Building a cancer registry performance dashboard by leveraging existing workflow documents at a comprehensive cancer center.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 296-296
Author(s):  
Jing Jing Wang Yakowec ◽  
Ingrid Stendhal ◽  
Hakim Lakhani ◽  
Joseph O. Jacobson
Keyword(s):  
Cancer Registry ◽  
Performance Metrics ◽  
Care Facility ◽  
Case Finding ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Case Load ◽  
Case Count ◽  
Routine Basis

296 Background: Quantifying the performance of a cancer center’s cancer registry is important to plan for resources needed to address shortcomings and projected increases in workload. The objective of this project was to understand the workflow, reporting requirements, and existing documentation of the cancer registry at Dana-Farber Cancer Institute (DFCI) in order to build a dashboard that quantifies monthly performance. Methods: Current state workflow maps were created detailing the three phases of the cancer registry’s operations: case finding, case abstraction, and case follow-up. Individual meetings and a workshop with the cancer registry staff were held to validate workflows, gather operational challenges and improvement ideas, and set performance metrics. Leveraging information already being collected by staff as part of their workflow, a database was designed to collect and auto-visualize monthly performance using Excel and Tableau. Results: The performance dashboard shows monthly trends of ‘on target’ status of the cancer registry’s case finding, case abstraction, and case follow-up efforts. It also quantifies how delayed the cancer registry is in case finding or abstraction and provides new case count trends by care facility, staffing capacity based on case load, and trends in lost to follow-up patients. One hundred percent of the performance dashboard data is from documentation already generated by the cancer registry staff on a routine basis. Data on monthly case load from September 2017 through March 2018 are presented in the table below; given a maximum limit of 86 cases to abstract per abstractor per month, the cancer registry is currently at more than full capacity. Conclusions: A well-designed cancer registry performance dashboard that leverages existing data does not add burden to registry staff and informs how best to manage and utilize resources according to case load. [Table: see text]

scholarly journals Changes in fatigue, barriers, and predictors towards physical activity in advanced cancer patients over a period of 12 months—a comparative study

2021 ◽  
Author(s):  
J. Frikkel ◽  
M. Beckmann ◽  
N. De Lazzari ◽  
M. Götte ◽  
S. Kasper ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Physical Functioning ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Advanced Cancer Patients ◽  
Psychological Conditions ◽  
Patient Reported

Abstract Purpose Physical activity (PA) is recommended to improve advanced cancer patients’ (ACP) physical functioning, fatigue, and quality of life. Yet, little is known about ACPs’ attitude towards PA and its influence on fatigue and depressiveness over a longer period. This prospective, non-interventional cohort study examined ACPs’ fatigue, depression, motivation, and barriers towards PA before and after 12 months of treatment among ACP Methods Outpatients with incurable cancer receiving treatment at a German Comprehensive Cancer Center reporting moderate/severe weakness/tiredness during self-assessment via MIDOS II were enrolled. Fatigue (FACT-F), depression (PHQ-8), cancer-related parameters, self-assessed PA behavior, motivation for and barriers against PA were evaluated (T0). Follow-up data was acquired after 12 months (T1) using the same questionnaire. Results At follow-up, fatigue (p=0.017) and depressiveness (p=0.015) had increased in clinical relevant extent. Physically active ACP did not show significant progress of FACT-F (p=0.836) or PHQ-8 (p=0.799). Patient-reported barriers towards PA remained stable. Logistic regression analyses identified motivation as a positive predictor for PA at both time points (T0, β=2.152, p=0.017; T1, β =2.264, p=0.009). Clinically relevant depression was a negative predictor for PA at T0 and T1 (T0, β=−3.187, p=0.044; T1, β=−3.521, p=0.041). Conclusion Our findings emphasize the importance of psychological conditions in physical activity behavior of ACP. Since psychological conditions seem to worsen over time, early integration of treatment is necessary. By combining therapy approaches of cognitive behavioral therapy and exercise in interdisciplinary care programs, the two treatment options might reinforce each other and sustainably improve ACPs’ fatigue, physical functioning, and QoL. Trial registration German Register of Clinical Trials, DRKS00012514, registration date: 30.05.2017

Perceptions of barriers to patient financial hardship screening differ by provider role within gynecologic oncology outpatient care.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 317-317
Author(s):  
Jhalak Dholakia ◽  
Maria Pisu ◽  
Warner King Huh ◽  
Margaret Irene Liang
Keyword(s):  
Nurse Practitioners ◽  
Gynecologic Oncology ◽  
Financial Hardship ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Patient Centered ◽  
Staff Members ◽  
Care Plans ◽  
Patient Barriers

317 Background: Although approximately half of patients with gynecologic malignancy experience financial hardship (FH) during treatment, best practices to identify and assist patients with FH are lacking. To develop such practices, we assessed oncology provider and staff perspectives about FH screening and provision of assistance. Methods: An anonymous survey was conducted electronically within the Gynecologic Oncology outpatient office at a Comprehensive Cancer Center. Potential barriers to patient FH screening and follow-up were assessed within 2 domains: 1) logistic barriers to incorporating FH screening and follow-up into outpatient workflow and 2) perceived patient barriers to FH screening. Responses were elicited on a 5-point Likert scale from ‘very’ to ‘not at all’ significant and dichotomized into significant and not significant barriers. Results: Of 43 providers approached, 37 responded (86% response rate) of which 14 were physicians (MD)/nurse practitioners (NP) and 23 were other staff members (i.e., clinical and research nurses, social workers, pharmacists, care coordinators, lay navigators, and financial counselors). Altogether, 38% worked in their current position for >5 years (n=14), 11% for 3-5 years (n=4), and 51% for <3 years (n=19). For logistic barriers to implementing FH screening and follow-up, the most frequently reported significant barriers included lack of personnel training (69%) and lack of available staff (62%), training regarding follow-up (72%), and case tracking infrastructure (67%). The most frequent significant perceived patient barriers were lack of knowledge of whom to contact (72%), concerns about impact on treatment if FH needs were identified (72%), and lack of patient readiness to discuss financial needs (62%.) Compared to MD/NP, staff members more often indicated the following as significant barriers: difficulty incorporating FH screening into initial visit workflow (31 % vs. 57%, p=0.03), overstretched personnel (29% vs 73%, p=0.005), and patient concerns about influence on treatment (62% vs 86%, p=0.01). Conclusions: Care team members identified barriers to patient FH screening across logistic and patient-centered domains, although MD/NP less so than other staff possibly reflecting different exposures to patient financial needs during clinical encounters or burden of workflow. Implementation of universal FH screening, dedicated personnel, convenient tracking mechanisms, and multi-disciplinary provider and staff training may improve recognition of patient FH and facilitate its integration into oncology care plans.

scholarly journals Synergetic role of integrating the departments of cancer registry and clinical research at an academic comprehensive cancer center

2017 ◽  
Vol 7 (2) ◽  
pp. 33 ◽  
Author(s):  
McKenzie Bedra ◽  
Tammy Vyskocil ◽  
Jennifer Emel ◽  
Crystal Edwards ◽  
Cherif Boutros
Keyword(s):  
Clinical Research ◽  
Cancer Registry ◽  
Comprehensive Cancer Center ◽  
Cancer Center

Soft tissue sarcoma of the vulva: A clinical study

2003 ◽  
Vol 13 (4) ◽  
pp. 528-531 ◽  
Author(s):  
H. C. Ulutin ◽  
R. C. Zellars ◽  
D. Frassica
Keyword(s):  
Epithelioid Sarcoma ◽  
Surgical Margins ◽  
External Beam Radiation ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Clinical Aspects ◽  
Beam Radiation ◽  
Inguinal Lymph Node Dissection ◽  
Mean Time

The purpose of this study is to report clinical aspects and treatment results of patients seen at Johns Hopkins. A search of the tumor registry of the Sidney Kimmel Comprehensive Cancer Center found 453 patients with malignancies of the vulva registered between 1977 and 1997. Patient and tumor characteristics, treatment methods, and follow-up were obtained from charts. Seven patients were identified with sarcoma of the vulva. Of these, one was removed from analysis due to histology. Three patients had leiomyosarcoma, two had fibrosarcoma, and one had epithelioid sarcoma. The mean age was 41. Mean time to diagnosis was 6 months. All but one of the tumors was located on the labia majora. Median tumor size was 3.5 cm. Surgery varied from wide local excision to radical vulvectomy with inguinal lymph node dissection. Surgical margins were microscopically negative in five of the six cases. Two patients had received adjuvant external beam radiation. One of them had a tumor greater than 5 cm and close surgical margins and the other had high-grade tumor, which recurred after previous surgery. Mean follow-up was 127.8 months. There have been no recurrences to date.

Use of diagnostic testing for patients with early-stage breast cancer in a multi-hospital quality collaborative in Michigan.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 242-242
Author(s):  
Tara M. Breslin ◽  
James Kubus ◽  
Haythem Y. Ali ◽  
T. Trevor Singh ◽  
Paul T. Adams ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Diagnostic Imaging ◽  
Early Stage ◽  
Diagnostic Testing ◽  
Early Stage Breast Cancer ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Positron Emission ◽  
Bone Scans

242 Background: In 2012, ASCO identified five opportunities to improve the quality of cancer care and reduce costs. Two of these recommendations focused on limiting use of advanced diagnostic imaging with computed tomography (CT), Positron Emission Tomography (PET), and radionuclide bone scans (BS) at diagnosis and during surveillance for women with early stage breast cancer with a low risk of metastasis. We describe the use of diagnostic imaging among patients with early stage breast cancer treated at hospitals in Michigan. Methods: The Michigan Breast Oncology Quality Initiative is a collaboration between Michigan hospitals, the University of Michigan Comprehensive Cancer Center, and the National Comprehensive Cancer Network (NCCN). This collaborative collects longitudinal demographic, staging, treatment, and follow up data using the NCCN Breast Outcomes Database platform. We analyzed use of advanced diagnostic testing with CT, PET, BS and contrast it with use of traditional imaging (mammography/ultrasound) at diagnosis and during follow up in patients with stage 0, I, II breast cancer between 1998 to 2009. Patients who died or recurred were excluded. Results: The cohort included 7,632 patients (19.6% stage 0, 48.1% stage I, 32.3% stage II) treated at 17 hospitals. Use of traditional imaging was documented in nearly 100% of patients at diagnosis and throughout the follow up period. With respect to advanced diagnostic imaging, 20.3 % underwent CT, 4.7% underwent PET, and 11.6% underwent BS at diagnosis. Advanced testing use decreased over time (Table). Conclusions: Despite published guidelines, which recommend against their routine use, advanced diagnostic imaging use was prevalent among patients treated for early breast cancer at MiBOQI hospitals. Education efforts should target physicians and patients on the lack of proven benefit and potential risks of using advanced diagnostic imaging in this population. [Table: see text]

Outcomes of supportive/palliative care (SPC) for advanced cancer patients (AdCa) in a general public hospital and a comprehensive cancer center.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 208-208
Author(s):  
Marvin Omar Delgado-Guay ◽  
Jeanette Ferrer ◽  
Jewel Ochoa ◽  
Hilda Cantu ◽  
Janet L. Williams ◽  
...  
Keyword(s):  
General Public ◽  
Public Hospital ◽  
Clinical Pathways ◽  
Symptom Assessment ◽  
Well Being ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Time Range ◽  
Advanced Cancer Patients

208 Background: AdCa experience severe physical, psychosocial and existential distress. Their needs might not be met only by standard care. We compared outcomes of AdCa receiving SPC at a General Public Hospital (GPH) and at a Comprehensive Cancer Center (CCC). Methods: We reviewed 364 consecutive AdCa(182 at GPH and 182 at CCC). AdCa were managed by SPC-specialists with common clinical-pathways. We assessed symptoms(Edmonton Symptom Assessment System:ESAS) and outcomes at consult and first follow-up. Results: Race was White, African-American, and Hispanic in 42(23%), 70(39%), 63(35%) at GPH vs. 112(64%, p<0.0001), 30(17%, p<0.0001), 20(11%, p<0.0001) at CCC, respectively. Age, gender and cancer diagnoses were similar at both sites. 98(54%) at GPH vs. 181(99%) at CCC reported to have some health-insurance(p<0.0001). Symptoms at consult-time at GPH and CCC: Pain 133(85%) vs. 151(91%,p=0.0586); Fatigue 127(80%) vs. 153(94%,p<0.0001); Nausea 69(44%) vs. 89(55%,p=0.0438); Depression 79(51%) vs. 109(68%,p=0.0015); Anxiety 72(46%) vs. 121(75%,p<0.0001); Drowsiness 78(50%) vs. 119(76%, p<0.0001); Appetite 89(56%) vs. 146(91%, p<0.0001); Dyspnea 72(46%) vs. 107(65%,p=0.0004); Sleep 90(59%) vs. 142(88%,p<0.0001); and Well-Being 95(63%) vs. 132(93%,p<0.0001). Both SPC provided multiple not different interventions: opioid-management, medication review for polypharmacy, bowel-regimen, antiemetics, and interdisciplinary counseling. At follow-up ESAS-improvement(decrease ≥2 points) was: pain 21/80(26%) at GPH vs. 43/107(40%) at CCC(p=0.0469), anxiety 18/75(24%) vs. 40/98(41%,p=0.0202); appetite 15/74(20%) vs. 37/90(41%,p=0.0043); sleep 20/74(27%) vs. 42/95(44%,p=0.0215); nausea 23/77(30%) vs. 35/97(36%,p=0.3879); depression 18/74(24%) vs. 30/94(32%,p=0.2796). Median Time(range) from consult-to-follow-up at GPH 21 days(0-427) vs. 14 days(1-275,p=0.032), and from consult-to-death at GPH 53 days(1-699) vs. 51 days(1-898,p=0.8473). Conclusions: AdCa at GPH and CCC had frequent and severe-symptoms. Response-rate was lower and follow-up less-frequent at GPH. SPC needs to be more frequent and more resources are needed at GPH.

Impact of parenteral opioid shortage on opioid prescriptions among patients seen by the palliative care team of a comprehensive cancer center.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 201-201
Author(s):  
Ali Haider ◽  
Yu Qian ◽  
Zhanni Lu ◽  
Syed Mussadiq Ali Akbar Naqvi ◽  
Amy Zhuang ◽  
...  
Keyword(s):  
Palliative Care ◽  
Pain Management ◽  
Cancer Pain ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Cancer Type ◽  
Cancer Pain Management ◽  
Before And After ◽  
The Impact

201 Background: Recent parenteral opioid shortage (POS) has the potential to impact cancer pain management in hospitalized patients. This study aims to compare changes in the opioid prescriptions by the inpatient palliative care (PC) team before and after the institution first reported the POS. Methods: We reviewed and compared the electronic health records of 386 consecutive eligible consultations seen by the inpatient PC team equally in one month before and after the announcement of POS on February 8, 2018. The eligibility criteria include (1) cancer diagnosis, (2) ≥18 years of age, (3) taking opioid medication at the time of consultation, and (4) having at least two consecutive visits with the PC team. Patient demographics, cancer type, opioid type, route, and dose defined as the morphine equivalent daily dose were assessed. Results: POS was associated with less use of parenteral opioids (patient controlled analgesia, and intravenous breakthrough) and more use of non-parenteral opioids (extended release, transdermal, and oral breakthrough) by the referring oncology teams, and PC team (P≤.001) (Table 1). At first PC follow-up, significantly less proportion of patients achieved better pain control after POS [119/193 (62%) versus 144/193 (75%) (P=.006)] However, at second PC follow-up, the proportion of pain improvement was similar in both cohorts. Conclusions: There is a significant change in opioid routes associated with POS. POS was associated with worse analgesia. More research is needed to better understand the impact of POS on cancer pain management.[Table: see text]

scholarly journals Patient Cessation Activity after Automatic Referral to a Dedicated Cessation Support Service

2017 ◽  
Vol 13 (2) ◽  
pp. 78-86
Author(s):  
Katharine A. Amato ◽  
Mary E. Reid ◽  
Maansi Bansal-Travers ◽  
Heather M. Ochs-Balcom ◽  
K. Michael Cummings ◽  
...  
Keyword(s):  
Support Service ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Tobacco Use Cessation ◽  
The Past ◽  
Quit Smoking ◽  
Opt Out ◽  
Quit Attempts ◽  
First Contact

Introduction: We characterised tobacco use, cessation patterns, and patient satisfaction with a cessation support program at an NCI Designated Comprehensive Cancer Center following a mandatory tobacco assessment and automatic referral.Methods: A 3-month follow-up survey (via web, paper, or telephone) was administered between March 2013 and November 2013 for all patients referred to and contacted by a cessation support service, and who consented to participation three months prior to administration. Patients were asked about their perceived importance and self-efficacy to quit smoking, quit attempts, and satisfaction with the cessation service.Results: Fifty-two percent (257/499) of patients who participated in the cessation support service, and consented to be contacted again, completed a follow-up survey. Of those who participated, 9.7% were referred to the service as having recently quit tobacco (in the past 30 days) and 23.6% reported having quit at the time of first contact. At the 3-month follow-up, 48.1% reported being smoke-free for the previous seven days. When patients were asked about their experience with the cessation service, 86.4% reported being very or mostly satisfied with the service, and 64.3% reported that their experience with the service increased their satisfaction with the care received at the cancer centre.Conclusions: Our findings suggest that recently diagnosed cancer patients are aware that quitting tobacco is important, are making attempts to quit, and are amenable to an opt-out automatic referral cessation support service as part of their cancer care.

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