scholarly journals Promoting Best Gynecologic Oncology Practice: A Role For The Society of Gynecologic Oncologists of Canada

2006 ◽  
Vol 13 (3) ◽  
pp. 94-98
Author(s):  
L. M. Elit ◽  
M. Johnston ◽  
M. Brouwers ◽  
M. Fung- Kee-Fung ◽  
G. Browman ◽  
...  
Keyword(s):  
Practice Guidelines ◽  
Gynecologic Oncology ◽  
Gynecologic Cancer ◽  
Cancer Control ◽  
Recurrent Ovarian Cancer ◽  
Primary Treatment ◽  
Evaluation Tool ◽  
Full Spectrum ◽  
Canadian Guideline ◽  
Oncology Practice

During March 30–April 1, 2005, the Society of Gynecologic Oncologists of Canada (GOC) and the Canadian Strategy for Cancer Control (CSCC) Clinical Practice Guidelines Action Group (CPG-AG) met to • determine how GOC would like to influence practice in the care of women with gynecologic cancer. • explore a collaborative model for developing and implementing evidence-based practice guidelines. • investigate the utility of the CPG evaluation and adaptation cycle as a tool for selecting, adapting, and adopting guidelines. At the workshop meeting, 21 members of the GOC and the CPG-AG heard presentations from various Canadian guideline initiatives. As an example of adaptation and adoption processes, the AGREE (Appraisal of Guidelines for Research and Evaluation) tool was applied to guidelines in recurrent ovarian cancer, and the group explored their opportunity to use knowledge translation to influence the care of women with gynecologic cancer. The themes influencing practice are consistent with GOC’s mandate. The future is expected to involve partnering with other groups to maximize scarce resources. Resources should be directed to facilitating implementation of existing guidelines rather than to developing new documents. The full spectrum of cancer care includes prevention, screening, diagnosis, primary treatment, follow-up, treatment of recurrent disease, and palliation. High-quality evidence is available in some areas, but gaps exist where guideline panels could provide guidance. Development of a pan-Canadian gynecologic oncology process could provide an opportunity to influence access to care at the political and policy levels. The GOC will develop linkages such that the toolbox available through CSCC-CPG-AG can be incorporated into future collaboration.

Integrating Family Caregiver Support Into a Gynecologic Oncology Practice: An ASCO Quality Training Program Project

2020 ◽  
Vol 16 (3) ◽  
pp. e264-e270
Author(s):  
Grace B. Campbell ◽  
Michelle M. Boisen ◽  
Lauren C. Hand ◽  
Young Ji Lee ◽  
Nora Lersch ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Training Program ◽  
Gynecologic Oncology ◽  
Gynecologic Cancer ◽  
Health Record ◽  
Caregiver Support ◽  
Process Maps ◽  
Assessment Protocol ◽  
Electronic Health ◽  
Oncology Practice

PURPOSE: A needs assessment of family caregivers (CGs) in our gynecologic oncology clinic found that 50% of CGs report nine or more distressing unmet needs, but only 19% of patients had a documented CG. We conducted an ASCO Quality Training Program project with the following aims: (1) to identify and document primary CGs for 85% of patients within two clinic visits of a gynecologic cancer diagnosis, and (2) assess the needs of and provide interventions to 75% of identified family CGs. METHODS: Plan-Do-Study-Act (PDSA) methodology and tools endorsed by the ASCO Quality Training Program were used. An interprofessional team reviewed baseline data (ie, any mention of a family CG in the electronic health record visit note; CG distress survey), defined the problem and project aims, created process maps, and identified root causes of poor CG identification and documentation. Eight successive PDSA cycles were implemented between October 2018 and March 2019 to address identified root causes. RESULTS: For aim 1, CG identification increased from 19% at baseline to 57% postimplementation, whereas for aim 2, assessment improved from 28% at baseline to 60% postimplementation. Results fell somewhat short of initial goals, but they represent an important initial improvement in care. The core team has begun additional PDSA cycles to improve CG identification rates and extend the momentum of the project. CONCLUSION: This project demonstrated that a CG assessment protocol can be implemented in a large, academic, gynecologic oncology clinic. Additional efforts to integrate CG identification, assessment, and intervention more fully within the clinic and electronic health record are under way.

Gynecologic Oncology in the Department of Defense

2019 ◽  
Vol 37 (05/06) ◽  
pp. 222-226
Author(s):  
Chad A. Hamilton ◽  
George L. Maxwell ◽  
Yovanni Casablanca
Keyword(s):  
Department Of Defense ◽  
Clinical Care ◽  
Full Range ◽  
Gynecologic Oncology ◽  
Gynecologic Cancer ◽  
Military Medicine ◽  
Team Approach ◽  
Full Spectrum ◽  
Oncology Research ◽  
The Military

AbstractGynecologic oncology existed within the Department of Defense (DOD) prior to its recognition as a separate subspecialty of obstetrics and gynecology. Military gynecologic oncologists were among the founders of the specialty and continue a tradition of leadership and engagement within the field at the national and international level. The full range of gynecologic oncology services is located at the military's largest medical centers, acknowledging the team approach with multiple subspecialties necessary to provide the highest standard of modern gynecologic cancer care. Gynecologic oncologists within the military receive training on par or exceeding that of their civilian counterparts, and their education extends beyond traditional training to prepare them for the unique challenges within military medicine as well. The clinical offerings from these practitioners and their facilities are state of the art, and each offers the full spectrum of care inclusive of surgery and chemotherapy. Closely coupled with expert clinical care is medical education and comprehensive cancer research. The gynecologic oncology research conducted by the DOD spans the scientific spectrum from basic laboratory investigations, to translational and molecular analyses, to all phases of clinical trials. This discussion will examine gynecologic oncology services in the DOD inclusive of infrastructure, personnel and training, clinical care and outcomes, as well as research contributions.

The financial impact of an enhanced recovery after surgery (ERAS) protocol in an academic gynecologic oncology practice

2020 ◽  
Vol 156 (2) ◽  
pp. 284-287 ◽  
Author(s):  
Zachary L. Gentry ◽  
Teresa K.L. Boitano ◽  
Haller J. Smith ◽  
Dustin K. Eads ◽  
John F. Russell ◽  
...  
Keyword(s):  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Gynecologic Oncology ◽  
Financial Impact ◽  
Oncology Practice ◽  
Eras Protocol

scholarly journals In This Issue of Current Oncology

2006 ◽  
Vol 13 (3) ◽  
pp. 80-80
Author(s):  
M. Chasen
Keyword(s):  
Gynecologic Oncology ◽  
The Subject ◽  
Oncology Practice

Promoting best gynecologic oncology practice is the subject of a manuscript from the Society of Gynecologic Oncologists of Canada. [...]

Abstract 247: STEMI 365: Creating a Yearlong Program to Reduce Cardiac Recidivism After STEMI

2016 ◽  
Vol 9 (suppl_2) ◽  
Author(s):  
Daniel Ryczek ◽  
David Burt
Keyword(s):  
Myocardial Infarction ◽  
Practice Guidelines ◽  
Relapse Prevention ◽  
Best Practice ◽  
The United States ◽  
Post Myocardial Infarction ◽  
Care Hospital ◽  
Evaluation Tool ◽  
Best Practice Guidelines ◽  
The Creation

Survivors of myocardial infarctions are at increased risk of recurrent infarctions and have an annual death rate of 5%, six times that in people of the same age who do not have coronary heart disease. Despite the existence of published interventions and clinical recommendations aimed at secondary and tertiary prevention their application and adherence statistics in post-myocardial infarction patients are woeful. The objective of this paper is to detail the creation of a template curriculum that gives best practice recommendations to post STEMI patients in an effort to reduce recidivism by combining current medical methodology with lessons learned from other fields currently addressing the problem of recidivism and relapse. STEMI 365 is a yearlong program that aims to reduce cardiac recidivism in STEMI survivors. STEMI 365 is composed of three parts: best practice guidelines, evaluation toolkit, and template curriculum. The best practice guidelines document is broken into sections on cardiac rehabilitation, lifestyle modification, drug therapy, patient follow-up and screening, and patient education. All guidelines are informed by the latest recommendations and research in the fields of medicine and relapse prevention. The evaluation toolkit is composed of the cardiac recidivism risk tool, the self-evaluation tool, and the global evaluation tool. The goal of the toolkits is to guide resource allocation by understanding a patient’s unique cardiac recidivism risk, internal sources of potential relapse, and external sources of potential relapse. The Federal Post Conviction Risk Assessment developed by the Administrative Office of the United States Courts informs the toolkits’ construction. The template curriculum is a summation of the programs and interventions that can be utilized by a health system to decrease cardiac recidivism in STEMI survivors. The curriculum addresses one year of time divided into three phases: inpatient, outpatient, and maintenance. The interventions rage in scope from training a patient’s family members in bystander CPR to the creation of a centralized patient monitoring program and post-myocardial infarction clinic. Each phase combines the best modalities in treatment found in the fields of post-myocardial infarction care, hospital re-admission prevention, substance abuse relapse prevention, scholastic dropout prevention, and criminal justice. Personal interviews were conducted with leaders in each field to ensure the correct application of their methodologies. STEMI 365 provides tools to identify patients at highest risk of cardiovascular relapse, to apply local and regional resources in an effective way based on patient risk, and to customize interventions to a health system’s available resources. STEMI 365 is beginning an application phase at this institution, and will be available to other health systems in the near future.

scholarly journals Approach to Palliative Care Consultation for Patients With Malignant Bowel Obstruction in Gynecologic Oncology: A Qualitative Analysis of Physician Perspectives

2020 ◽  
Vol 16 (8) ◽  
pp. 483-489
Author(s):  
Claire Hoppenot ◽  
Fay J. Hlubocky ◽  
Julie Chor ◽  
S. Diane Yamada ◽  
Nita K. Lee
Keyword(s):  
Palliative Care ◽  
Qualitative Analysis ◽  
Bowel Obstruction ◽  
Gynecologic Oncology ◽  
Gynecologic Cancer ◽  
Malignant Bowel Obstruction ◽  
Specific Patient ◽  
Palliative Care Consultation ◽  
Care Consultation ◽  
Nonsurgical Patients

PURPOSE: Malignant bowel obstruction (MBO) from gynecologic cancer is associated with increased symptoms and short survival. A gynecologic oncologist’s approach to palliative care consultation in the setting of MBO has not been well studied—it could be an opportune time for collaboration with palliative care. MATERIALS AND METHODS: This qualitative analysis of interviews with gynecologic oncologists focuses on their perspectives on palliative care consultation at the time of MBO. Interviews were analyzed using a framework analysis, and key themes and quotations were extracted. RESULTS: We interviewed 15 gynecologic oncologists from 8 institutions in Chicago. They described a variety of expectations from palliative care consultation. Most frequently, they consulted palliative care for specific questions but managed the remainder of the care. Most participants frequently consulted palliative care, but they also worried about fragmentation of care, the timing of when to introduce a new team during MBO, and the selection of appropriate patients for a limited resource. Many participants preferred earlier palliative care consultation, and many described an emotional toll of caring for patients with MBO. Palliative care consultation was most readily discussed for nonsurgical patients. CONCLUSION: Participants’ expectations of palliative care consultations during MBO varied and were not always met. We recommend strengthening communication and protocols for palliative care involvement that meet the needs of specific patient populations and physician teams for surgical and nonsurgical patients. More research is needed to better understand how to integrate palliative care into oncologic and surgical care with gynecologic oncologists.

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