scholarly journals Data Linkage for Optimizing Rectal Cancer Care in Alberta

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Quynh Le ◽  
Lorraine Shack ◽  
Adam Elwi ◽  
Francesca Coutinho ◽  
Ryan Rochon ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Cancer Care ◽  
Data Linkage ◽  
Surgical Techniques ◽  
Quality Metrics ◽  
Physician Education ◽  
Tumor Board ◽  
Standards Of Care ◽  
Feedback Report

IntroductionDespite good overall care in Alberta Health Services the local recurrence rates are higher than what is accepted as standard of care for rectal cancer treatment. There are variations in pre-operative staging, application of best surgical techniques and pathological grading, use of neoadjuvant and adjuvant therapies, and in clinical reporting. Objectives and ApproachWe aimed at reducing the variations through the design and implementation of a provincial clinical pathway for rectal cancer by 2018. Our approaches included: 1) multidisciplinary tumor board consultation together with physician education sessions in reviewing standards of care and quality metrics; 2) data linkage and analysis based on chart reviews and extraction of data from Alberta Cancer Registry; and 3) production of provincial reports and individual feedbacks to physicians. CancerControl Alberta and Cancer Strategic Clinical Network collaborated in the linkage and analysis of data as well as mobilization oncology physicians to the initiative. ResultsA review of a set of metrics for producing individual and provincial feedback reports to rectal cancer physicians. The set has 24 key quality metrics includes five, four, eight, and six metrics for radiologists, pathologists, oncologists, and surgeons respectively. Thirty-two surgeons have received individual physician feedback reports. Feedback reports for radiologist, pathologist and oncologist are being finalized with input from key opinion leaders in each physician group. Key impacts to the quality of rectal cancer diagnosis, treatment, and care between 2013 and 2015 include increases in use of rectal cancer pre-operative MRIs for curative resections (+23%), completeness of synoptic MRI reports for pre-operative MRIs (+21%), grade 3 TME of curative resections (+4%), and pathologic reporting of TME assessments (+2%). Conclusion/ImplicationsPhysician feedback report system will enable the Alberta rectal cancer community to sustain the results and address strategies to continuously enhance the quality of rectal cancer care and survival. We recommend ongoing annual dissemination of feedback reports to support continuous improvement of rectal cancer care.

Development of a comprehensive set of colorectal cancer care quality metrics.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 670-670
Author(s):  
Laurence E. McCahill ◽  
Jamie Kokko ◽  
Chris Werkemma ◽  
Pierson Ebrom ◽  
Sarat Khandavalli
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Rectal Cancer ◽  
Cancer Care ◽  
Quality Metrics ◽  
Care Quality ◽  
Post Treatment ◽  
Care Providers ◽  
Care Surgery

670 Background: Institute of Medicine report calls for improved quality of cancer care. Numerous entities have sought measures of health care quality, but there is limited consensus regarding metrics for quality of colorectal cancer (CRC) care. Current measures are very limited; there exist no comprehensive metrics for quality of CRC care across the continuum of care. We sought to identify robust quality metrics, including measures related to pathology, coordination of cancer care, surgery, radiation, chemotherapy and surveillance, in order to identify gaps in quality of CRC care. Methods: National guidelines (NCCN and ASCO), National Quality Forum, and select peer reviewed publications were reviewed to develop evidence based metrics to assess quality of CRC care from diagnosis to post treatment surveillance and survivorship. A core group of health care providers, including a surgical oncologist, a pathologist and a Cancer nurse practitioner developed the metrics based on literature review. Measures were reviewed by key physician stakeholders including Radiation Oncology, Medical Oncology, General surgery, and Gastroenterology to obtain support for the quality initiative at our institution. Results: Twenty-three quality metrics were developed including 6 metrics related to access and process, 6 related to pathology, 7 related to multidisciplinary care and 4 measures related to surveillance and survivorship. Novel metrics included documentation of a three generational cancer family history, documentation of preoperative CT imaging of chest/abdomen/pelvis, MSI and KRAS testing in specific populations, appropriate pre-operative radiation oncologist evaluation for rectal cancer, multidisciplinary team planning prior to treatment initiation for rectal cancer and patients with newly identified liver metastases, appropriate referral for genetic counseling and surveillance annual CT scans for 3 years post treatment. Conclusions: These novel and comprehensive metrics allow for detailed review of the quality of CRC care received by patients at our institution. Individual patient data are currently being abstracted to assess the utility and logistics of implementing these quality metrics at a community cancer center.

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 care for patients with stage III/IV NSCLC: Learnings for multidisciplinary teams from the ACCC national quality survey.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19195-e19195
Author(s):  
Ravi Salgia ◽  
Leigh Boehmer ◽  
Catherine Celestin ◽  
Judy Yu ◽  
David R. Spigel
Keyword(s):  
Significant Negative Correlation ◽  
Steering Committee ◽  
Stage Iii ◽  
Tumor Board ◽  
Standards Of Care ◽  
Multidisciplinary Teams ◽  
Optimal Care ◽  
Double Blind ◽  
National Quality

e19195 Background: Refinement of the multidisciplinary team (MDT) approach continues to offer significant potential for improving the quality of non-small cell lung cancer (NSCLC) care and adherence to guideline-recommended protocols. This opportunity arises, in part, from insufficient characterization of MDT practice patterns and barriers to optimal care provision within U.S. cancer programs. The Association of Community Cancer Centers (ACCC), therefore, conducted a national survey to improve understanding on how patients with stage III/IV NSCLC were diagnosed and managed across different practice settings, with the aim of informing the design and execution of process-improvement plans to address identified barriers. Methods: ACCC convened an expert steering committee of multidisciplinary specialists, including oncologists, thoracic surgeons, pathologists, pulmonologists, and representation from patient advocacy, for a comprehensive, double-blind, web-based survey (January–April 2019), to obtain insights on cancer patient care in a diverse set of U.S. community cancer programs. Results: Of 1211 questionnaires, 639 responses affiliated to 160 unique cancer programs across 44 U.S. states were suitable for analysis. In total, 41% (n = 261) of respondents indicated that their cancer program did not have a thoracic multidisciplinary clinic. The average time to first therapeutic intervention in newly diagnosed patients was 4 weeks (range = 1–10 weeks; n = 298). A significant negative correlation between frequency of tumor board meetings and time to complete disease staging (r = −0.13, P = 0.03) was observed. Nurse navigators ( P = 0.03) and radiation oncologists (P = 0.04) were significantly more likely to engage in shared decision-making practices than other disciplines. The most challenging barriers to delivering high-quality NSCLC care are listed (Table). Conclusions: Multiple opportunities exist to improve the delivery and quality of care for patients with stage III/IV NSCLC, including lowering barriers to effective screening, diagnosis, and care coordination and adhering to evolving standards of care. [Table: see text]

scholarly journals Implementation of a Hospital-Based Quality Assessment Program for Rectal Cancer

2014 ◽  
Vol 10 (3) ◽  
pp. e120-e129 ◽  
Author(s):  
Samantha Hendren ◽  
Ellen McKeown ◽  
Arden M. Morris ◽  
Sandra L. Wong ◽  
Mary Oerline ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Quality Improvement ◽  
Quality Assessment ◽  
Cancer Care ◽  
Registry Data ◽  
Tumor Registry ◽  
Assessment Program

A program linking tumor registry data to quality-improvement data for rectal cancer quality assessment was successfully implemented in 10 hospitals. This program can serve as a template for organizations interested in improving the quality of rectal cancer care.

scholarly journals Quality assurance through outcome registration in colorectal cancer: An ECCO initiative for Europe

2010 ◽  
Vol 57 (3) ◽  
pp. 17-21 ◽  
Author(s):  
Gijn Van ◽  
de Van
Keyword(s):  
Rectal Cancer ◽  
Cancer Patient ◽  
Cancer Care ◽  
Rectal Cancer Patient ◽  
Neoadjuvant Treatment ◽  
Surgical Techniques ◽  
Treatment Regimens ◽  
Quality Programs ◽  
Rectal Cancer Treatment ◽  
European Cancer

In recent years there have been significant improvements in outcome of rectal cancer treatment. Both new surgical techniques as well as effective neoadjuvant treatment regimens have contributed to these improvements. It is key to spread these advances towards every rectal cancer patient and to make sure that not only patients who are treated within the framework of clinical trials may benefit from these advancements. Throughout Europe there have been interesting quality programs that have proved to facilitate the spread of up to date knowledge and skills among medical professionals resulting in improved treatment outcome. Nevertheless, between European countries remain differences in outcome and treatment schedules that cannot be easily explained. The European CanCer Organisation (ECCO) has recognised these importances's and created the 'European Registration of Cancer Care' (EURECCA) framework to develop a European colorectal audit structure. EURECCA will advance future treatment improvements and spread these to all European cancer patients. It provides opportunities to treat elderly and comorbid patients evidence based while it offers an unique insight in social-economical healthcare matters. As such, ECCO has established the basis for a strong, multidisciplinary audit structure with the commitment to improve cancer care for every European cancer patient.

Improving care for patients with stage III/IV NSCLC: Learnings for multidisciplinary teams from the ACCC National Quality Survey.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 228-228
Author(s):  
Ravi Salgia ◽  
Leigh Boehmer ◽  
Catherine Celestin ◽  
Judy Yu ◽  
David R. Spigel
Keyword(s):  
Care Delivery ◽  
Significant Negative Correlation ◽  
Stage Iii ◽  
Tumor Board ◽  
Standards Of Care ◽  
Multidisciplinary Teams ◽  
Optimal Care ◽  
Double Blind ◽  
National Quality

228 Background: Refinement of the multidisciplinary team (MDT) approach continues to offer significant potential for improving the quality of non-small cell lung cancer (NSCLC) care and adherence to guideline-recommended protocols. This opportunity arises, in part, from insufficient characterization of MDT practice patterns and barriers to optimal care provision within U.S. cancer programs. The Association of Community Cancer Centers (ACCC), therefore, conducted a national survey to improve understanding on how patients with stage III/IV NSCLC were diagnosed and managed across different practice settings, with the aim of informing the design and execution of process-improvement plans to address identified barriers. Methods: ACCC convened an expert steering committee of multidisciplinary specialists, including oncologists, thoracic surgeons, pathologists, pulmonologists, and representation from patient advocacy, for a comprehensive, double-blind, web-based survey (January–April 2019) to obtain insights on cancer care delivery for patients with NSCLC in a diverse set of U.S. community cancer programs. Results: Of 1211 questionnaires, 639 responses affiliated to 160 unique cancer programs across 44 U.S. states were suitable for analysis. In total, 41% (n = 261) of respondents indicated that their cancer program did not have a thoracic multidisciplinary clinic. Nurse navigators (P = 0.03) and radiation oncologists (P = 0.04) were significantly more likely to engage in shared decision-making practices than other disciplines. The average time to first therapeutic intervention in newly diagnosed patients was 4 weeks (range = 1–10 weeks; n = 298). A significant negative correlation between frequency of tumor board meetings and time to complete disease staging (P = 0.03) was observed. The most challenging barriers to delivering high-quality NSCLC care are listed (Table). Conclusions: Multiple opportunities exist to improve the delivery and quality of care for patients with stage III/IV NSCLC, including reducing barriers to effective care coordination and patient education, screening, diagnosis and biomarker testing, and adherence to evolving standards of care. [Table: see text]

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.

Obstacles to the Implementation of Antiemetic Guidelines

2009 ◽  
Vol 7 (5) ◽  
pp. 601-605 ◽  
Author(s):  
Steven M. Grunberg
Keyword(s):  
Physician Behavior ◽  
Clinical Care ◽  
Guideline Implementation ◽  
Scientific Basis ◽  
Physician Education ◽  
Standards Of Care ◽  
Minimal Impact ◽  
Antiemetic Guidelines ◽  
The Relationship

Although guidelines help physicians deliver high quality clinical care, they will have minimal impact unless familiarity and adherence are achieved. Although nausea and vomiting are highly feared toxicities of chemotherapy that markedly decrease patient quality of life, modifications in physician behavior and improvements in standards of care, particularly in terms of preventing delayed emesis, have been slow. Variations in format, goals, physician education, and institutional education may all affect guideline implementation and state-of-the-art care. The relationship between these factors and the scientific basis of antiemetic guidelines must be considered to achieve optimal results and compliance.

Allocating Resources in Cancer Care During Pandemic. Findings from a Qualitative Interview Study with Oncologists and Ethical Analysis

2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 165-166
Author(s):  
Sabine Sommerlatte ◽  
◽  
Anna-Lena Kraeft ◽  
Celine Lugnier ◽  
Anke Reinacher-Schick ◽  
...  
Keyword(s):  
Priority Setting ◽  
Cancer Care ◽  
Qualitative Content Analysis ◽  
Qualitative Interviews ◽  
Health Resources ◽  
Diagnostic Procedures ◽  
Resource Scarcity ◽  
Standards Of Care ◽  
Qualitative Interview Study

"Allocation of health resources towards the treatment of patients with COVID-19 may affect the quality of care for non-COVID-19 patients. Several medical societies representing cancer health professionals have issued statements on priority setting in cancer care in the wake of the Sars-CoV-2 outbreak (1, 2). However, there is a lack of empirical data on how resources are prioritized in cancer care and which criteria are taken into consideration by those involved in decision making. In this paper we will present findings from qualitative interviews conducted with oncologists in Germany between February and July 2021. Transcripts of interviews are analysed following principles of qualitative content analysis based on Kuckartz (3). According to preliminary analysis of the first five interviews conducted three major topics emerge: 1. Experiences with scarcity regarding selected diagnostic procedures and treatment. 2. Material and procedural criteria for priority setting and decisions on deviations of standards of care. 3. Effects of priority setting on coping and psycho-social support. We will discuss findings with regards to their possible contribution to an empirical and normative founded guidance for priority setting in cancer care in times of Sars-CoV-2 outbreak and comparable events. 1. Deutsche Gesellschaft für Hämatologie und Onkologie. Coronavirus-Infektion (COVID-19) bei Patienten mit Blut- und rebserkrankungen. https://www.onkopedia.com/de/onkopedia/guidelines/coronavirus-infektion-covid-19-bei-patient-innen-mit-blut-und-krebserkrankungen/@@guideline/html/index.html 2. Marron JM, Joffe S, Jagsi R et al. Ethics and Resource Scarcity: ASCO Recommendations for the Oncology Community During the COVID19 Pandemic. J Clin Onc. April 28 2020, doi:10.1200/JCO.20.00960 3. Kuckartz, U. (2018). Qualitative Inhaltsanalyse. Methoden, Praxis, Computer¬unterstützung (4th ed.). Beltz Juventa. "

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