scholarly journals Developing an Intranet-Based Lymphedema Dashboard for Breast Cancer Multidisciplinary Teams: Design Research Study (Preprint)

2018 ◽  
Author(s):  
Anna Janssen ◽  
Candice Donnelly ◽  
Judy Kay ◽  
Peter Thiem ◽  
Aldo Saavedra ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Design Process ◽  
Clinical Data ◽  
Health Professionals ◽  
Multidisciplinary Team ◽  
Cancer Care ◽  
Design Research ◽  
Clinical Decision Making ◽  
Multidisciplinary Teams ◽  
Semistructured Interview

BACKGROUND A large quantity of data is collected during the delivery of cancer care. However, once collected, these data are difficult for health professionals to access to support clinical decision making and performance review. There is a need for innovative tools that make clinical data more accessible to support health professionals in these activities. One approach for providing health professionals with access to clinical data is to create the infrastructure and interface for a clinical dashboard to make data accessible in a timely and relevant manner. OBJECTIVE This study aimed to develop and evaluate 2 prototype dashboards for displaying data on the identification and management of lymphedema. METHODS The study used a co-design framework to develop 2 prototype dashboards for use by health professionals delivering breast cancer care. The key feature of these dashboards was an approach for visualizing lymphedema patient cohort and individual patient data. This project began with 2 focus group sessions conducted with members of a breast cancer multidisciplinary team (n=33) and a breast cancer consumer (n=1) to establish clinically relevant and appropriate data for presentation and the visualization requirements for a dashboard. A series of fortnightly meetings over 6 months with an Advisory Committee (n=10) occurred to inform and refine the development of a static mock-up dashboard. This mock-up was then presented to representatives of the multidisciplinary team (n=3) to get preliminary feedback about the design and use of such dashboards. Feedback from these presentations was reviewed and used to inform the development of the interactive prototypes. A structured evaluation was conducted on the prototypes, using Think Aloud Protocol and semistructured interviews with representatives of the multidisciplinary team (n=5). RESULTS Lymphedema was selected as a clinically relevant area for the prototype dashboards. A qualitative evaluation is reported for 5 health professionals. These participants were selected from 3 specialties: surgery (n=1), radiation oncology (n=2), and occupational therapy (n=2). Participants were able to complete the majority of tasks on the dashboard. Semistructured interview themes were categorized into engagement or enthusiasm for the dashboard, user experience, and data quality and completeness. CONCLUSIONS Findings from this study constitute the first report of a co-design process for creating a lymphedema dashboard for breast cancer health professionals. Health professionals are interested in the use of data visualization tools to make routinely collected clinical data more accessible. To be used effectively, dashboards need to be reliable and sourced from accurate and comprehensive data sets. While the co-design process used to develop the visualization tool proved effective for designing an individual patient dashboard, the complexity and accessibility of the data required for a cohort dashboard remained a challenge.

scholarly journals Developing an Intranet-Based Lymphedema Dashboard for Breast Cancer Multidisciplinary Teams: Design Research Study

10.2196/13188 ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. e13188 ◽  
Author(s):  
Anna Janssen ◽  
Candice Donnelly ◽  
Judy Kay ◽  
Peter Thiem ◽  
Aldo Saavedra ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Design Process ◽  
Clinical Data ◽  
Health Professionals ◽  
Multidisciplinary Team ◽  
Cancer Care ◽  
Design Research ◽  
Clinical Decision Making ◽  
Multidisciplinary Teams ◽  
Semistructured Interview

Background A large quantity of data is collected during the delivery of cancer care. However, once collected, these data are difficult for health professionals to access to support clinical decision making and performance review. There is a need for innovative tools that make clinical data more accessible to support health professionals in these activities. One approach for providing health professionals with access to clinical data is to create the infrastructure and interface for a clinical dashboard to make data accessible in a timely and relevant manner. Objective This study aimed to develop and evaluate 2 prototype dashboards for displaying data on the identification and management of lymphedema. Methods The study used a co-design framework to develop 2 prototype dashboards for use by health professionals delivering breast cancer care. The key feature of these dashboards was an approach for visualizing lymphedema patient cohort and individual patient data. This project began with 2 focus group sessions conducted with members of a breast cancer multidisciplinary team (n=33) and a breast cancer consumer (n=1) to establish clinically relevant and appropriate data for presentation and the visualization requirements for a dashboard. A series of fortnightly meetings over 6 months with an Advisory Committee (n=10) occurred to inform and refine the development of a static mock-up dashboard. This mock-up was then presented to representatives of the multidisciplinary team (n=3) to get preliminary feedback about the design and use of such dashboards. Feedback from these presentations was reviewed and used to inform the development of the interactive prototypes. A structured evaluation was conducted on the prototypes, using Think Aloud Protocol and semistructured interviews with representatives of the multidisciplinary team (n=5). Results Lymphedema was selected as a clinically relevant area for the prototype dashboards. A qualitative evaluation is reported for 5 health professionals. These participants were selected from 3 specialties: surgery (n=1), radiation oncology (n=2), and occupational therapy (n=2). Participants were able to complete the majority of tasks on the dashboard. Semistructured interview themes were categorized into engagement or enthusiasm for the dashboard, user experience, and data quality and completeness. Conclusions Findings from this study constitute the first report of a co-design process for creating a lymphedema dashboard for breast cancer health professionals. Health professionals are interested in the use of data visualization tools to make routinely collected clinical data more accessible. To be used effectively, dashboards need to be reliable and sourced from accurate and comprehensive data sets. While the co-design process used to develop the visualization tool proved effective for designing an individual patient dashboard, the complexity and accessibility of the data required for a cohort dashboard remained a challenge.

Multidisciplinary team meeting and EUSOMA quality indicators in breast cancer care: A French regional multicenter study

The Breast ◽  
2019 ◽  
Vol 46 ◽  
pp. 170-177 ◽  
Author(s):  
E. Pons-Tostivint ◽  
L. Daubisse-Marliac ◽  
P. Grosclaude ◽  
E. Oum sack ◽  
J. Goddard ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Indicators ◽  
Multicenter Study ◽  
Multidisciplinary Team ◽  
Cancer Care ◽  
Breast Cancer Care ◽  
Multidisciplinary Team Meeting ◽  
Team Meeting

Implementing value-based cancer care: A multidisciplinary approach to defining breast cancer outcomes.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 16-16
Author(s):  
Oluwadamilola M. Fayanju ◽  
Tinisha L. Mayo ◽  
Tracy E. Spinks ◽  
Seohyun Lee ◽  
Carlos Hernando Barcenas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Performance Improvement ◽  
Cancer Care ◽  
Treatment Options ◽  
The United States ◽  
Multidisciplinary Teams ◽  
Patient Portal ◽  
Breast Cancer Patients ◽  
Patient Centered ◽  
Patient Reported

16 Background: Value in healthcare (patient-centered outcomes achieved per dollar spent) unifies performance improvement goals with health outcomes of importance to patients. We describe the process through which value-based measures for breast cancer patients and dynamic capture of these metrics via our new electronic health record (EHR) were developed at our institution. Methods: A review of the breast cancer literature was conducted on treatment options as well as expected outcomes and potential treatment complications. Patient perspective was obtained via focus groups. Multidisciplinary teams met to inform a 3-phase process of (1) concept development, (2) measure specification, and (3) implementation via EHR integration, planned for spring 2016. Results: Outcomes were divided into 3 previously defined tiers (NEJM 2010; 363:2477-2481) that reflect the entire cycle of care (Table).Within these tiers, 22 patient-centered outcomes were defined with inclusion/exclusion criteria, specifications for reporting, and sources for data including the EHR and validated patient-reported outcome questionnaires (e.g., FACT-B+4) administered via our patient portal. Conclusions: A value-based approach to cancer care with transparently reported patient outcomes not only creates opportunity for performance improvement but also enables benchmarking within and across providers, healthcare systems, and even countries. Our value-based framework for breast cancer is the first of its kind in the United States, with a similar model being pursued internationally as well. [Table: see text]

Implementing a tumor program strengthening initiative in western Sydney.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19223-e19223
Author(s):  
Lynleigh Evans ◽  
Yiren Liu ◽  
Terence Kwan ◽  
Brendan Donovan ◽  
Karen Byth ◽  
...  
Keyword(s):  
Decision Making ◽  
Quality Improvement ◽  
Team Performance ◽  
Multidisciplinary Team ◽  
Cancer Care ◽  
Program Improvement ◽  
Multidisciplinary Teams ◽  
Improvement Program ◽  
Annual Survey ◽  
Monitoring Performance

e19223 Background: While multidisciplinary teams (MDTs) are well-established in many healthcare institutions, both how they function and their role in decision making vary widely. This study assessed the effectiveness of a multipronged approach to strengthening multidisciplinary team performance for a cancer service over three years. Methods: The study comprised the introduction of a structured quality improvement program, the Tumour Program Strengthening Initiative (TPSI), to improve MDT performance, and an annual survey to evaluate MDT members’ perceptions of their teams’ performance. Three iterations of the survey have been completed. Results: 12 teams participated in TPSI with 129, 118, and 146 members completing the MDT member survey in 2017, 2018, and 2019 respectively. Of the 18 questions that were asked throughout the study, nine showed significant improvement, and of these, seven were highly significant. Questions related to patient wellbeing and to audits and quality improvement showed no significant change. Conclusions: The Tumour Program Strengthening Initiative resulted in sustained and significant improvement in MDT performance over three years. The MDT survey proved to be useful not only for cancer care teams to identify their strengths and weaknesses and monitoring performance but also for management to flag priority areas for improvement and further support. The significance of this initiative is that overall program improvement reflects the strengthening of the weakest teams as well as further improvement in highly performing MDTs. [Table: see text]

scholarly journals Introduction to the United Kingdom National Multidisciplinary Guidelines for Head and Neck Cancer

2016 ◽  
Vol 130 (S2) ◽  
pp. S3-S4 ◽  
Author(s):  
V Paleri ◽  
N Roland
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Multidisciplinary Team ◽  
Cancer Care ◽  
Good Practice ◽  
Multidisciplinary Teams ◽  
Evidence Based ◽  
The United Kingdom ◽  
The Uk

AbstractThis is the 5th edition of the UK Multi-Disciplinary Guidelines for Head and Neck Cancer, endorsed by seven national specialty associations involved in head and neck cancer care. Our aim is to provide a document can be used as a ready reference for multidisciplinary teams and a concise easy read for trainees. All evidence based recommendations in this edition are indicated by ‘(R)’ and where the multidisciplinary team of authors consider a recommendation to be based on clinical experience, it is denoted by ‘(G)’ as a good practice point.

Patient experience and attitudes toward addressing the cost of breast cancer care.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6551-6551 ◽  
Author(s):  
Blair Billings Irwin ◽  
Yousuf Zafar ◽  
Ivy Altomare ◽  
Gretchen Genevieve Kimmick ◽  
P. Kelly Marcom ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Financial Distress ◽  
Cancer Care ◽  
Clinical Decision Making ◽  
Stage Iv ◽  
Insurance Companies ◽  
Disease Stage ◽  
High Quality ◽  
Societal Costs

6551 Background: The American Society of Clinical Oncology has suggested that patient-physician discussion of costs is a component of high quality care. Little data exists on patients’ experience confronting costs or attitudes on how cost should be addressed. Methods: We distributed a self-administered anonymous paper survey to consecutive patients with breast cancer presenting for a routine visit within 5 years of diagnosis at an academic center. Survey questions addressed financial distress, experience and preferences concerning discussions of cost, and views on cost control. Results are primarily descriptive, with comparison among patients on the basis of disease stage using Fisher’s exact test. All p-values are 2-sided. Results: We surveyed 134 patients (response rate 86%). Median age was 61. 72% stage I-III disease, and 28% (n=36) had stage IV disease. 44% (n=57) reported at least a moderate level of financial distress. Only 14% (n=18) reported ever discussing costs with their doctor, though 94% (n=121) felt doctors should talk to patients about costs. 53% (n=69) felt doctors should discuss direct costs with patients but only 38% (n=49) felt doctors should consider costs to society or insurance companies in their decision-making. Patients with metastatic disease were significantly less likely than those with earlier stage disease to want doctors to consider societal costs (33% (n=24) vs 6% (n=2), p<0.01). 88% (n=114) reported concern over costs of cancer care, but there was no consensus on how to control costs. Only 3% (n=4) favored greater cost sharing and 9% (n=11) supported greater means testing. A minority (33%, n=43) supported reducing drug costs through government price controls (33% n=43). The majority endorsed generic substitution (59%, n=75) and preferential selection of drugs which prolong survival 53% (n=69). Conclusions: Although many patients with breast cancer want to discuss costs of care with their doctors, there is little consensus on the ideal content of these discussions. Few patients support consideration of societal costs in clinical decision-making. Further research is needed to evaluate the potential for patient-physician discussions of cost to contribute to affordable high quality cancer care.

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