Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Cancer Program Standards 2012: Ensuring PatientCentered Care Stephen Dreyer, MD, FACS October 22, 2014 CoC Surveyor Fremont Health Medical Center Fremont, Nebraska Evolution of Program Standards • Cancer Program Standards prior to 2004 – Focused on structure and process to assure uniformity of care • Studies questioned Healthcare delivery system and the quality of care – Fragmented, poorly coordinated – Variability of care process – Adversely affected outcomes • National dialog on Quality of Care placed a strong emphasis on outcomes of health care activities. (4) Cancer Program Changes • New focus on outcomes and delivering patient centered care meant that program standards needed to be revised – Support concept of quality care • Clinical stage – treatment plan - outcome – Expand the concept of care to provide individualized patient support – Data quality improved – Reporting tools need to be developed – Measurable - analyzed and improved Commission on Cancer’s Response: ‘Cancer Program Standards 2012: Ensuring Patient-Centered Care’ Focus on quality of care via performance metrics quality improvement. Deliver in patient centered manner. - Genetic assessment and counseling - Palliative care services - Increase clinical trial accruals - Prevention and early screening - Studies of quality and improvements - Public reporting of outcomes - Patient navigation (2015) - Psychosocial distress screening (2015) -Survivorship care plan (2015) -Patient centered manner Benefits of Patient-Centered Standards • Support customization of care each individual according to needs and circumstances (tool box) • • • • Access Decision making Support during treatment Survivorship • Respond to the specific needs of a community reduce the burden of cancer • Incidence and stage of disease • Strengthens the partnership between public and healthcare system. Patient Outcomes Standard 4.1 Prevention Standard 4.2 Screening Prevention Programs • S 4.1 Each year the cancer committee provides at least 1 cancer prevention program that is targeted to meet the needs of the community and should be designed to reduce the incidence of a specific cancer type. The prevention program is consistent with evidence based national guidelines for cancer prevention. Prevention Programs • Examples of cancer prevention programs: – Chemoprevention programs – Education/cancer awareness – Skin cancer prevention – Smoking cessation – Smoking prevention in adolescents – Nutrition, physical activity, and weight loss programs – Vaccination for HPV Effective Prevention Program • Improve the health of a community reducing incidence • Identify community need – – – – Study top 5 cancer sites state cancer registry NCI - http://statecancerprofiles.cancer.gov/ Factors and behaviors that could be altered reduce risk • Prevention activity should be based on a nationally recognized guideline • Activity is documented and results are analyzed Incidence Lung Cancer Polk County Incidence Lung Cancer by County Elements of a Guideline • • • • Study of the population Defined invention is planned Goal is established Analysis of results Cancer Prevention Guidelines • http://www.ncbi.nlm.nih.gov/books/ • Search • Tobacco cessation – Adults cessation – Youth prevention • Quick Start Guide – Browse by Title – Filter term NCI Books NCI Book - Tobacco NCI Books • http://www.ncbi.nlm.nih.gov/books – http://www.ncbi.nlm.nih.gov/books/NBK63 952/ – http://www.ncbi.nlm.nih.gov/books/NBK22 3926/ – http://www.ncbi.nlm.nih.gov/books/NBK22 3918/#ddd00119 Guideline Clearing House • http://www.guideline.gov/ • Search on home page – tobacco cessation – Treatment of tobacco dependence – Smoking cessation services in primary care – Counseling and intervention in adults and pregnant women • Search – Organization • American Cancer Society – Topic National Guideline Clearinghouse List of Guidelines Additional Resources • Agency for Healthcare Research and Quality • http://www.ahrq.gov/professionals/cliniciansproviders/guidelinesrecommendations/index.html – Treating tobacco use and dependence – Guide to clinical preventive services Implement Prevention Programs • Tobacco Cessation – team with other medical specialists tobacco affects outcome of the disease process – Incorporate smoking cessation activities into the routine treatment process – Pick new site each year – Periodically review the outcome and make improvements • Hospital community • Youth prevention Implement Prevention Programs • Breast – Obesity and breast cancer risk • Annual mammogram • American Cancer Society information – High risk group identified for chemoprevention • Skin cancer – Incidence of melanoma Implement Prevention Programs • Prevention programs continued the next year – Continuing need – Results can be improved • Education and cancer awareness lectures – Audience assessed for increased knowledge and need for action • Community needs assessment – Presented to the cancer committee and date – Used to select site and activity Documentation for Compliance • Evidence in minutes – Cancer committee has assessed cancer prevention needs of the community – At least 1 prevention program has been conducted – Prevention program is consistent with an evidence based guideline and intervention – Results of the activity are evaluated by the cancer committee Prevention Outcomes • Measure, analyze, and improve – change • Short term – Numbers of participants – Goal met – Effectiveness of education programs increasing knowledge and action • Long term – Reduction in the incidence of a specific site Screening Program • S 4.2 Each year, the cancer committee provides at least 1 screening program that is targeted toward decreasing the number of patients with late stage disease. The screening program is based on community needs and is consistent with evidence based national guidelines and interventions. A process is developed to follow up on all positive findings. Effective Screening Program • Support concept of quality care – Clinical stage – treatment plan – outcome • Identify area of need specific to service area of the cancer program • Establish an effective screening program – Conducted according to an established guideline – Deal with positive results Community Need (Study) • Focus activities in sites with high number of late stage disease and specific patient groups • NCDB – Benchmark reports – Comparative studies – Number of variables Stage by Age Group Enter Your Text Here (if any) ©2009 National Cancer Data Base - Generated on Sep-11-2013 Study Program Screening Results Screening Guidelines • American Cancer Society • National Comprehensive Cancer Network • Centers for Disease Control and Prevention Documentation for Compliance • Evidence in minutes – Cancer committee identifies cancer screening needs of the community – At least 1 screening program has been conducted – Screening program is consistent with an evidence based guideline and intervention – Process is developed to deal with all positive findings – Results of the activity are evaluated by the cancer committee Screening Outcomes • Measure, analyze, and improve – change • Short term outcome – Numbers • First time screening • Participate in annual screening • Interval between screenings – Number with positive results referred • Long term outcome – Increased numbers of early stage disease Questions? Thank You