Improving a Grief and Loss Program: Caring for Patients, Families, and Staff

2013 ◽  
Vol 67 (1-2) ◽  
pp. 233-239 ◽  
Author(s):  
Susan A. Wintermeyer-Pingel ◽  
Donna Murphy ◽  
Karen J. Hammelef
Keyword(s):  
Program Evaluation ◽  
Support Groups ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Grief And Loss ◽  
Staff Support ◽  
Care Services ◽  
Grief Support ◽  
Phone Calls ◽  
The University

The University of Michigan Comprehensive Cancer Center (UMCCC) Grief and Loss Program provides supportive care services during bereavement which is considered part of the care continuum. This program received 50 death notifications per month upon project initiation and currently receives approximately 125 per month. Initial program evaluation was conducted via a pilot survey of bereaved parents as well as verbal and written evaluations from the transdisciplinary staff of Patient and Family Support Services. Grief support prior to evaluation included mailings, phone calls as indicated, poorly attended bereavement support groups, and limited staff support. Based on program evaluation, grief support continues through the use of mail/e-mail and phone calls to those at risk for complicated grief. Three to four gatherings per year are offered rather than monthly support groups, and connections to community resources are provided. The Comfort And Resources at End of Life (C-A-R-E) program was implemented to support and educate staff. Next steps include further program evaluation and potential research to examine best practices for the bereaved.

Oral oncolytic education and adherence monitoring in poor, rural and minority patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19212-e19212
Author(s):  
Tiffany Menhorn ◽  
Amy Zarick-Jones ◽  
Moises Harari Turquie ◽  
Shenthol Sasankan ◽  
Neda Hashemi-Sadraei ◽  
...  
Keyword(s):  
Native Americans ◽  
Poverty Rate ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
University Of New Mexico ◽  
Phone Calls ◽  
Adherence Monitoring ◽  
The University ◽  
Oral Oncolytics

e19212 Background: Oral oncolytics therapy use has been exponentially growing over the last several years necessitating education and monitoring. Pharmacy driven interventions have been shown to increase side effects detection, mitigation and ensure adherence. The University of New Mexico Comprehensive Cancer Center (UNMCCC) treats a unique population composed of poor (poverty rate 19.7%), rural (22.6%) and minority (Native Americans and Hispanics constitute 10.4% and 48% of the population respectively). Methods: New patients starting oral oncolytics were enrolled from May 2019 to January 2020 with an initial 30-minute educational visit with a pharmacist. UNMCCC initiated a pharmacy driven process of tracking patients via phone calls to monitor compliance, early presence of adverse events and issues surrounding the administration of oral oncolytics. Phone calls were conducted monthly for three months and then spaced out depending on patient and drug characteristics. Late education occurred when the initial education was performed after the patient started chemotherapy. Late first follow-ups occurred when the follow-up date was greater thirty-eight days after the start of chemotherapy. Results: A total of 196 patients started on oral chemotherapy of which 70% (139) received education following prescription, 17% (35) received late education and 11% (22) missed education. Newly started actively monitored patients significantly increased to 196 patients by the ninth month of the program. A total of 296 follow ups calls were performed within the first three months, 41% (111) were considered late follow-up. The first, second and third call were missed in 18% (49), 14% (40) and 16% (45) of patients. Conclusions: The UNMCCC cares for poor, rural and minority based patients and was able to reach the majority of patients in a timely manner for education and adherence monitoring. Our efforts were significantly hampered by the increasing number of active patients needing monitoring as the program progressed which will require further resources including, a close collaboration between physicians and pharmacists to provide a service that was previously absent and process changes which we are addressing as our next steps.

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 Rapid Utilization of Telehealth in a Comprehensive Cancer Center as a Response to COVID-19: Cross-Sectional Analysis (Preprint)

2020 ◽  
Author(s):  
Peter E Lonergan ◽  
Samuel L Washington III ◽  
Linda Branagan ◽  
Nathaniel Gleason ◽  
Raj S Pruthi ◽  
...  
Keyword(s):  
San Francisco ◽  
Video Conferencing ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Primary Language ◽  
Cross Sectional ◽  
Patient Demographics ◽  
Race Ethnicity ◽  
The University ◽  
Sectional Analysis

BACKGROUND The emergence of the coronavirus disease (COVID-19) pandemic in March 2020 created unprecedented challenges in the provision of scheduled ambulatory cancer care. As a result, there has been a renewed focus on video-based telehealth consultations as a means to continue ambulatory care. OBJECTIVE The aim of this study is to analyze the change in video visit volume at the University of California, San Francisco (UCSF) Comprehensive Cancer Center in response to COVID-19 and compare patient demographics and appointment data from January 1, 2020, and in the 11 weeks after the transition to video visits. METHODS Patient demographics and appointment data (dates, visit types, and departments) were extracted from the electronic health record reporting database. Video visits were performed using a HIPAA (Health Insurance Portability and Accountability Act)-compliant video conferencing platform with a pre-existing workflow. RESULTS In 17 departments and divisions at the UCSF Cancer Center, 2284 video visits were performed in the 11 weeks before COVID-19 changes were implemented (mean 208, SD 75 per week) and 12,946 video visits were performed in the 11-week post–COVID-19 period (mean 1177, SD 120 per week). The proportion of video visits increased from 7%-18% to 54%-72%, between the pre– and post–COVID-19 periods without any disparity based on race/ethnicity, primary language, or payor. CONCLUSIONS In a remarkably brief period of time, we rapidly scaled the utilization of telehealth in response to COVID-19 and maintained access to complex oncologic care at a time of social distancing.

scholarly journals Experience of palliative care services at tertiary comprehensive cancer center during COVID-19 lockdown phase: An analytical original study

2020 ◽  
Vol 26 (5) ◽  
pp. 27
Author(s):  
Priti Sanghavi ◽  
Manisha Singh ◽  
Bhavna Patel ◽  
Ravi Umrania ◽  
Kikato Chishi ◽  
...  
Keyword(s):  
Palliative Care ◽  
Original Study ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Care Services ◽  
Palliative Care Services

scholarly journals Considerations for Managing Patients With Hematologic Malignancy During the COVID-19 Pandemic: The Seattle Strategy

2020 ◽  
Vol 16 (9) ◽  
pp. 571-578 ◽  
Author(s):  
Mary-Elizabeth M. Percival ◽  
Ryan C. Lynch ◽  
Anna B. Halpern ◽  
Mazyar Shadman ◽  
Ryan D. Cassaday ◽  
...  
Keyword(s):  
Hematologic Malignancy ◽  
Hematologic Malignancies ◽  
The United States ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Clinical Practices ◽  
General Management ◽  
Disease States ◽  
Potential Risks ◽  
The University

In January 2020, the first documented patient in the United States infected with severe acute respiratory syndrome coronavirus 2 was diagnosed in Washington State. Since that time, community spread of coronavirus disease 2019 (COVID-19) in the state has changed the practice of oncologic care at our comprehensive cancer center in Seattle. At the Seattle Cancer Care Alliance, the primary oncology clinic for the University of Washington/Fred Hutchinson Cancer Consortium, our specialists who manage adult patients with hematologic malignancies have rapidly adjusted clinical practices to mitigate the potential risks of COVID-19 to our patients. We suggest that our general management decisions and modifications in Seattle are broadly applicable to patients with hematologic malignancies. Despite a rapidly changing environment that necessitates opinion-based care, we provide recommendations that are based on best available data from clinical trials and collective knowledge of disease states.

Creating an Effort Tracking Tool to Improve Therapeutic Cancer Clinical Trials Workload Management and Budgeting

2011 ◽  
Vol 9 (11) ◽  
pp. 1228-1233 ◽  
Author(s):  
Pam James ◽  
Patty Bebee ◽  
Linda Beekman ◽  
David Browning ◽  
Mathew Innes ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Clinical Research ◽  
Data Management ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
University Of Michigan ◽  
Web Based ◽  
Workload Management ◽  
Effective Cost ◽  
The University

Quantifying data management and regulatory workload for clinical research is a difficult task that would benefit from a robust tool to assess and allocate effort. As in most clinical research environments, The University of Michigan Comprehensive Cancer Center (UMCCC) Clinical Trials Office (CTO) struggled to effectively allocate data management and regulatory time with frequently inaccurate estimates of how much time was required to complete the specific tasks performed by each role. In a dynamic clinical research environment in which volume and intensity of work ebbs and flows, determining requisite effort to meet study objectives was challenging. In addition, a data-driven understanding of how much staff time was required to complete a clinical trial was desired to ensure accurate trial budget development and effective cost recovery. Accordingly, the UMCCC CTO developed and implemented a Web-based effort-tracking application with the goal of determining the true costs of data management and regulatory staff effort in clinical trials. This tool was developed, implemented, and refined over a 3-year period. This article describes the process improvement and subsequent leveling of workload within data management and regulatory that enhanced the efficiency of UMCCC's clinical trials operation.

scholarly journals Urologic Oncology Patient Perspectives During COVID-19 Treatment Delays

2021 ◽  
Author(s):  
Anna Faris ◽  
Lindsey Herrel ◽  
James Montie ◽  
Stephanie Chisholm ◽  
Ashley Duby ◽  
...  
Keyword(s):  
Treatment Delay ◽  
Ordinal Scale ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Oncology Patient ◽  
Urologic Oncology ◽  
Personalized Care ◽  
Phone Calls ◽  
Urologic Cancer ◽  
Clinically Significant

Abstract Purpose The COVID-19 pandemic led to delays in urologic cancer treatment. We sought the patient perspective on these delays. Methods We conducted a mixed methods study with an explanatory-sequential design. Survey findings are presented here. Patients from a Midwestern Comprehensive Cancer Center and the Bladder Cancer Advocacy Network provided demographic and clinical data and responded to statements asking them to characterize their experience of treatment delay, patient-provider communication and coping strategies. We quantified patient distress with an ordinal scale (0-10), based on the National Comprehensive Cancer Network Distress Thermometer (NCCN-DT). Results Forty-four consenting patients responded to the survey. Most were older than 61 years (77%) and male (66%). Their diagnoses included bladder (45%), prostate (30%) and kidney (20%) cancers. Median time since diagnosis was 6 months, 95% had plans for surgical treatment. Dominant reactions to treatment delay included fear that cancer would progress (50%) and relief at avoiding COVID-19 exposure (43%). Most patients reported feeling that their providers acknowledged their emotions (70%), yet 52% did not receive follow up phone calls and only 55% felt continually supported by their providers. Patients’ median distress level was 5/10 with 68% of patients reaching a clinically significant level of distress (≥4). Thematically grouped suggestions for providers included better communication (18%), more personalized support (14%), and better patient education (11%). Conclusion During the COVID-19 pandemic, a high proportion of urologic cancer patients reached a clinically significant level of distress. While they felt concern from providers, they desired more engagement and personalized care.

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