scholarly journals Building an oncology community of practice to improve cancer care

2018 ◽  
Vol 25 (6) ◽  
Author(s):  
W. Fingrut ◽  
L. A. Beck ◽  
D. Lo

Background Communities of practice (cops) have been shown to be effective models for achieving quality outcomes in health care.Objective Here, we describe the application of the cop model to the Canadian oncology context.Methods We established an oncology cop at our urban community hospital and its networks. Goals were to decrease barriers to access, foster collaboration, and improve knowledge of guidelines in cancer care. We hosted 6 in-person multidisciplinary meetings, focusing on screening, diagnosis, and management of common solid tumours. Health care providers affiliated with our hospital were invited to attend and to complete post-meeting surveys. Likert scales assessed whether cop goals were realized.Results Meetings attracted a mean of 57 attendees (range: 48–65 attendees), with a mean of 84% completing the surveys and consenting to the analysis. Attendees included family physicians (mean: 41%), specialist physicians (mean: 24%), nurses (mean: 10%), and allied health care providers (mean: 22%). Repeat attendance increased during the series, with 85% of attendees at the final meeting having attended 1 or more prior meetings. Across the series, most participants agreed or strongly agreed that the cop reduced barriers (mean: 76.0% ± 7.9%) and improved access to cancer care services (mean: 82.4% ± 8.1%) and subject matter experts (mean: 91.7% ± 4.2%); fostered teamwork (mean: 84.5% ± 6.8%) and a culture of collaboration (mean: 94.8% ± 4.2%); improved knowledge of cancer care services (mean: 93.3% ± 4.8%), standards of practice (mean: 92.3% ± 3.1%), and quality indicators (mean: 77.5% ± 6.3%); and improved cancer-related practice (mean: 88.8% ± 4.6%) and satisfaction in caring for cancer patients (mean: 82.9% ± 6.8%). Participant feedback carried a potential for bias.Conclusions We demonstrated the feasibility of oncology cops and found that participants perceived their value in reducing barriers to access, fostering collaboration, and improving knowledge of guidelines in cancer care.

2019 ◽  
Vol 27 (2) ◽  
Author(s):  
J. Irish ◽  
J. Kim ◽  
J. Waldron ◽  
A.C. Wei ◽  
E. Winquist ◽  
...  

Background At the request of the Head and Neck Cancers Advisory Committee of Ontario Health (Cancer Care Ontario), a working group and expert panel of clinicians with expertise in the management of head-and-neck cancer developed the present guideline. The purpose of the guideline is to provide advice about the organization and delivery of health care services for adult patients with head-and-neck cancer. Methods This document updates the recommendations published in the Ontario Health (Cancer Care Ontario) 2009 organizational guideline The Management of Head and Neck Cancer in Ontario. The guideline development methods included an updated literature search, internal review by content and methodology experts, and external review by relevant health care providers and potential users. Results To ensure that all patients have access to the highest standard of care available in Ontario, the guideline establishes the minimum requirements to maintain a head-and-neck disease site program. Recommendations are made about the membership of core and extended provider teams, minimum skill sets and experience of practitioners, cancer centre–specific and practitioner-specific volumes, multidisciplinary care requirements, and unique infrastructure demands. Conclusions The recommendations contained in this document offer guidance for clinicians and institutions providing care for patients with head-and-neck cancer in Ontario, and for policymakers and other stakeholders involved in the delivery of health care services for head-and-neck cancer.    


Author(s):  
Fatemeh Rahmanian ◽  
Soheila Nazarpour ◽  
Masoumeh Simbar ◽  
Ali Ramezankhani ◽  
Farid Zayeri

AbstractBackgroundA dimension of reproductive health services that should be gender sensitive is reproductive health services for adolescents.ObjectiveThis study aims to assess needs for gender sensitive reproductive health care services for adolescents.MethodsThis was a descriptive cross-sectional study on 341 of health care providers for adolescents in health centers and hospitals affiliated to Shiraz University of Medical Sciences in Iran in 2016. The subjects of the study were recruited using a convenience sampling method. The tools for data collection were: (1) a demographic information questionnaire and; (2) a valid and reliable questionnaire to Assess the Needs of Gender-Sensitive Adolescents Reproductive Health Care Services (ANQ-GSARHS) including three sections; process, structure and policy making for the services. Data were analyzed using SPSS 21.ResultsThree hundred and forty-one health providers with an average working experience of 8.77 ± 5.39 [mean ± standard deviation (SD)] years participated in the study. The results demonstrated the highest scores for educational needs (92.96% ± 11.49%), supportive policies (92.71% ± 11.70%) and then care needs (92.37% ± 14.34%) of the services.ConclusionsProviding gender sensitive reproductive health care services for adolescents needs to be reformed as regards processes, structure and policies of the services. However, the gender appropriate educational and care needs as well as supportive policies are the priorities for reform of the services.


2021 ◽  
Vol 6 (3) ◽  
Author(s):  
Mackenzie A ◽  
◽  
Wang J ◽  
Teppema S ◽  
Duncan I ◽  
...  

Reimbursement for health care services is transferring more risk away from payers and toward health care providers in the form of Alternative Payment Models (APMs), also known as Value-Based Care (VBC) models. VBC models cover a wide variety of forms but all include guarantees by providers of services to improve quality of care and/or reduce cost. Types of risk include performance risk, contract design risk or stochastic risk (because of the random variation in health care services and costs). A form of contract risk that can be a significant driver of cost is model risk, defined as the probability that the savings calculated at contract reconciliation will deviate from the actual savings generated. To estimate the degree of risk we quantify the potential variance in outcomes in a naïve population prior to intervention and the components that could affect outcomes, using examples of maternity and type 2 diabetes. This analysis has implications for both participants in, and designers of value-based contracts.


2021 ◽  
pp. 141-151
Author(s):  
Paweł Lipowski

The aim of this study is to identify the legal characteristics of contracts for the health care services provided by a public payer, i.e. the National Health Fund (NFZ) as part of treatment covered by universal health insurance, as compared to those provided by the health care providers with public or private legal status. This issue is discussed in relation to the legal conditions for the treatment of patients on a commercial basis in those institutions (private or public) which have contracts for the provision of healthcare services under the general health insurance (so-called contracts). The discussion is presented based on author’s own observations, resulting both from his scientific studies in the field of medical law and his work in various entities operating in the health care system.


2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Akashi Andrew Rurangirwa ◽  
Ingrid Mogren ◽  
Joseph Ntaganira ◽  
Kaymarlin Govender ◽  
Gunilla Krantz

2020 ◽  
Author(s):  
Jan-Willem Wasmann ◽  
Cris Lanting ◽  
Wendy Huinck ◽  
Emmanuel Mylanus ◽  
Jeroen van der Laak ◽  
...  

The global digital transformation enables computational audiology for advanced clinical applications that have the potential to impact the global burden of hearing loss. In this paper we describe emerging hearing-related artificial intelligence applications and argue for their potential to improve access, precision and efficiency of hearing health care services. In addition, we raise awareness of risks that must be addressed to enable a safe digital transformation in audiology. We envision a future where computational audiology is implemented via open-source models using interoperable shared data and where health care providers adopt new roles within a network of distributed expertise. All of this should take place in a health care system where privacy, the responsibility of each stakeholder and, most importantly, the safety and autonomy of patients are all guarded by design.


10.2196/27499 ◽  
2021 ◽  
Vol 23 (10) ◽  
pp. e27499
Author(s):  
Laura Maruster ◽  
Durk-Jouke van der Zee ◽  
Erik Buskens

Background Tracing frequent users of health care services is highly relevant to policymakers and clinicians, enabling them to avoid wasting scarce resources. Data collection on frequent users from all possible health care providers may be cumbersome due to patient privacy, competition, incompatible information systems, and the efforts involved. Objective This study explored the use of a single key source, emergency medical services (EMS) records, to trace and reveal frequent users’ health care consumption patterns. Methods A retrospective study was performed analyzing EMS calls from the province of Drenthe in the Netherlands between 2012 and 2017. Process mining was applied to identify the structure of patient routings (ie, their consecutive visits to hospitals, nursing homes, and EMS). Routings are used to identify and quantify frequent users, recognizing frail elderly users as a focal group. The structure of these routes was analyzed at the patient and group levels, aiming to gain insight into regional coordination issues and workload distributions among health care providers. Results Frail elderly users aged 70 years or more represented over 50% of frequent users, making 4 or more calls per year. Over the period of observation, their annual number and the number of calls increased from 395 to 628 and 2607 to 3615, respectively. Structural analysis based on process mining revealed two categories of frail elderly users: low-complexity patients who need dialysis, radiation therapy, or hyperbaric medicine, involving a few health care providers, and high-complexity patients for whom routings appear chaotic. Conclusions This efficient approach exploits the role of EMS as the unique regional “ferryman,” while the combined use of EMS data and process mining allows for the effective and efficient tracing of frequent users’ utilization of health care services. The approach informs regional policymakers and clinicians by quantifying and detailing frequent user consumption patterns to support subsequent policy adaptations.


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