scholarly journals Multidisciplinary Cancer Care: Development of an Infectious Diseases Physician Assistant Workforce at a Comprehensive Cancer Center

2010 ◽  
Vol 6 (6) ◽  
pp. e31-e34 ◽  
Author(s):  
Candice N. White ◽  
Roy A. Borchardt ◽  
Mary L. Mabry ◽  
Kathleen M. Smith ◽  
Victor E. Mulanovich ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Patient Care ◽  
Cancer Care ◽  
Physician Assistant ◽  
Physician Assistants ◽  
Physician Satisfaction ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Care Services ◽  
Care Development

The authors outline the process through which the infectious diseases department at The M. D. Anderson Cancer Center successfully integrated physician assistants into patient care services, as judged by an overall increase in departmental productivity, broadened patient care coverage, and physician satisfaction with midlevel services.

scholarly journals Easier Said Than Done: Keys to Successful Implementation of the Distress Assessment and Response Tool (DART) Program

2016 ◽  
Vol 12 (5) ◽  
pp. e513-e526 ◽  
Author(s):  
Madeline Li ◽  
Alyssa Macedo ◽  
Sean Crawford ◽  
Sabira Bagha ◽  
Yvonne W. Leung ◽  
...  
Keyword(s):  
Cancer Care ◽  
Large Scale ◽  
Performance Indicator ◽  
Evaluation Framework ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Successful Implementation ◽  
Psychosocial Needs ◽  
Electronic Screening ◽  
Screening For Distress

Purpose: Systematic screening for distress in oncology clinics has gained increasing acceptance as a means to improve cancer care, but its implementation poses enormous challenges. We describe the development and implementation of the Distress Assessment and Response Tool (DART) program in a large urban comprehensive cancer center. Method: DART is an electronic screening tool used to detect physical and emotional distress and practical concerns and is linked to triaged interprofessional collaborative care pathways. The implementation of DART depended on clinician education, technological innovation, transparent communication, and an evaluation framework based on principles of change management and quality improvement. Results: There have been 364,378 DART surveys completed since 2010, with a sustained screening rate of > 70% for the past 3 years. High staff satisfaction, increased perception of teamwork, greater clinical attention to the psychosocial needs of patients, patient-clinician communication, and patient satisfaction with care were demonstrated without a resultant increase in referrals to specialized psychosocial services. DART is now a standard of care for all patients attending the cancer center and a quality performance indicator for the organization. Conclusion: Key factors in the success of DART implementation were the adoption of a programmatic approach, strong institutional commitment, and a primary focus on clinic-based response. We have demonstrated that large-scale routine screening for distress in a cancer center is achievable and has the potential to enhance the cancer care experience for both patients and staff.

scholarly journals Board-Certified Oncology Pharmacists: Their Potential Contribution to Reducing a Shortfall in Oncology Patient Visits

2016 ◽  
Vol 12 (4) ◽  
pp. e359-e368 ◽  
Author(s):  
Robert Ignoffo ◽  
Katherine Knapp ◽  
Mitchell Barnett ◽  
Sally Yowell Barbour ◽  
Steve D’Amato ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Treatment ◽  
Patient Care ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Delphi Panel ◽  
Potential Contribution ◽  
Oncology Patient ◽  
Care Services ◽  
Number Of Patients

Purpose: With an aging US population, the number of patients who need cancer treatment will increase significantly by 2020. On the basis of a predicted shortage of oncology physicians, nonphysician health care practitioners will need to fill the shortfall in oncology patient visits, and nurse practitioners and physician assistants have already been identified for this purpose. This study proposes that appropriately trained oncology pharmacists can also contribute. The purpose of this study is to estimate the supply of Board of Pharmacy Specialties–certified oncology pharmacists (BCOPs) and their potential contribution to the care of patients with cancer through 2020. Methods: Data regarding accredited oncology pharmacy residencies, new BCOPs, and total BCOPs were used to estimate oncology residencies, new BCOPs, and total BCOPs through 2020. A Delphi panel process was used to estimate patient visits, identify patient care services that BCOPs could provide, and study limitations. Results: By 2020, there will be an estimated 3,639 BCOPs, and approximately 62% of BCOPs will have completed accredited oncology pharmacy residencies. Delphi panelists came to consensus (at least 80% agreement) on eight patient care services that BCOPs could provide. Although the estimates given by our model indicate that BCOPs could provide 5 to 7 million 30-minute patient visits annually, sensitivity analysis, based on factors that could reduce potential visit availability resulted in 2.5 to 3.5 million visits by 2020 with the addition of BCOPs to the health care team. Conclusion: BCOPs can contribute to a projected shortfall in needed patient visits for cancer treatment. BCOPs, along with nurse practitioners and physician assistants could substantially reduce, but likely not eliminate, the shortfall of providers needed for oncology patient visits.

Analysis of financial sustainability of survivorship clinics led by advanced practice providers.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11560-11560
Author(s):  
Maria Alma Rodriguez ◽  
Guadalupe R. Palos ◽  
Katherine Ramsey Gilmore ◽  
Paula A. Lewis-Patterson ◽  
Patricia Chapman ◽  
...  
Keyword(s):  
Physician Assistants ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Advanced Practice ◽  
Survivorship Care ◽  
Manage Care ◽  
Recovery Percentage ◽  
Long Term Survivors ◽  
Delivery Models

11560 Background: Disease specific Survivorship Care Clinics (SCs) have been established within a comprehensive cancer center. Clinics are staffed by Advanced Practice Providers (APPs), Physician Assistants and Advanced Practice Registered Nurses, with experience in the management of each disease type. To determine the sustainability of this model of survivorship care, we analyzed the professional fees’ revenue generated by APPs’ billings for 6 clinics and then compared the APPs’ salaries across all clinics. Methods: A retrospective analysis was conducted of 6 survivorship clinic’s patient volumes and clinic days supported by APPs from 9/1/16-4/30/17. The full FTE salary of the APPs, including benefits were prorated to the time dedicated to each of the SCs. Institutional financial data was used to align professional fees to actual reimbursements received. Salary recovery percentage was calculated as the ratio of reimbursement received to prorated FTE salary. Results: Table shows variation in APPs’ salary commensurate to FTE proportion. Results also indicate there was an average of 99% professional fee recovery. Clinics with an FTE proportion > 0.5 had recovery higher than the anticipated prorated salary, suggesting there is a threshold to maximize efficacy and sustainability. Conclusions: APPs professional fees for care provided to cancer survivors are reimbursable, across disease types or payers, and proportionally supports their salaries. Our findings suggest delivery models based on APPs to manage care of long-term survivors can be self-supporting.[Table: see text]

Pastoral care of cancer patients: Defining utilization of services at a comprehensive cancer center.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24171-e24171
Author(s):  
Elizabeth Palmer ◽  
Anghela Paredes ◽  
Madison Hyer ◽  
Timothy M. Pawlik
Keyword(s):  
Pastoral Care ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Spiritual Care ◽  
Cancer Care ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Spiritual Needs ◽  
Active Listening ◽  
Patients With Cancer

e24171 Background: Addressing the religious/spiritual needs of patients is an important component of comprehensive cancer care. Patients often report that providers infrequently engage them about their needs during treatment. In addition, providers cite inadequate training as a significant barrier to providing spiritual care. While patients may benefit from the presence of a spiritual care specialist during cancer treatment, the utilization and content of these services are not well defined. We sought to characterize utilization of pastoral care (PC) services, as well as delineate differences in PC utilization among patients with cancer. Methods: Data on patients being treated for cancer at a Comprehensive Cancer Center between 2015-2018 were obtained from the electronic medical record. Overall utilization, type of PC services utilized, as well as factors associated with use of PC were assessed. Analyses included descriptive statistics and logistic regression. Results: Among 14,322 cancer patients, roughly one-third (n = 5166, 36.1%) had at least one PC encounter during their cancer treatment. Interventions most frequently provided by PC included supportive presence (93.5%) and active listening (86.6%), while the most frequently explored topics were treatment expectations (59.8%), issues with faith/beliefs (42.9%), and available coping mechanisms (35.4%). Patients diagnosed with colorectal (OR:1.42, 95%CI:1.07-1.89), liver (OR:2.41, 95%CI:1.80-3.24), or pancreatic cancer (OR:1.43, 95%CI:1.02-2.00) were more likely to utilize PC services compared with other cancers. Patients that identified as Catholic (OR:1.47, 95%CI:1.17-1.84) or Christian (OR:1.73, 95%CI:1.39-2.15) were more likely to request PC services (both p < 0.001) than individuals who had no religious preference/affiliation. Among surgical patients (n = 1,174), the majority of encounters with PC services were in the postoperative setting (n = 801, 70.6%). Patients most often reported that PC helped with verbalization of their feelings (93.6%) and helped reduce stress (76.9%). Conclusions: Over one-third of patients with cancer interacted with PC and received services that often addressed both psychosocial and spiritual concerns. Overall PC utilization and types of PC services rendered varied relative to demographic and religious factors. Providers should be aware of varying patient religious/spiritual needs so as to optimize the entire cancer care experience for patients.

Advanced cancer patients' (CP) attitudes and perceptions regarding reasons for outpatient supportive care (SC) referral at a comprehensive cancer center: A randomized controlled study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24135-e24135
Author(s):  
Angelique Wong ◽  
Frank V. Fossella ◽  
George R. Simon ◽  
Rama Maddi ◽  
Zhanni Lu ◽  
...  
Keyword(s):  
Supportive Care ◽  
Cancer Care ◽  
Comprehensive Cancer Center ◽  
Controlled Study ◽  
Cancer Center ◽  
Cancer Type ◽  
Attitudes And Perceptions ◽  
Outpatient Supportive Care

e24135 Background: Current ASCO guidelines propose early access to SC in all CP to improve quality of care, quality of life, and symptoms. Very few studies have evaluated patients’ perceived criteria for referral to outpatient SC and perceptions of patients who are referred early in their disease trajectory. Methods: In this study we evaluated CP attitudes and perceptions regarding the role of and access to outpatient Supportive Care clinic (SCC) at a comprehensive cancer center. CP with life expectancy of greater than 6 months (as determined by the oncologist) and who are newly registered at MD Anderson Cancer Center were randomized to either obtain an educational brochure that explained the role of the SCC or no brochure. Both groups then completed a survey regarding the role and access to of outpatient SCC. After completion of the survey, patients were asked if they would like to be seen by the SC team. If so, they were scheduled by their oncologist for a SC consult. Results: 288 patients were evaluable: median age was 63, 43% were female, 84% were Caucasian, and the most common cancer type was lung cancer (39%). Median survival was 15 months. Patients who received a brochure reported more understanding of the role of SC vs those who did not receive a brochure (63% vs 37%, p = 0.04). Both groups felt that SC could help to address physical (47% vs 54%) and psychosocial (50% vs 50%) symptoms. Both groups felt SC could help to address questions regarding prognosis (50% vs 50%) and future care (53% vs 47%). Both groups did not feel that time (50% vs 50%) nor financial concerns (49% vs 51%) would be barriers to access SC. Both groups did not feel that receiving SC would impede their cancer care (60% vs 40%) nor change their oncologists’ perspective of them (25% vs 75%). Both groups felt they could receive SC and cancer care simultaneously (50% vs 50%). Approximately half of the patients in both groups perceived it was not too early for a referral to SC. There were no statistical differences in these groups for these findings. Conclusions: Patients who received a brochure had a better understanding of the role of SC. A very significant proportion in both groups had limited awareness of the value of SC. Oncologist driven referral and education of SC may facilitate better understanding of the value of SC. Further studies are needed.

scholarly journals Implementing a Multidisciplinary Approach for Older Adults with Cancer: Geriatric Oncology in Practice

2019 ◽  
Author(s):  
Carolyn Presley ◽  
Jessica Krok-Schoen ◽  
Sarah Wall ◽  
Anne Noonan ◽  
Desiree Jones ◽  
...  
Keyword(s):  
Older Adults ◽  
Cancer Care ◽  
Multidisciplinary Approach ◽  
Geriatric Oncology ◽  
Clinic Visit ◽  
Sensory Loss ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Multiple Chronic Conditions ◽  
Care Clinic

Abstract Background: Evidence-based practice in geriatric oncology is growing, and national initiatives have focused on expanding cancer care and research to improve health outcomes of older adults. However, there are still gaps between knowledge and practice for older adults with cancer. Methods: The Cancer and Aging Resiliency (CARE) clinic is a multidisciplinary approach for implementing geriatric-driven health care for older adults with cancer. The CARE clinic was developed as a direct response to recommendations targeting key multifactorial geriatric health conditions (e.g. falls, nutritional deficits, sensory loss, cognitive impairment, frailty, multiple chronic conditions, and functional status). We review the influence of these factors across the cancer care trajectory, including at screening, diagnosis, and treatment and discuss ways in which these conditions may be targeted to improve cancer care in older adults. Results: The CARE clinic was implemented at The Ohio State University Comprehensive Cancer Center (OSUCCC) and targets modifiable risk factors affecting outcomes in older adults with cancer: weight loss, polypharmacy, physical impairments, social support, and mood symptoms. The multidisciplinary team at the CARE clinic discusses and delivers a comprehensive set of recommendations, all in one clinic visit, to minimize burden on the patient and the caregiver. The CARE clinic is part of a set of initiatives that feature education of future leaders in geriatric oncology, survivorship care for an aging population, and outcomes research. Conclusions: Older adults with cancer have a unique set of needs that need to be taken into account throughout their cancer care. The CARE clinic model is an important example of an approach that may combat these difficulties and lead to better outcomes among older adults with cancer.

scholarly journals In the World of Politics and Stigma Around Cancer, Can Cancer Survivors With Political Career Become Cancer Advocates?

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 180s-180s
Author(s):  
M. Abdullah
Keyword(s):  
Breast Cancer ◽  
Cancer Prevention ◽  
Cancer Patients ◽  
Cancer Care ◽  
Prevention And Control ◽  
Cancer Center ◽  
First Lady ◽  
Cancer Prevention And Control ◽  
Care Services ◽  
And Control

Background and context: According to WHO estimates in 2012, around 20,000 Afghans suffered from various types of cancers while around 15,000 die of this disease. Until late 2015, there was not a single dedicated bed for cancer patients nor there was a doctor, nurse or other cancer care professionals within the structure of Afghan government, especially within the Ministry of Public Health. In November 2014 when Dr. Shinkai Karokhail, member of parliament, returned Afghanistan after spending almost a year overseas for breast cancer treatment misdiagnosed in Afghanistan, she and H.E. the First Lady, Rolla Ghani, began advocating for cancer prevention and control in Afghanistan. They managed to bring the few cancer care professionals and advocates under one umbrella called Afghanistan Cancer Foundation (ACF). Aim: To provide cancer care services to cancer patients. Strategy/Tactics: The main strategy was the involvement of known social and political figures in cancer advocacy. Considering the disparity in cancer incidence among men and women and breast cancer being the leading cancer, one of the most influential people was H.E. the First Lady who is a strong advocate of women rights. The other tactic was the involvement of members of parliament who were cancer survivors. Program/Policy process: Once the political commitment regarding cancer prevention and control was gained, H.E. the First Lady and members of parliament asked the Ministry of Finance to allocate fund for cancer prevention and control. Thus, first fund of only $50,000 was provided by the Ministry of Finance provided to Ministry of Health in the fiscal year 2015. Outcomes: As a result of the advocacy efforts by cancer control advocates, especially by Ms. Shinkai Karokhail, the breast cancer survivor, and H.E. the First Lady of Afghanistan, the first 10-bed day-care and 29-bed IPD cancer center was established in Afghanistan in March 2016. Subsequently, the National Cancer Control Program (NCCP) was created in January 2017 within the Ministry of Public Health. In addition, the first hospital-based cancer registry was formed which will be followed by establishment of Kabul Cancer Registry. The only cancer center provided health care services to around 12,000 patients in 2017 who were either not receiving cancer care services or were traveling to neighboring countries for diagnosis and treatment. What was learned: Cancer patients/survivors who have political career can be the best cancer prevention and control advocates.

Benefits of satellite lab in the reduction of chemotherapy waiting time.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18218-e18218
Author(s):  
Abdullah Ahmed Bany Hamdan ◽  
Jesusa Christine Tamani ◽  
Sheena Peethambaran ◽  
Isamme Alfayyad ◽  
Richard Erlandez ◽  
...  
Keyword(s):  
Patient Care ◽  
Waiting Time ◽  
Positive Impact ◽  
Turnaround Time ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Base Line ◽  
Oncology Patients ◽  
Mean Waiting Time ◽  
Before And After

e18218 Background: Oncology patients need to receive their course of treatment in a timely manner. Increasing the efficiency of laboratory testing could potentially improve hospital operations and thus have a positive impact on patient care. One way of doing this is by initiating an installation of a satellite laboratory. The purpose of this study is to determine the advantages of having a satellite laboratory in an oncology unit. Moreover, it shall also try to determine whether the presence of satellite laboratory will help reduce the chemotherapy waiting time of oncology patients. Methods: This study utilized experimental study design in order to analyze and compare Laboratory Turnaround time (TAT) and the chemotherapy waiting time before and after establishment of satellite laboratory. The samples taken as base line data was 150 and compared to samples taken from 2013-2015. The population of this study included patients in Comprehensive Cancer Center of King Fahad Medical City diagnosed with cancer and received chemotherapy regardless of their age and sex. Results: Laboratory Mean TAT decrease significantly from 1 hour and 30 minutes in 2012 to 43 minutes, 43 minutes, and 37 minutes in 2013, 2014 and 2015 respectively. Also chemotherapy Mean waiting time decreased from 2012 base line of 252 to 164 minutes in 2013, 115 minutes in 2014 and 146 minutes in 2015. The chemotherapy waiting time shows a decreasing pattern as the laboratory time decrease from 2013 to 2015. This shows that there is a decrease in the chemotherapy time and turnaround time before and after the intervention. We also have identified that there is a direct relationship between the reduction of turnaround time and chemotherapy waiting time. Conclusions: The need to structure how we deliver patient care specifically to cancer patient is an important drive for quality improvement. Basing on the result of the project and with the increase in patient satisfaction rate, it can be concluded that it is possible to reduce patients’ mean chemotherapy waiting time by applying more efficient process, which is the installation of satellite laboratory.

Growing Healing Touch as supportive cancer care in western New York.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 176-176
Author(s):  
Suzanne M Hess ◽  
Lynda M. Beaupin
Keyword(s):  
New York ◽  
Cancer Care ◽  
Symptom Relief ◽  
Physical Symptom ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Healing Touch ◽  
Energy Medicine ◽  
Supportive Cancer Care ◽  
Energy Field

176 Background: Healing Touch (HT) is a specific energy medicine modality that incorporates several techniques to balance the human energy field to help promote healing. It is a safe and non-invasive therapy that complements traditional, standard care and is recognized by NIH’s National Center for Complementary and Integrative Health. HT was first introduced to cancer survivors at our NCI-designated Comprehensive Cancer Center in 2013. We demonstrate HT is well-received and easy to integrate into traditional cancer care. Methods: A Certified Healing Touch Practitioner taught pediatric survivors and families HT techniques, as well as trained staff and volunteers to participate in the pilot program and to offer HT sessions throughout the year. Results: See Table. Qualitative analysis of participant’s feedback indicate benefits in the following themes: 1. Physical Symptom Relief 2. Emotional Issue Relief 3. Spiritual/Grief Support 4. Recommendation to Other Patients. Conclusions: Healing Touch is an energy medicine modality that is easy to teach, simple to integrate into routine cancer care, and beneficial for caregivers and survivors alike. [Table: see text]

Sign in / Sign up

Export Citation Format

Share Document