Presentation on theme: "Cancer Program Standards 2012: Ensuring Patient-Centered Care"— Presentation transcript:
1 Cancer Program Standards 2012: Ensuring Patient-Centered Care Stephen Dreyer, MD, FACSOctober 22, 2014CoC SurveyorFremont Health Medical CenterFremont, NebraskaThe purpose of this presentation is to describe the benefits of an accredited cancer program to a healthcare facility. To accomplish this the following topics will be covered.1. Describe the organizational structure and purposeof a CoC Accredited Program.2. Review the current status of the AccreditedPrograms in your state3. Describe the revisions to cancer programstandards that relate to quality care.4. Demonstrate new initiatives involving qualitymeasures and outcomes assessment.5. Assure patients that they are receiving quality careclose to home.
2 Evolution of Program Standards Cancer Program Standards prior to 2004Focused on structure and process to assure uniformity of careStudies questioned Healthcare delivery system and the quality of careFragmented, poorly coordinatedVariability of care processAdversely affected outcomesNational dialog on Quality of Care placed a strong emphasis on outcomes of health care activities. (4)
3 Cancer Program Changes New focus on outcomes and delivering patient centered care meant that program standards needed to be revisedSupport concept of quality careClinical stage – treatment plan - outcomeExpand the concept of care to provide individualized patient supportData quality improvedReporting tools need to be developedMeasurable - analyzed and improvedThe CoC has responded to this new emphasis on outcomes by making significant cancer program changes. The new focus meant that the functions of the standards needed to be better integrated and effective in their purpose. New standards had to be created that expanded the concept of care and its delivery. The cancer activity related to each standard had to be done in a measurable way so that it could be analyzed and improved. Data quality needed to be improved and data reporting tools needed to be developed.
4 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 mannerDeveloped new patient-focused standards:Genetic assessment and counselingPalliative care servicesIncreased clinical trial accrualPatient navigation (2015)Psychosocial distress screening (2015)Survivorship care plan (2015)Address the full continuum of care and improving coordinationIncrease participation in care decisions by patients and familyIncrease patient satisfactionNew tools and practices to support standard implementation
5 Benefits of Patient-Centered Standards Support customization of care each individual according to needs and circumstances (tool box)AccessDecision makingSupport during treatmentSurvivorshipRespond to the specific needs of a communityreduce the burden of cancerIncidence and stage of diseaseStrengthens the partnership between public and healthcare system.Just some of the key benefits to developing patient centered standards
6 Standard 4.1 Prevention Standard 4.2 Screening Patient OutcomesStandard 4.1 PreventionStandard 4.2 Screening
7 Prevention ProgramsS 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.
8 Prevention Programs Examples of cancer prevention programs: Chemoprevention programsEducation/cancer awarenessSkin cancer preventionSmoking cessationSmoking prevention in adolescentsNutrition, physical activity, and weight loss programsVaccination for HPV
9 Effective Prevention Program Improve the health of a community reducing incidenceIdentify community needStudy top 5 cancer sitesstate cancer registryNCI -Factors and behaviors that could be altered reduce riskPrevention activity should be based on a nationally recognized guidelineActivity is documented and results are analyzed
17 Guideline Clearing House Search on home page – tobacco cessationTreatment of tobacco dependenceSmoking cessation services in primary careCounseling and intervention in adults and pregnant womenSearchOrganizationAmerican Cancer SocietyTopic
20 Additional Resources Agency for Healthcare Research and Quality Treating tobacco use and dependenceGuide to clinical preventive services
21 Implement Prevention Programs Tobacco Cessationteam with other medical specialists tobacco affects outcome of the disease processIncorporate smoking cessation activities into the routine treatment processPick new site each yearPeriodically review the outcome and make improvementsHospital communityYouth prevention
22 Implement Prevention Programs BreastObesity and breast cancer riskAnnual mammogramAmerican Cancer Society informationHigh risk group identified for chemopreventionSkin cancerIncidence of melanoma
23 Implement Prevention Programs Prevention programs continued the next yearContinuing needResults can be improvedEducation and cancer awareness lecturesAudience assessed for increased knowledge and need for actionCommunity needs assessmentPresented to the cancer committee and dateUsed to select site and activity
24 Documentation for Compliance Evidence in minutesCancer committee has assessed cancer prevention needs of the communityAt least 1 prevention program has been conductedPrevention program is consistent with an evidence based guideline and interventionResults of the activity are evaluated by the cancer committee
25 Prevention Outcomes Measure, analyze, and improve – change Short term Numbers of participantsGoal metEffectiveness of education programs increasing knowledge and actionLong termReduction in the incidence of a specific site
26 Screening ProgramS 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.
27 Effective Screening Program Support concept of quality careClinical stage – treatment plan – outcomeIdentify area of need specific to service area of the cancer programEstablish an effective screening programConducted according to an established guidelineDeal with positive results
28 Community Need (Study) Focus activities in sites with high number of late stage disease and specific patient groupsNCDBBenchmark reportsComparative studiesNumber of variables
38 Screening Guidelines American Cancer Society National Comprehensive Cancer NetworkCenters for Disease Control and Prevention
39 Documentation for Compliance Evidence in minutesCancer committee identifies cancer screening needs of the communityAt least 1 screening program has been conductedScreening program is consistent with an evidence based guideline and interventionProcess is developed to deal with all positive findingsResults of the activity are evaluated by the cancer committee
40 Screening Outcomes Measure, analyze, and improve – change Short term outcomeNumbersFirst time screeningParticipate in annual screeningInterval between screeningsNumber with positive results referredLong term outcomeIncreased numbers of early stage disease