Raising all boats in supportive oncology: Initial impact of the Coleman Supportive Oncology Collaborative (CSOC).

Authors

null

James Gerhart

Rush University Medical Center, Chicago, IL

James Gerhart, Christine B. Weldon, William Dale, Urjeet Patel, Paramjeet Khosla, Shelly S. Lo, Carol Newsom, Patricia A. Robinson, Joanna Martin, Desiree Azizoddin, Eileen Knightly, Rosa Berardi, Aidnag Diaz, Teresa Lillis, Julia Rachel Trosman, Frank J. Penedo

Organizations

Rush University Medical Center, Chicago, IL, Northwestern University Feinberg School of Medicine, Chicago, IL, CIY, Chicago, IL, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, Mount Sinai Hospital, Chicago, IL, Loyola University Medical Center, Maywood, IL, Mercy Hospital and Medical Center, Chicago, IL, Jesse Brown VA Medical Center, Chicago, IL, University of Illinois Hospital and Health Sciences System, Chicago, IL, The Coleman Foundation, Chicago, IL, Center for Business Models in Healthcare, Chicago, IL

Research Funding

Other Foundation

Background: The Institute of Medicine (IOM) and Commission on Cancer (CoC) recommend systematic delivery of supportive oncology and survivorship care to all cancer patients. CSOC aims to improve the quality of supportive care across Chicago-area providers. Methods: 35 CSOC participating institutions (cancer centers, support centers, hospice) formed care delivery design teams - Distress, Survivorship and Palliative. Teams collaboratively developed solutions to supportive oncology gaps: patient screening tools, care delivery processes, provider training, and quality metrics to assess supportive oncology quality and the CSOC impact. Six implementation centers (2 safety-net, 3 academic & 1 public) reviewed charts at baseline (2014 diagnoses) and after the initial implementation period (2015 diagnoses), compared by frequencies and Fisher’s exact test. Results: Eight metrics contained patient data at 2 time points; improvements were seen in 7/8 metrics. (See Table). Conclusions: CSOC developed supportive oncology screening, and care processes aligned with IOM and CoC standards. Significant improvements were shown after implementation across diverse settings. Ongoing work will further evaluate the impact of CSOC efforts on patient care.

Metric% Patients Dx in 2014% Patients Dx in 2015P-value
Documented discussion on understanding of illness within 30 days (d)
of diagnosis (dx) -QOPI 2 NQF 0386
54 (453/843)55 (592/1075)NS
Pts given prognosis timeframe (ds to weeks, ws to months, mths to
years, yrs+) within 30 d of dx - QOPI 2 NQF 0386
24 (205/843)34 (364/1075)<0.0001
Documented health care agent / validated POA within 90 d
of dx -QOPI 25a
5 (42/843)11 (115/1075)<0.0001
Stage IV pts with documented advance directive within 90 d
of dx -QOPI 25a
1 (10/452)27 (101/379)<0.0001
Stage I-III pts with supportive oncology needs screening -QOPI
24 CoC 3.2
38 (148/391)60 (415/691)<0.0001
Stage IV pts with supportive oncology needs screening
within 30 d of dx
6 (27/452)15 (58/379)<0.0001
Stage IV pts with documented palliative referral - QOPI 43 NQF 021515 (68/452)43 (163/379)<0.0001
Stage I-III pts receiving treatment summary and Survivor Care
Plan within 180 d of treatment -QOPI 18 20 CoC 3.3
2 (9/391)7 (47/691)=0.0009

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Abstract Details

Meeting

2017 Palliative and Supportive Care in Oncology Symposium

Session Type

Poster Session

Session Title

Poster Session A

Track

Integration and Delivery of Palliative and Supportive Care,Communication and Shared Decision Making,Symptom Biology, Assessment, and Management,Models of Care

Sub Track

Integration and Delivery of Palliative and Supportive Care

Citation

J Clin Oncol 35, 2017 (suppl 31S; abstract 150)

DOI

10.1200/JCO.2017.35.31_suppl.150

Abstract #

150

Poster Bd #

F12

Abstract Disclosures

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