American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

2017 Poster Presentations

Below you will find posters presented at the 2017 Cancer Programs Conference. Click on the poster thumbnails to view the full poster.

Clinical Trials

Oncology Clinical Trial Accrual: From Zero to Hero at Steeplechase Cancer Center!

Steeplechase Cancer Center/Robert Wood Johnson University Hospital Somerset
Somerville, NJ
Stacey Alphas, RN, BSN

The health care environment is rapidly changing while complexity in research increases. Successful research efforts are impacted by numerous factors. The value of community-based research has long been recognized, however, creating a “culture of research” in a community hospital requires leadership, engagement and a multidisciplinary approach. One in five clinical trials for adults with cancer never finishes due to poor accrual. Nationally, adult oncology trials accrue about 3–5 percent of eligible patients. This is a major barrier to progress in cancer therapy. We instituted a multimodality approach to recruitment at Steeplechase Cancer Center (SCC) with the focus on physician engagement.


Community Needs Assessment

Patient and Family Advisory Councils as a Tool for Community Needs Assessment

Presbyterian Cancer Care
Albuquerque, NM
Marissa Nordstrom, MA

This poster centers on how a Patient and Family Advisory Council (PFAC) promotes Patient and Family Centered Care and can be a useful mechanism to identify barriers to care. Many programs use population, registry, or program level data, but a PFAC provides ongoing input from a community of people who have experienced care in the program itself.  A PFAC is both a source of ideas and a way to test ideas related to improving care. It can complement other ways of assessing community needs and potentially save programs money by vetting proposals before changes are implemented. The poster will specifically cover how the PFAC was instrumental in the development and growth of our nurse navigator program.


Navigation

Community Breast Navigation Program Increases Mammography Utilization in Hartford, CT

UConn Health Carole and Ray Neag Cancer Center
Farmington, CT
Rashea Banks, MPH

The Community Breast Navigator educated women on the importance of breast screenings, clinical breast exams, and self-breast exams and contacted Patient Access and Radiology Departments at UConn Health to schedule screenings. The patient was reminded of the mammography screening 1-3 days before the appointment. If the patient failed to attend the appointment, the Community Breast Navigator contacted the patient and UConn Health to reschedule the screening. Within 13 months at Community Health Services, Inc. and Community Health Center, Inc., 79 (58.5 percent) of the 135 women referred in the study period received breast screening through the Community Breast Navigation Program.


Successful Navigation in a Snap-Shot: Using EMR Flowsheet for Standardized Measurement of Oncology Navigation Metrics

Northwest Community Healthcare
Arlington Heights, IL
Christine Masonick, RN, MSN, OCN

As the value of interdisciplinary navigation is anecdotally shared as improving patient experience and expediting care, more studies are needed that demonstrate mechanisms to capture navigation metrics. Also data is needed to validate oncology navigators’ return on investment. With the implementation of a new Electronic Medical Record (EMR), EPIC in May 2015, our cancer program developed a navigator flowsheet to capture data over time and to quantify navigation efforts. Data such as time spent, number of contacts, acuity scale, and barriers addressed, interventions, time from abnormal imaging to diagnosis and to initial treatment, reason for referral, and patient education can provide a snapshot of navigation. Data points which are easily captured through EMR reports will provide data to quantify navigator activities and provide data for community needs assessment.


The Transition from Treatment to Follow-Up Care: A Critical Time for Patient Navigation

Avera Cancer Institute
Sioux Falls, SD
Jamie Arens, MSW, LICSW, CSW-PIP

There are many points of transition in cancer care, and each presents a unique set of challenges for patients and providers (Nekhlyudov, Levit, Hurria, & Ganz, 2014). This includes the transition from treatment to follow-up care. For patients, challenges include the need for continued support, education, and communication with the oncology team. For providers, challenges include management of late- and long-term effects, modifying health behaviors, and care coordination (IOM, 2005). These challenges can be overcome with patient navigation. However, survivors’ access to navigation is not universal. This evaluation describes the implementation and assessment of these services at Avera Cancer Institutes.


Palliative Care

End of Life Treatment for Cancer Patients Based on Registry Data

University of Southern California
Los Angeles, CA
Kevin Do, MD

Chemotherapy at end of life has been described as a low yield, high cost endeavor. As such, we aim to characterize cancer patients who receive aggressive treatments at end of life and provide tools for providers to identify which patients are of a higher likelihood to receive chemotherapy at end of life setting. Treatment usage was characterized by cancer types, patient characteristics, as well as by treatment modality between radiation therapy and chemotherapy. We also compared providers by gender to assess for any behavioral differences in rates of treatment.


Quality

Cancer Committee Meets LEAN

Cancer Care and Hematology-UCHealth
Fort Collins, CO
Valerie Cummins, BSN, OCN, CCRP

After preparation for the previous Commission on Cancer (CoC) survey it became evident that this institution needed a different method to organize the process.  A three year calendar, based on the survey period, was created to assist with tracking and planning.  A minutes document was created that contained prompts based on CoC standard requirements. This framework enabled the committee to ensure that complete information was provided at each report out.  This change in process resulted in increased efficiency, decreased redundancies, and improved organization when submitting the information to the Survey Application Record (SAR) which we now do at the close of each year.


Creating a Cancer Ecology Registry in a Community Cancer Center

Providence St. Mary Regional Cancer Center
Walla Walla, WA
James Cunningham, MD

Cancers, characterized by clonal evolution and frequent dependence on host supporting microenvironment can be thought of as part of an ecosystem. Cancer ecology, the study of that host-cancer relationship, allows use of the language and principles of evolutionary biology and may help inform oncologists to better understand those selection pressures which shape the host-cancer relationship. A registry study in a community hospital cancer center has begun to prospectively determine feasibility for quantifying a set of parameters, an "ecogram," in newly diagnosed cancer patients, reflecting those selection pressures and laying a framework for subsequent individualized ecologic intervention as part of therapy.


CPOE also Stands for….Careful Physicians Opting for Excellence. A Successful Approach to Implementing Electronic Chemotherapy Order Entry

Advocate Christ Medical Center
Oak Lawn, IL
Vanessa Lehnhardt, PharmD, BCOP

You know the safety rationale for utilizing electronic chemotherapy orders, but do you know how to approach this concept with success?  Advocate Health Care’s safety first approach paved the way for Chemotherapy PowerPlans as one method to reducing errors and increasing safety for our oncology population.  Implementation of computerized physician order entry of chemotherapy regimens in a distinct hospital is no small feat. Now imagine the stretch goal of taking this safety feature to a system level, standardizing safety in regard to the ordering and delivery of cancer treatment to Advocate - the largest health system in Illinois.


Impacting NQMBC Timeliness of Care; Reducing Time Between Screening Mammogram and Diagnostic Mammogram Through a Study of Quality and a Quality Improvement Initiative

Englewood Hospital and Medical Center
Englewood, NJ
Christine Weiselberg, DNP, FNP-BC

Data pulled from the National Quality Measures for Breast Cancer (NQMBC) database revealed that breast center patients were waiting an average of 15.3 business days for their diagnostic mammograms following their screening/annual mammogram. The national benchmark indicates an average wait time of: Median = six business days. Based on these findings it was recognized that the center lies within the 13th percentile. This prolonged period of time between screening and diagnostic imaging may delay patient care and negatively impact the center's overall patient satisfaction scores. The team planned to study causes of delay and develop an action plan to improve timeliness of care, targeting achievement of benchmark (median) of six business days.


Implementation of an Electronic Surveillance Database for Colorectal Cancer Patients

Kaiser Permanente
San Francisco, CA
Pamela Washington, DrPhD

An electronic surveillance database was created to monitor patients for five years following curative treatment for colorectal cancer. The database serves as an alert system and data repository for imaging, serology, and colonoscopy surveillance tests preloaded for each patient in accordance with NCCN guidelines based upon TNM cancer staging. It can also be used to assess surveillance results and recurrence rates. To date, more than 500 cases are being monitored. By 2019, the database is poised to be the largest in Kaiser Permanente (KP) dedicated to active surveillance following colorectal cancer treatment.


Implementing Patient-Care Coordination Rounds to Promote Patient-Centered Care

Edward and Marie Matthews Center for Cancer Care
Plainsboro, NJ
Karen Davison, BSN, RN, OCN

The treatment team at the Matthews Center for Cancer Care established patient-care coordination rounds as a program goal to meet Commission on Cancer (CoC) Standard 1.5. The objective of the rounds was to improve communication of patient goals of care across the interdisciplinary treatment team, discuss relevant social, financial, nutritional issues to ensure appropriate referrals are made to support staff/palliative care, and to review future treatment schedules to prevent patients from showing up for unscheduled appointments. Patient care rounds are held weekly and include staff/physicians from medical/radiation oncology, palliative care, social work, oncology dietitian, survivorship coordinator, outpatient infusion staff, and pharmacist.


Improving Cancer Care Management Through Early Recognition and Treatment of Chemotherapy and Biotherapy Associated Hypersensitivity Reactions

PIH Health
Whittier, CA
Sarah Merkle, RN, MSN, AOCNS

Cancer therapies such as chemotherapy and biotherapy have the potential to cause hypersensitivity reactions (HSRs). Hypersensitivity and anaphylactic reactions can be triggered by the therapeutic agent, the diluent, or the solution. Immediate interventions are necessary to prevent progression of symptoms, more reactions, and delays in care. The purpose of this project is to improve patient care by providing immediate interventions for patients who experience a HSR through nursing education and implementation of a standardized procedure.


Optimizing Oncology Medical Practice Throughput Utilizing First Appointment Start Times (FAST) Data

MD Anderson Cancer Center at Cooper
Camden, NJ
Violet Yacovelli, BSN, RN

First Appointment Start Times (FAST) project, utilizing a Lean Six Sigma Root Cause analysis approach with a multidisciplinary team, resulted in a notation of two critical appointment start times or “tollgates.” The methodology was developed and piloted in two locations, which was operationalized and hardwired, focusing on these critical start times and allowing the clinics to reduce total cycle time from an average of 43.5 minutes to 22.7 minutes and normalizing at 24.3 minutes year to date.


Screening and Detection

Colon Cancer Screening in Rural Southeastern Ohio

Southeastern Ohio Regional Medical Center
Cambridge, OH
Katelyn Miller, CMA (AAMA), BSHCM

A local cancer coalition in rural Southeastern Ohio utilized cancer registry data to identify a serious regional problem regarding a very high rate of late-stage colon cancer diagnoses. The coalition formulated a plan of action that included efforts to educate patients and primary care practitioners about the value of colon cancer screening. The poster will discuss the coalitions efforts that resulted in a significant increase in the number of screening colonoscopies, a dramatic decrease in late-stage cases, and a significant decrease in the incidence of colon cancer in the county. The coalition has been nationally recognized with several awards for its work.


Increasing Access to Breast Cancer Screening Through an Integrated Screening Program

Norma Pfriem Breast Care Center
Bridgeport, CT
Patricia Poniros, RN

Our center relies upon grant funding to help our vulnerable population commit to care. Without financial assistance these women are reluctant to even make an appointment for mammograms or clinical breast exams. We can help to ease that burden through our breast and cervical early detection program which offers a variety of services and grants.


Procrastination Is Cancer's Breast Friend

St. Peter's Cancer Care /St. Peter's Health Partners
Albany, NY
Anne Lawton, RN

"Procrastination is Cancer's Breast Friend" was a pilot program held on February 11, 2017. It was a collaborative effort between the Cancer Care Center and the Breast Care Center with the goal to increase Breast Cancer Screenings for Employees of St. Peter's Health Partners. Data collected prior to the event, showed only 50 percent of employees were getting their mammograms per guidelines. An event was planned for employees only to get screening and to collect data to measure the reasons why women were not getting their mammogram.  Post screening data was used to plan future screening events and to propose Paid Time Off for Cancer Screenings to the Leadership Team at St. Peter's Health Partners.


Real Men Get Checked

Vidant Edgecombe Hospital
Tarboro, NC
Betsy Collins, RN, MSN, AOCN

This poster describes a small community program's effort to increase education surrounding prostate cancer and the importance of screening by involving the barbers in the local barbershops. It also will describe our efforts to increase participation in screenings in an effort to diagnose the disease in a much earlier stage.


Survivorship

A Collaborative Process for Cancer Survivorship Care Plan Delivery

USC-Norris Cancer Center
Los Angeles, CA
Afsaneh Barzi, MD, PhD

The Commission on Cancer (CoC) accreditation Standard 3.3 requires that the cancer committee develops and implements a process to disseminate a treatment  summary and follow-up plan to patients who have completed cancer treatment. Norris Comprehensive Cancer Center (USC-Norris) has a collaborative process to meet this benchmark. The multidisciplinary team includes cancer registrar, nurses, and physicians.


Breast Cancer Survivorship Workshop Series: Filling the Gaps in Breast Cancer Survivorship

Beaumont Health
Royal Oak, MI
Basil Hakmeh, MPH

Breast cancer survivors (BCS) experience many physical, emotional, and mental changes during and following completion of treatment; it is important that these changes are addressed to ensure that a BCS’s life can continue seamlessly while trying to achieve the new normal. Our institution has established a nurse-navigator led, risk-based breast cancer survivorship clinic. The nurse navigation-led clinic takes place during follow-up, focuses on wellness and health promotion, and allows survivorship care to be individually tailored. The purpose of this session will be to describe its development, outline the resources needed for its implementation, and identify gaps and how this clinic fills these gaps.


Implementation of Survivorship Care Plans in an Integrated Hospital Setting

Kaiser Permanente Roseville and Sacramento
Roseville, CA
Derrick Schmidt, MD, PhD

As part of the largest non-profit integrated health care system in the United States, Kaiser Permanente’s Roseville/Sacramento Medical Centers were challenged to provide a timely delivery of a robust and meaningful Survivorship Care Plan. Collaboration across multiple disciplines combined with leveraging technology provided an opportunity to exceed the 2016 Commission on Cancer (CoC) standard by delivering Survivorship Care Plans to 52 percent of all eligible patients.


Meeting Patient-Centered Care Standards: Integrative Oncology as Supportive Care During Treatment and Tertiary Prevention in Survivorship Using IThrive® Software

Floyd Medical Center
Rome, GA
Allen Stephens, DNP, RN, AGACNP-BC

NCCN distress screening can identify patients during cancer therapy who have significant emotional and physical issues. These issues can be addressed using physician prescribed integrative oncology modalities. After treatment and into survivorship, prevention of cancer recurrence can be prescribed through the use of an online mobile enabled software program called IThrive. We present our experience in both of these processes as part of patient navigation in a community-based cancer center.


Survivorship Care Planning at a Community Cancer Center: A Framework to Meet the Challenge

Renown Health Institute for Cancer
Reno, NV
Charmian Lykins, MPH, RN, OCN

Working within a fragmented care delivery context makes complying with Survivorship Care Plan accreditation standards very challenging. Problems can include: tracking patients with various treatment modalities given by different providers or locations, appropriate timing for the survivorship care plan delivery, network building, and how to determine the denominator for accreditation compliance. Renown Health Institute for Cancer in Reno, NV, would like to share our framework for how we successfully tackled these issues in a community cancer center serving approximately 1,000 analytic cases in urban and rural settings.