patients: recommendations for developing clinical smoking interventions.

1997 ◽  
Vol 15 (6) ◽  
pp. 2194-2204 ◽  
Author(s):  
V L Tyc ◽  
M M Hudson ◽  
P Hinds ◽  
V Elliott ◽  
M Y Kibby
Keyword(s):  
Cancer Patients ◽  
Tobacco Use ◽  
Pediatric Cancer ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Smoking Prevention ◽  
Current Status ◽  
Adolescent Cancer ◽  
Pediatric Cancer Patients ◽  
Successful School

PURPOSE AND METHODS: The current status of tobacco use among young cancer patients and the acute and chronic complications associated with tobacco use in these patients is reviewed. RESULTS AND CONCLUSION: Studies report that adolescent cancer survivors use tobacco as much as their peers who have never been treated for cancer, despite the adverse consequences of engaging in this unhealthy habit. Health care professionals have the opportunity and responsibility to incorporate tobacco counseling as a routine component of medical care delivery. Nurse/physician-delivered smoking interventions have been found to promote smoking cessation in adults, although little effort has been devoted to the development of similarly effective smoking interventions for pediatric cancer patients who smoke. Components of existing smoking prevention/cessation curricula from successful school-based interventions and physician-delivered smoking interventions can be adapted and tailored to pediatric cancer patients in medical settings. Smoking interventions that educate patients about their increased vulnerability to tobacco-related consequences, relative to their healthy peers, may have an enhanced impact. Guidelines for conducting a comprehensive assessment of tobacco use and implementing smoking interventions with pediatric cancer patients is provided. Strategies for modifying the cancer patient's perceived vulnerability to tobacco-related consequences is also discussed.

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