Implementing patient-centered care: Challenges in community oncology.

Authors

null

Kathleen Clifford

St. Luke's Mountain States Tumor Institute

Kathleen Clifford, Colleen Tallen, Mary Helen Davis, Tamara Griess, Dan Zuckerman, Lynne Padgett

Organizations

St. Luke's Mountain States Tumor Institute, Saint Mary's Health Care, Norton Cancer Institute, Saint Elizabeth Regional Medical Center, National Cancer Institute

Research Funding

No funding sources reported
Background: The newest Commission on Cancer (CoC) standards focus on patient-centered care across the cancer continuum and include palliative care (PC) and psychosocial care (PS). Little is published regarding the challenges of implementing these standards in community oncology settings. To help examine the integration of PC and PS and to identify barriers and best practices, an assessment was conducted by sites selected to take part in the National Cancer Institutes’ Community Cancer Centers Project (NCCCP). Methods: The NCCCP’s goals to improve quality of care and reduce healthcare disparities included goals for expansion of PC and PS services. Volunteers formed workgroups using monthly teleconferences to share best practices and resources. A questionnaire based on the National Quality Forum (NQF) preferred practices was completed (January-April 2012) by 22 of 29 sites. Results: All respondents have inpatient PC available, 65% in the outpatient setting; 39% described PC as an integral part of their cancer program. All have designated outpatient staff providing symptom management and rehabilitation services. Nurse practitioners and physician assistants are used at 78% of the centers. Interdisciplinary staff includes pharmacists and dietitians; integrative/complementary medicine is found in 57% of the centers. All have integrated PS services: social workers are available in 91% of sites, 30% have psychiatrists, and 30% have psychologists. Most perform psychosocial screening using the NCCN Distress Management tool; 74% have standardized processes. Spiritual support is present in 70% of programs, sexual counseling services in 26%. The majority provides bereavement support. 48% have an outpatient advanced directive program. Inpatient hospice beds are available in 52% of the institutions and 22% own a hospice. Conclusions: Challenges remain with implementation of psychosocial screening and care. Programs to address sexual counseling and advanced directives are lacking. Additional efforts are needed to integrate PC services across the cancer continuum. Project funded with federal funds from the NCI, Contract No. HHSN261200800001E.

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Abstract Details

Meeting

2012 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

General Poster Session B

Track

Quality Measurement,Quality Improvement ,The Use of IT to Improve Quality,Involving Patients in Quality Care

Sub Track

Guideline Recommendation Compliance and Its Effects on Quality

Citation

J Clin Oncol 30, 2012 (suppl 34; abstr 192)

DOI

10.1200/jco.2013.31.31_suppl.192

Abstract #

192

Poster Bd #

D16

Abstract Disclosures

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