ASO Author Reflections: The National Cancer Database as a Tool to Advance the Quality of Cancer Care Delivery in the US

2019 ◽  
Vol 26 (S3) ◽  
pp. 623-624
Author(s):  
Katherine Mallin
Keyword(s):  
Cancer Care ◽  
Care Delivery ◽  
National Cancer Database ◽  
The Us

Preparing for an Epidemic: Cancer Care in an Aging Population

2014 ◽  
pp. 133-137 ◽  
Author(s):  
Ya-Chen Tina Shih ◽  
Arti Hurria
Keyword(s):  
Older Adults ◽  
Cancer Care ◽  
Care Delivery ◽  
Quality Care ◽  
Aging Population ◽  
Population Based ◽  
Cancer Drug ◽  
Evidence Based ◽  
Evidence Based Care

The Institute of Medicine's (IOM) Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population was charged with evaluating and proposing recommendations on how to improve the quality of cancer care, with a specific focus on the aging population. Based on their findings, the IOM committee recently released a report highlighting their 10 recommendations for improving the quality of cancer care. Based on those recommendations, this article highlights ways to improve evidence-based care and addresses rising costs in health care for older adults with cancer. The IOM highlighted three recommendations to address the current research gaps in providing evidence-based care in older adults with cancer, which included (1) studying populations which match the age and health-risk profile of the population with the disease, (2) legislative incentives for companies to include patients that are older or with multiple morbidities in new cancer drug trials, and (3) expansion of research that contributes to the depth and breadth of data available for assessing interventions. The recommendations also highlighted the need to maintain affordable and accessible care for older adults with cancer, with an emphasis on finding creative solutions within both the care delivery system and payment models in order to balance costs while preserving quality of care. The implementation of the IOM's recommendations will be a key step in moving closer to the goal of providing accessible, affordable, evidence-based, high-quality care to all patients with cancer.

scholarly journals Assessing Patients’ Perceptions of Cancer Care Coordination in a Community-Based Setting

2020 ◽  
Vol 16 (8) ◽  
pp. e726-e733
Author(s):  
Izumi Okado ◽  
Kevin Cassel ◽  
Ian Pagano ◽  
Randall F. Holcombe
Keyword(s):  
Care Coordination ◽  
Family Caregiver ◽  
Cancer Care ◽  
Care Delivery ◽  
Disease Stage ◽  
Patient Navigator ◽  
Patient Questionnaire ◽  
Cancer Disease ◽  
Caregiver Support

PURPOSE: Effective care coordination (CC) is a hallmark of a high-quality cancer care. However, efforts to improve cancer care delivery are limited by the lack of a clinically useful tool to assess CC. In this study, we examined patients’ perceptions of cancer CC using a novel tool, the Care Coordination Instrument (CCI), and evaluated the quality of the CCI. METHODS: The CCI is a 29-item patient questionnaire that assesses CC across varied practice settings and patient populations overall and for three critical domains of CC: communication, navigation, and operational. We conducted univariable and multivariable regression analyses to identify patient clinical and practice characteristics associated with optimal versus suboptimal CC. RESULTS: Two hundred patients with cancer completed the CCI questionnaire between October 2018 and January 2019, of whom 189 were used for the analysis. The presence of a family caregiver and a diagnosis of a blood cancer were correlated with overall positive reports of CC ( P < .001 and P < .05, respectively). Poorer perceptions of CC were associated with having a head and neck cancer and the absence of family caregiver support. The effects of cancer disease stage and having access to a patient navigator on CC were not statistically significant. CONCLUSION: Integrating a patient-centered tool to assess cancer CC can be a strategy to optimize cancer care delivery. Understanding factors associated with effective and ineffective CC can help inform efforts to improve overall quality of care and care delivery.

Improving the Quality of Rectal Cancer Care in the US: Is Accreditation Enough?

2018 ◽  
Vol 227 (4) ◽  
pp. S150
Author(s):  
Kerui Xu ◽  
Charles W. Acher ◽  
Nick A. Zaborek ◽  
Jessica R. Schumacher ◽  
Elise H. Lawson
Keyword(s):  
Rectal Cancer ◽  
Cancer Care ◽  
The Us

Improving the quality of oral cancer drug delivery across a health system.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 184-184
Author(s):  
Katherine Enright ◽  
Rosemary Ku ◽  
Daniela Gallo-Hershberg ◽  
Aliya Pardhan ◽  
Leta Marie Forbes
Keyword(s):  
Patient Education ◽  
Cancer Care ◽  
Care Delivery ◽  
Treatment Plan ◽  
Quality Measures ◽  
Patient Specific ◽  
Cancer Drug ◽  
Use Of Technology ◽  
Adherence Monitoring

184 Background: Oral systemic therapy (ST) presents unique care delivery challenges. Gaps in patient education and monitoring for patients on oral ST delivery are well documented and can result in decreased adherence or increased toxicity. Within Ontario, cancer care is provincially coordinated through Ontario Health- Cancer Care Ontario (OH-CCO), but locally implemented by 14 Regional Cancer Programs (RCPs). Using a centrally coordinated, but regionally implemented quality improvement (QI) approach, we aimed to improve the quality of oral ST delivery across Ontario by enabling the use of patient specific monitoring plans to optimize treatment adherence and toxicity management. Methods: Between 2018 and 2020 a 2 year focused QI project was undertaken. A suite of 19 quality measures were developed to measure different quality domains for oral ST delivery including treatment plan documentation, patient education, toxicity/adherence monitoring and toxicity outcomes. In year 1, all regions used the suite of quality measures to establish baseline performance and develop a QI plan using rapid cycle improvement methodology to improve performance in at least 1 domain based on regional gaps and priorities. Projects were implemented and evaluated during year 2. OH-CCO provided QI coaching through dissemination of standardized QI tools, a monthly discussion forum and project specific feedback. At the end of year 2, a post-implementation evaluation was performed for each region. Results: 15 centers participated, representing all RCPs across Ontario. The participating centers implemented QI projects focused on treatment plan documentation (N = 3), patient education (N = 10) and toxicity/adherence management (N = 5), with some focusing on multiple domains. All centers reported an improvement in at least 1 domain (see Table). Key enablers identified include engagement with a multi-disciplinary team and the use of technology, while barriers include lack of onsite dispensing pharmacy. Future work will continue to focus on quality of oral ST delivery and better pharmacy integration. Conclusions: Through a centrally coordinated, locally implemented QI project, improvement in quality of oral ST care was achieved across Ontario. This model of QI focus has the potential to be adaptable across health systems. [Table: see text]

scholarly journals The Impact of the COVID-19 Pandemic on Cancer Care and Health-Related Quality of Life of Non-Hispanic Black/African American, Hispanic/Latina and Non-Hispanic White Women Diagnosed with Breast Cancer in the U.S.: A Mixed-Methods Study Protocol

2021 ◽  
Vol 18 (24) ◽  
pp. 13084
Author(s):  
Chiara Acquati ◽  
Tzuan A. Chen ◽  
Isabel Martinez Leal ◽  
Shahnjayla K. Connors ◽  
Arooba A. Haq ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mixed Methods ◽  
Cancer Care ◽  
Care Delivery ◽  
Mixed Methods Study ◽  
Black African ◽  
Related Quality ◽  
Health Related ◽  
Hispanic White

The COVID-19 pandemic has had critical consequences for cancer care delivery, including altered treatment protocols and delayed services that may affect patients’ quality of life and long-term survival. Breast cancer patients from minoritized racial and ethnic groups already experience worse outcomes, which may have been exacerbated by treatment delays and social determinants of health (SDoH). This protocol details a mixed-methods study aimed at comparing cancer care disruption among a diverse sample of women (non-Hispanic White, non-Hispanic Black/African American, and Hispanic/Latina) and assessing how proximal, intermediate, and distal SDoH differentially contribute to care continuity and health-related quality of life. An embedded mixed-methods design will be implemented. Eligible participants will complete an online survey, followed by a semi-structured interview (with a subset of participants) to further understand factors that influence continuity of care, treatment decision-making, and self-reported engagement. The study will identify potentially modifiable factors to inform future models of care delivery and improve care transitions. These data will provide the necessary evidence to inform whether a subsequent, multilevel intervention is warranted to improve quality of care delivery in the COVID-19 aftermath. Additionally, results can be used to identify ways to leverage existing social resources to help manage and support patients’ outcomes.

Impact of the COVID-19 pandemic on care delivery and outcomes for patients with metastatic pancreatic ductal adenocarcinoma (mPDAC).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 4137-4137
Author(s):  
Ravi Kumar Paluri ◽  
Paul Cockrum ◽  
Ashley Ann Laursen ◽  
Joseph Louis Gaeta ◽  
Shu Wang ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Cancer Care ◽  
De Novo ◽  
Care Delivery ◽  
Stage Iv ◽  
Ductal Adenocarcinoma ◽  
Similar Proportion ◽  
Number Of Patients ◽  
The Us ◽  
The Impact

4137 Background: The coronavirus disease 2019 (COVID-19) pandemic has caused abrupt changes to the US health system and disruption in cancer care delivery. Little has been reported on the impact of COVID-19 on patients with mPDAC and the care delivery. Our study aimed to characterize the impact of COVID-19 on healthcare utilization and outcomes for patients with mPDAC in the US in the community oncology setting. Methods: We performed a retrospective cohort study of adult patients diagnosed with mPDAC between March – September 2019 and March – September 2020 using the nationwide Flatiron Health EHR database, comprising data from over 280 (largely community based) cancer clinics. Patients were stratified into two cohorts based on the year of diagnosis (2019 vs. 2020). Clinical characteristics were summarized including age at metastatic diagnosis, stage at initial diagnosis, and ECOG performance score (PS). Overall survival (OS) from metastatic diagnosis was estimated using Kaplan-Meier methods. A sensitivity analysis limiting the follow-up time to November of each year was conducted. Results: Overall, 1,719 patients were included in the study (2019: n = 923, 2020: n = 796); both cohorts had similar demographic compositions in terms of age and sex (2019: median age = 70 (IQR: 62 – 76), 52.2% male; 2020: median age = 70 [IQR: 62 – 76], 53.5% male). In 2020, the number of newly diagnosed mPDAC patients decreased by 13.8% compared to 2019. A slightly higher proportion of patients were initially diagnosed with stage IV disease in 2020 (69.7%) vs 2019 (62.3%). A similar proportion of patients with ECOG PS 0-1 was observed between the two cohorts (2019: 48.5%; 2020: 47.9%). The number of visits recorded within the first 90 days after metastatic diagnosis was similar between the two cohorts (2019: median 8 [IQR: 3 – 14]; 2020: median 9 [IQR: 4 – 14]). For both cohorts, the proportion of patients who received 1L treatment was similar (2019: 75.8%; 2020: 76.5%), and the most common 1L treatment regimen was gemcitabine plus nab-paclitaxel (2019: 37.6%; 2020: 40.9%). Of the 1L treated populations, 37.6% of patients diagnosed in 2019 received second line (2L) compared to 17.9% of the 2020 cohort; 16.9% of 1L treated patients in 2019 received 2L in the sensitivity analysis. Patients diagnosed in 2020 had a significantly lower median OS of 6.1 months (95% CI: 5.4 – 6.9) compared to patients diagnosed in 2019: 8.4 months (7.5 – 9.0) (p < 0.001). Conclusions: During the COVID-19 pandemic era, the diagnoses of de novo mPDAC appears to have been impacted, with a higher number of patients diagnosed with advanced stage at presentation. Our analysis suggests that while patients diagnosed in 2020 received a similar level of care as those in 2019, their survival outcomes were adversely affected. Further research is necessary to characterize the impact of the COVID-19 pandemic on cancer care and outcomes.

scholarly journals Measuring the Quality of a Childhood Cancer Care Delivery System: Assessing Stakeholder Agreement

2013 ◽  
Vol 16 (4) ◽  
pp. 639-646 ◽  
Author(s):  
Nicole M.E. Bradley ◽  
Paula D. Robinson ◽  
Mark L. Greenberg ◽  
Ronald D. Barr ◽  
Anne F. Klassen ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Delivery System ◽  
Cancer Care ◽  
Care Delivery

scholarly journals Filling the Gap: Development of the Oncology Nurse Practitioner Workforce

2010 ◽  
Vol 6 (1) ◽  
pp. 2-6 ◽  
Author(s):  
Brenda Nevidjon ◽  
Paula Rieger ◽  
Cynthia Miller Murphy ◽  
Margaret Quinn Rosenzweig ◽  
Michele R. McCorkle ◽  
...  
Keyword(s):  
Nurse Practitioner ◽  
Cancer Care ◽  
Care Delivery ◽  
Care Needs ◽  
Oncology Nurse ◽  
The Us ◽  
New Strategy ◽  
Oncology Care ◽  
Potential Cancer

A new strategy for oncology care delivery that includes increasing the numbers and expanding the roles of nonphysician practitioners is critically important to meet the current and potential cancer care needs of the US population.

scholarly journals Development of National Cancer Database for Cost and Quality of Life (CaDCQoL) in India: a protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e048513
Author(s):  
Shankar Prinja ◽  
Jyoti Dixit ◽  
Nidhi Gupta ◽  
Nikita Mehra ◽  
Ashish Singh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Care ◽  
Healthcare Costs ◽  
National Level ◽  
National Database ◽  
Cancer Site ◽  
Economic Evaluations ◽  
National Cancer Database ◽  
Study Results

IntroductionThe rising economic burden of cancer on healthcare system and patients in India has led to the increased demand for evidence in order to inform policy decisions such as drug price regulation, setting reimbursement package rates under publicly financed health insurance schemes and prioritising available resources to maximise value of investments in health. Economic evaluations are an integral component of this important evidence. Lack of existing evidence on healthcare costs and health-related quality of life (HRQOL) makes conducting economic evaluations a very challenging task. Therefore, it is imperative to develop a national database for health expenditure and HRQOL for cancer.Methods and analysisThe present study proposes to develop a National Cancer Database for Cost and Quality of Life (CaDCQoL) in India. The healthcare costs will be estimated using a patient perspective. A cross-sectional study will be conducted to assess the direct out-of-pocket expenditure (OOPE), indirect cost and HRQOL among cancer patients who will be recruited at seven leading cancer centres from six states in India. Mean OOPE and HRQOL scores will be estimated by cancer site, stage of disease and type of treatment. Economic impact of cancer care on household financial risk protection will be assessed by estimating prevalence of catastrophic health expenditures and impoverishment. The national database would serve as a unique open access data repository to derive estimates of cancer-related OOPE and HRQOL. These estimates would be useful in conducting future cost-effectiveness analyses of management strategies for value-based cancer care.Ethics and disseminationApproval was granted by Institutional Ethics Committee vide letter no. PGI/IEC-03/2020-1565 of Post Graduate Institute of Medical Education and Research, Chandigarh, India. The study results will be published in peer-reviewed journals and presented to the policymakers at national level.

Effect of a gastrointestinal multidisciplinary clinic on the quality of pancreatic cancer care delivery at a community cancer center.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 378-378
Author(s):  
Laurence E. McCahill ◽  
Gerald P. Wright ◽  
Sunil Konduri ◽  
Mary May ◽  
Coralyn Martinez ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cancer Care ◽  
Care Delivery ◽  
Clinical Stage ◽  
Quality Measures ◽  
Cancer Center ◽  
R0 Resection ◽  
Value Assessment ◽  
Periampullary Neoplasms

378 Background: Healthcare reform calls for measurements of value in services received. The 2002 IOM report Crossing the Quality Chasm emphasized deficits in efficiency, effectiveness, and patient centeredness. In 2009, a pancreatic cancer panel proposed 43 measures for high quality pancreatic cancer care. We incorporated these composite measures into a unique program of multidisciplinary (MD) care, nurse navigation (NN), and quality monitoring. Methods: A MD gastrointestinal cancer program was initiated in Jan 2010. Key components included a treatment planning conference followed immediately by a MD clinic. A GI NN coordinated staging, clinical evaluation, and treatment initiation. Patients with suspected /newly diagnosed pancreatic or periampullary neoplasms were included. We evaluated our quality of cancer care and outcomes proposed by the pancreatic cancer quality expert panel. Results: A total of 76 patients with pancreatic neoplasms were evaluated over 18 months, 55 subjects had confirmed malignancies. Of these, 20 were clinical Stage I/II, 15 stage III and 20 Stage IV. Quality measures in Table 1 focus on quality measures. 25 patients underwent resection. Mean OR time was 424 min, mean EBL 843 mL, morbidity 30%, mortality 4%, R0 resection rate 76%, mean nodes evaluated 24, and mean hospital LOS 10 days. Complete adherence with guidelines occurred in all 30 non-operative patients and 22 of 25 patients who undergoing resection. Overall compliance for all pancreatic cancer care guidelines was 99.7%. Conclusions: Comprehensive MD pancreatic cancer evaluation and care is feasible in a community cancer. We believe this study establishes new benchmarks of quality and value assessment for pancreatic cancer programs. [Table: see text]

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