scholarly journals Physician and Practice Characteristics Influencing Tumor Board Attendance: Results From the Provider Survey of the Los Angeles Women's Health Study

2011 ◽  
Vol 7 (2) ◽  
pp. 103-110 ◽  
Author(s):  
Kevin S. Scher ◽  
Diana M. Tisnado ◽  
Danielle E. Rose ◽  
John Lloyd Adams ◽  
Clifford Y. Ko ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Los Angeles ◽  
Treatment Planning ◽  
Cancer Care ◽  
Tumor Board ◽  
Health Study ◽  
Practice Characteristics ◽  
Planning Approach ◽  
Provider Survey

Multidisciplinary approaches to cancer care have shown improvements in the quality of care. The tumor board treatment planning approach provides a structure for engaging providers in discussions of cancer cases that are designed to enhance the quality of care.

Physician and practice characteristics influencing tumor board attendance: Results from the provider survey of the Los Angeles Women's Health Study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17501-e17501
Author(s):  
K. Scher ◽  
D. M. Tisnado ◽  
D. Rose-Ash ◽  
A. Rastegar ◽  
J. Adams ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Los Angeles ◽  
Multidisciplinary Care ◽  
Tumor Board ◽  
Health Study ◽  
Coordination Of Care ◽  
Volume Number ◽  
Practice Characteristics ◽  
Tumor Boards ◽  
Low Volume

e17501 Background: Coordination of care has grown in importance with the advent of new modalities of treatment requiring specialized expertise. In cancer care, multidisciplinary approaches have shown improvements in quality of care and patient satisfaction. Tumor boards provide a mechanism for improving coordination of care. We evaluated physician and practice characteristics that predict frequency of tumor board attendance. Methods: This cross-sectional study utilizes data obtained by surveying physicians of a population-based sample of women with incident breast cancer. Physicians were queried regarding tumor board attendance, specialty (medical oncologist [MO], radiation oncologist [RO], surgeon indicating that the hospital at which most breast cancer surgeries are performed has an American College of Surgeons accredited program [ACOSSg] and surgeon without such affiliation [non-ACOSSg]), physician characteristics (gender, race, teaching involvement, patient volume, number of offices, ownership interest), and practice setting (practice type, size, reimbursement). Univariate, bivariate, and multivariate analyses were performed for the dependent variable characterizing provider report of frequency of tumor board meeting attendance. Results: Most surveyed physicians (83%) report attending tumor board weekly (58%) or monthly (25%). Weekly participation was reported by 63%, 92%, 47%, and 32% of MOs, ROs, ACOSSgs, and non-ACOSSgs (p < 0.01). Specialty and higher patient volumes are significant predictors of more frequent attendance, after adjustment for practice size and type. In comparison to the most prevalent specialty category (low volume ACOSSgs), high volume MOs attend more (p = 0.01), and low volume non-ACOSSgs attend less frequently (p = 0.00). Conclusions: Tumor board attendance implies increased participation in multidisciplinary care, but specific subsets of providers are less frequent users. This not only has implications for choosing providers, but also for efforts to increase attendance. Tumor board agendas and formalized institution wide policies could be designed to further engage low frequency attendees as a means to promote multidisciplinary care and improve health outcomes. [Table: see text]

scholarly journals Multidisciplinary Cancer Care With a Patient and Physician Satisfaction Focus

2010 ◽  
Vol 6 (6) ◽  
pp. e35-e37 ◽  
Author(s):  
Gregory Litton ◽  
Dianne Kane ◽  
Gina Clay ◽  
Patricia Kruger ◽  
Thomas Belnap ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Cancer Care ◽  
Physician Satisfaction ◽  
Care Process ◽  
Multidisciplinary Clinic ◽  
Intermountain Healthcare ◽  
Multidisciplinary Clinics

If implemented appropriately, multidisciplinary clinics can enhance quality of care and increase downstream revenue. The multidisciplinary clinic at Intermountain Healthcare has greatly improved the cancer care process for patients, physicians, and the community.

scholarly journals Aggressiveness of Cancer Care Near the End of Life: Is It a Quality-of-Care Issue?

2008 ◽  
Vol 26 (23) ◽  
pp. 3860-3866 ◽  
Author(s):  
Craig C. Earle ◽  
Mary Beth Landrum ◽  
Jeffrey M. Souza ◽  
Bridget A. Neville ◽  
Jane C. Weeks ◽  
...  
Keyword(s):  
Quality Of Care ◽  
End Of Life ◽  
Cancer Care ◽  
Aggressive Treatment ◽  
Care Issue ◽  
Open Question

The purpose of this article is to review the literature and update analyses pertaining to the aggressiveness of cancer care near the end of life. Specifically, we will discuss trends and factors responsible for chemotherapy overuse very near death and underutilization of hospice services. Whether the concept of overly aggressive treatment represents a quality-of-care issue that is acceptable to all involved stakeholders is an open question.

scholarly journals Incarceration and Cancer-Related Outcomes (ICRO) study protocol: using a mixed-methods approach to investigate the role of incarceration on cancer incidence, mortality and quality of care

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e048863
Author(s):  
Lisa Puglisi ◽  
Alexandra A Halberstam ◽  
Jenerius Aminawung ◽  
Colleen Gallagher ◽  
Lou Gonsalves ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Quality Of Care ◽  
Mixed Methods ◽  
Cancer Incidence ◽  
Cancer Care ◽  
Survival Models ◽  
Structural Racism ◽  
Interaction Terms ◽  
The Relationship

IntroductionIncarceration is associated with decreased cancer screening rates and a higher risk for hospitalisation and death from cancer after release from prison. However, there is a paucity of data on the relationship between incarceration and cancer outcomes and quality of care. In the Incarceration and Cancer-Related Outcomes Study, we aim to develop a nuanced understanding of how incarceration affects cancer incidence, mortality and treatment, and moderates the relationship between socioeconomic status, structural racism and cancer disparities.Methods and analysisWe will use a sequential explanatory mixed-methods study design. We will create the first comprehensive linkage of data from the Connecticut Department of Correction and the statewide Connecticut Tumour Registry. Using the linked dataset, we will examine differences in cancer incidence and stage at diagnosis between individuals currently incarcerated, formerly incarcerated and never incarcerated in Connecticut from 2005 to 2016. Among individuals with invasive cancer, we will assess relationships among incarceration, quality of cancer care and mortality, and will assess the degree to which incarceration status moderates relationships among race, socioeconomic status, quality of cancer care and cancer mortality. We will use multivariable logistic regression and Cox survival models with interaction terms as appropriate. These results will inform our conduct of in-depth interviews with individuals diagnosed with cancer during or shortly after incarceration regarding their experiences with cancer care in the correctional system and the immediate postrelease period. The results of this qualitative work will help contextualise the results of the data linkage.Ethics and disseminationThe Yale University Institutional Review Board (#2000022899) and the Connecticut Department of Public Health Human Investigations Committee approved this study. We will disseminate study findings through peer-reviewed publications and academic and community presentations. Access to the deidentified quantitative and qualitative datasets will be made available on review of the request.

Clinical Governance Benchmarking Issues in Oncology: Aggressiveness of Cancer Care and Consumption of Strong Opioids. A Single-Center Experience on Measurement of Quality of Care

2010 ◽  
Vol 96 (3) ◽  
pp. 443-447 ◽  
Author(s):  
Petros Giovanis ◽  
Giovanni De Leonardis ◽  
Antonella Garna ◽  
Viviana Lovat ◽  
Francesca Caldart ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Cancer Care ◽  
Clinical Governance ◽  
Single Center ◽  
Single Center Experience ◽  
Strong Opioids

Improving the organisation of breast cancer care increases quality of care while reducing costs

2004 ◽  
Vol 2 (3) ◽  
pp. 113
Author(s):  
G.L Beets ◽  
C.N.A Frotscher ◽  
C.D Dirksen ◽  
M.H Hebly ◽  
M.F von Meyenfeldt
Keyword(s):  
Breast Cancer ◽  
Quality Of Care ◽  
Cancer Care ◽  
Breast Cancer Care ◽  
Reducing Costs

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.

scholarly journals Continuing towards optimization of bladder cancer care in Canada: Summary of the 3rd BCC-CUA-CUOG bladder cancer quality of care consensus meeting

2020 ◽  
Vol 14 (3) ◽  
Author(s):  
Wassim Kassouf ◽  
Armen Aprikian ◽  
Fred Saad ◽  
Neil Fleshner ◽  
Nimira AliMohamed ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Quality Of Care ◽  
Cancer Care ◽  
Consensus Meeting

Breast cancer patients' quality of care: Does racial concordance matter or is it just a matter of trust?

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6537-6537
Author(s):  
K. P. Joseph ◽  
R. Franco ◽  
K. Fei ◽  
N. Bickell
Keyword(s):  
Breast Cancer ◽  
Quality Of Care ◽  
Cancer Patients ◽  
Cancer Care ◽  
Perceived Quality ◽  
Care Quality ◽  
Breast Cancer Patients ◽  
Office Staff ◽  
Racial Concordance

6537 Background: As insurers consider paying for performance and quality measures grow in importance, factors that affect patients' perceived quality of cancer care matter. Concordance by race in physician-patient relationships has been associated with patient satisfaction and use of health care, however how that is mediated is unclear. Methods: 210 of 300 eligible women stage I or II breast cancer at 1 of 8 participating NYC hospitals responded to our survey (70% response rate): 20% were African-American (AA), 40% were white, and 30% were Hispanic and 9% were other races. Trust is based on a validated scale and calibrated to a 100 point scale (Cronbach α = 0.76). Bivariate analyses and logistic models were used to identify factors associated with patient ratings of quality of care. Results: Only 55% of women rated the quality of their cancer care as excellent. AA women breast cancer patients were less likely to rate their care as excellent (p=0.004). Compared to women who didn't rate their care as excellent, those who rated it excellent had greater trust in their physician (p < 0.0001) and indicated that were treated well by their physicians' office staff (p = 0.01). Of note, AA patients had lower levels of trust (p = 0.004). Women who were of the same race as their physician did not perceive better quality of care as compared to those who were not racially concordant (p = 0.18); nor did they have higher trust in their physician (p = 0.59). Multivariate models evaluating the role of patient race, education, income, knowing which physician to talk to, how well the staff treated the patient, and racial concordance with physician, found that trust in physician was significantly associated with patient perception of excellent quality care (aRR = 1.38; 95%CI: 1.03–1.65) and being AA was associated with worse perceived quality (aRR = 0.47; 95%CI: 0.21–0.88) (model c = 0.79; p < 0.0001). Conclusions: Racial concordance between physicians and patients does not directly affect patients' perceived quality of care. However, women's trust in their physician and their perceived treatment by office staff are associated with excellent cancer care quality ratings. Efforts should be made to increase effective intercultural communication particularly among AA women in order to improve ratings of cancer care quality. No significant financial relationships to disclose.

Does a quality-of-care problem exist? Cancer Care Ontario practice pattern data and the recommendations of two lung cancer practice guidelines.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 190-190
Author(s):  
Melissa C. Brouwers ◽  
Julie Makarski
Keyword(s):  
Lung Cancer ◽  
Quality Of Care ◽  
Practice Guidelines ◽  
Cancer Care ◽  
Practice Patterns ◽  
Practice Pattern ◽  
Theory Approach ◽  
System Quality ◽  
Depth Analysis

190 Background: Practice-pattern data, evidence-based knowledge and transfer, and performance management strategies define Cancer Care Ontario’s quality improvement strategy. Knowledge products, such as practice guidelines, are intended to provide recommendations for practice, based on best available evidence, to improve quality of care and reduce variation in practice. Review of 2010-2011 Cancer System Quality Index (CSQI) data revealed complex practice patterns in treatment of non-small cell lung cancer patients with stages II and IIIa resected and stages IIIa and IIIb non-resected disease in Ontario. A multi-method study was initiated to understand the patterns, to identify if a quality of care problem exists and to propose improvements moving forward. Methods: Surgeons, medical oncologists and radiation oncologists from Ontario were invited to participate in a survey consisting of 6 areas of inquiry. A grounded theory approach was used to guide key informant interviews of purposively sampled clinicians and administrators. A more in-depth analysis of the CSQI data was planned. Results: Clinicians responding to survey provided positive assessments of PG recommendations and evidentiary base; perceptions of practice patterns were less problematic than hypothesized; estimates of benchmarks were highly variable; and assessments of barriers to recommendation implementation included slow referral process, lack of organization support and patients seen in practice not reflected in the evidence. From the interviews, 5 themes emerged: unique patient, unique physician, family, clinical team, and clinical evidence. Further analysis of CSQI data was not possible given limitations related to data collection. Conclusions: A perceived quality of care problem initiated this study. Concerns centred on significant proportion of patients receiving no treatment; modest percentage of patients receiving treatment that aligned with PG recommendations; and regional variation within each of the clinical care options. Our data show that defining a quality of care problem is significantly more complex than consideration of practice patterns alone.

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