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

2018 Poster Presentations

Below you will find posters presented at the 2018 Cancer Programs Conference. Click on the poster thumbnails to view the full poster.

Measuring Quality and Outcomes

Concurrent Abstracting and Follow-up

Spectrum Health
Grand Rapids, MI
Deb Bisel, MSN, RN, OCN, CBCN

Traditionally cases abstracted in our registry were completed within six months of date of first contact. The Rapid Quality Reporting System (RQRS) required us to abstract the breast, rectal and colon cases within 30 days. The question became why aren't we doing this for all of our cases? We embarked on an 18 month journey to complete all cases in a concurrent fashion so that the case was abstracted as completely as possible within 30 days. To accomplish this goal, CTRs specialize in specific sites and abstract only those sites. This has resulted in increased efficiency and accuracy. Within 30 days these cases are completed as thoroughly as possible. CTRs use concurrent follow-up process to follow patients through first course treatment. This increases the percent of patients with current follow-up as they only focus on patients within their sites.

Using Performance Data to Improve Physician Performance: A Single Institution Study Comparing Smoking Cessation Counseling Rates Pre- and Post-Data Reporting

Stamford Hospital
Stamford, CT
Nicole Burgwardt, MD

Sociologists have noted that individuals change their behavior when they are aware they are being studied (Hawthorne Effect). Providing performance feedback is one such method. We evaluated this effect on smoking cessation counseling due to the public health implication of tobacco use. Smoking cessation counseling rates of 106 physicians in Stamford Health Medical Group (SHMG) were collected from May 2016–March 2018. During 2017, physicians were provided their individual data to review quarterly and the counseling rate goal was set at 53%. A statistically significant increase in physicians providing smoking cessation counseling, as well as patients counseled resulting from providing performance feedback to providers, was observed.

Addressing the Opioid Epidemic in Community Oncology Programs

Duke Cancer Network
Durham, NC
Kerri Dalton, MSN, RN, AOCNS

In 2016, the rate of opioid–related deaths was skyrocketing. It was becoming apparent that no community or clinical provider was immune to the impact of the epidemic. In addition, new regulations and guidelines for prescribing opioids for pain management were announced by state Medical boards and the CDC. The Duke Cancer Network (DCN), a network of community programs, recognized that oncologists used opioids frequently to manage cancer pain. DCN sought development of best practice: aligning emerging regulations and eliminating systematic vulnerabilities in the prescribing of opioids. A work group, Pain Initiative Team (PIT), defined the scope, created tools/resources, and processes at four pilot sites.

A Well Scoped Project: Colorectal Cancer Screening Initiative

Northwestern Medicine
Chicago, IL
Ashley Denny, RN, MS

The goal of this project was to improve our colorectal cancer screening rates from a baseline of 58% to our target of 64%. After a detailed review of our baseline data and discussion with frontline providers, we found that a vast majority of our patients were screened with colonoscopy. Upon further investigation, to understand why patients were not up to date with their screening, we found three key areas to address; ease of documentation, ease of referral and ease of scheduling. From implementation of intervention through April 2017 we saw approximately 700 discreetly scanned external colonoscopies and a 23% increase in decision support utilization. Over a 12 month period, we saw a 6% increase in our overall screening rates to meet our target of 64%.

Oncology Patients on Non-Oncology Units: A Multidisciplinary Approach to Meet CoC’s Standard 1

Saint Joseph Hospital
Denver, CO
Amanda Feild, MSN, RN, PCCN

Oncology nurses play a critical role in the delivery of care to hospitalized patients with cancer. The Commission on Cancer’s Clinical Practice Guidelines state that nursing care of the cancer patient is to be provided by nurses with specialized knowledge and skill in oncology because the complex needs of patients with cancer require specialized oncology nursing knowledge to achieve optimal care outcomes. The oncology nurse is integral to the multidisciplinary oncology team, specifically nurses with certification in oncology nursing. Our unit’s current certification rate is 71 percent, which solidifies the importance of ensuring oncology patients are admitted to the oncology unit.

Detection of Earlier Stage Lung Cancers through the Development of a Multidisciplinary Lung Nodule Center poster

Detection of Earlier Stage Lung Cancers through the Development of a Multidisciplinary Lung Nodule Center

Sidney Kimmel Cancer Center
Sewell, NJ
Michele Gaguski, MSN, RN, AOCN, CHPN, NE-BC, APN-C

Lung cancer remains the second most commonly diagnosed malignancy and the number one cause of mortality due to cancer. The potential benefits of lung cancer screening cannot be underestimated. Identification of high risk individuals who meet criteria for low dose CT (LDCT) screening is critical to early diagnosis and prompt treatment. As a result of LDCT screening, nodules are often found, and management can be challenging and complex for the clinical team. Using evidenced-based strategies, the Lung Program Executive Committee (LPEC) developed a designated Lung Nodule Center (LNC) within the cancer program. The approach to the creation of this center was multi-faceted and included the development, integration and promotion of evidenced-based guidelines and algorithms for management of high risk lung nodules.

A Multidisciplinary Approach to Improve the Efficiency of Breast MRI Utilization

Bellingham Regional Breast Center
Bellingham, WA
Cary Kaufman, MD, FACS

Recognizing a delay for newly diagnosed breast cancer patients that have their breast MRI ordered only after the multidisciplinary conference or surgical consultation, we developed a protocol to improve timeliness of care. Breast Program Leadership identified guidelines when a newly diagnosed breast cancer patient would warrant a breast MRI. The message went to the primary care provider who now ordered the breast MRI prior to conference or surgical consultation. We examined sixty consecutive patients from two time periods, half before and half after institution of the MRI protocol.

Breast Conservation Surgery Rate for Women with AJCC Clinical Stage 0, I, or II Breast Cancer: An Initiative to Promote Breast Conservation Surgery

Richmond University Medical Center
Staten Island, NY
Nisha Lakhi, MD

Based on data from the NCDB, mastectomy rate for AJCC clinical stage 0, I, or II breast cancer at our institution from 2012 to 2015 ranged from 45.2-56 percent compared with New York State (33.6%) and all CoC programs (37.4%). Retrospective review of medical records of all patients who had surgery for AJCC clinical stage 0, I, or II breast cancer at our institution from January 2011 to December 2015. Patients were categorized into two groups, those who had breast conservation surgery (BCS) and those who had mastectomy. Modifiable factors that were more likely to contribute to mastectomy were identified. An intervention was designed to specifically address the contributing factors in an effort to promote BCS.

Disparities in Minimally Invasive Surgery for Colorectal Cancer in Florida poster

Disparities in Minimally Invasive Surgery for Colorectal Cancer in Florida

Mayo Clinic
Jacksonville, FL
Osayande Osagiede, MBBS, MPH

Minimally invasive surgery (MIS) may produce equivalent oncologic and clinical outcomes to open surgery for colorectal cancer, but the associated costs may increase the tendency for social and racial disparities. The aim of this study was to determine if racial, socioeconomic and geographic disparities exist in access to MIS techniques, both laparoscopic and robotic, among patients with colorectal cancer in Florida. We utilized the Florida Inpatient Discharge Dataset to examine the clinical data of patients who underwent elective resections for colorectal cancer during 2013-2015. Multivariate analysis was performed to identify differences in gender, age, race/ethnicity, location (urban vs rural), geographic region, insurance coverage and clinical characteristics associated with the surgical route. Length of stay was included as an outcome of interest.

Implementation of Community Colon Health Screening Program: Response to Colon Cancer Analysis

Park Ridge Health Cancer Services
Hendersonville, NC
Kosha Parcell, RN, BSN, OCN

At Park Ridge Health, we reviewed the incidence of colon cancer involving males and females ages 50 to 75. The average age at diagnosis of colon cancer at Park Ridge Health is between 60 and 69 years of age with a high incidence involving males (54%) versus females (46%) according to the annual report. Within the analysis, colon cancer was determined to be a site of disease most often diagnosed at a later stage for our facility. These findings led our facility to implement a program to improve community education, awareness and screening for colon health.

Holden Comprehensive Cancer Center: Infusion Scheduling & Workflow Improvement with the Use of Simulation & Lean Management

University of Iowa Hospitals and Clinics
Iowa City, IA
Zachary Pollock, PharmD, MS

Holden Comprehensive Cancer Center Infusion Suite identified ongoing challenges to meet patient demand. This was demonstrated by staff overtime, patient wait times, and unpredictable seating times. Peaks and valleys were witnessed with identified high patient Work In Process (WIP) numbers. Also reviewed was order quality, infusion duration accuracy and use of overbooking appointments. After implementation of improvements for the template and practice guidance, we saw a significant decrease in wait time from a patient’s scheduled appointment to their chair time. We have been able to better level load the day by maximizing the use of our template.

Adherence to a 3-Part Margin Assessment Protocol Improves Outcomes for Intraoperative Radiation Therapy Patients

Lovelace Women's Hospital
Albuquerque, NM
Calvin Ridgeway, MD, FACS

Intraoperative radiation therapy is a viable treatment option for increasing numbers of early stage breast cancer patients undergoing lumpectomy. In properly selected patients, it allows for completion of lumpectomy and radiation therapy in a single operative session. A negative surgical margin on final pathology is one of the key components for a successful outcome. We utilized a three-part protocol of intraoperative assessment with MarginProbe, specimen radiography, and gross pathologic evaluation prior to the radiation. This resulted in a margin specific failure rate of 1 out of our 41 first patients.

Strategic Implementation of a Shared Service Cancer Registry Model in a Large National Healthcare System

Strategic Implementation of a Shared Service Cancer Registry Model in a Large National Healthcare System

Sarah Cannon Cancer Centers
Nashville, TN
Melissa Rinker, CTR

In 2018 Sarah Cannon launched an enterprise-wide restructuring and approach to cancer registry operations and accreditation management. This involved a refinement of scope, job descriptions and allocation of resources. The primary goals of the overhaul included: increased quality and timeliness of data collection, standardization of daily operations for data collection, cancer conference management and overall accreditation management and utilization of employee skill sets (right people doing right jobs). In addition to re-structuring of people and skills, information technology enhancements and interfaces were developed and utilized to increase efficiencies and productivity. Success will be measured in terms of: concurrent abstracting at all facilities, high quality data available for meaningful analysis and quality studies, successful outcomes from CoC and NAPBC surveys, programs operating at survey ready level at all times, gaps in services identified in a timely fashion.

Can Technology Help Us Find Patients? Identifying Patients for Navigation and Cancer Registry with the Use of a Software Product

Can Technology Help Us Find Patients? Identifying Patients for Navigation and Cancer Registry with the Use of a Software Product

Sarah Cannon/HCA
Nashville, TN
Cheryl Sheridan, RHIT, CTR

We diagnose more than 120,000 patients per year within our system. We have more than 200 nurse navigators, the largest cancer navigation program in the U.S. With such significant volume we needed to create a standardized method using technology to identify cancer patients at the point of diagnosis. This tool needed to identify patients for our nurse navigators to ensure we are improving the timeliness of care for our patients. The tool also needed to be developed as a case finding tool for our cancer registry to decrease the manual hours that our registrars spent on case finding. Our poster will demonstrate the tool developed (PT ID) and the significant impact it has had on our nurse navigators and cancer registry.

Barriers to the Utilization of Genetic Testing and Genetic Counseling in Patients with Suspected Hereditary Breast and Ovarian Cancers: A Single Institution Study

Barriers to the Utilization of Genetic Testing and Genetic Counseling in Patients with Suspected Hereditary Breast and Ovarian Cancers: A Single Institution Study

Baylor Scott and White
Dallas, TX
Laura Siciliano, RN, OCN, CTR

Breast cancer is caused by an inherited predisposition in approximately 5-10% of women and 10% of men with breast cancer. Additionally, up to 25% of women with ovarian cancer can attribute their cancer to a heritable condition. Germline mutations in breast and ovarian cancer susceptibility genes often cause cancer at a younger age than patients with wild-type status, and many of these germline mutations also increase the risk for other types of cancers. It is important to identify patients at risk for cancers associated with known genetic mutations, and to implement appropriate risk-reducing interventions and screening protocols as recommended by groups such as the National Comprehensive Cancer Network (NCCN) in order to reduce their cancer risk.

Oncology Length of Stay: A Study of Drivers of Variation with Implementation of Real Time Resolution of Barriers

Oncology Length of Stay: A Study of Drivers of Variation with Implementation of Real Time Resolution of Barriers

Baylor Scott and White
Dallas, TX
Laura Siciliano, RN, OCN, CTR

The complex and unpredictable nature of oncology lends to interdependencies, unintended consequences, and wide variation. Length of stay (LOS) is an outcome metric used to evaluate the cumulative effect of inpatient processes. The oncology population LOS at Baylor University Medical Center (BUMC) is above external benchmark. A multidisciplinary team of Oncology Nurses, Physicians, Administration, Quality, Comprehensive Care Management, Health Information Management (HIM), and the Advanced Analytics departments studied LOS to understand the drivers of variation and identify opportunities to decrease unnecessary days. The most effective implementation was enhanced multidisciplinary rounding (MDR) that added the Attending Physician, HIM, and a mobile huddle board containing pertinent patient details to existing MDRs. These brief huddles led to real-time resolution of barriers to discharge and visibility of the expected LOS for the documented acuity.

Holden Comprehensive Cancer Center: Oncology Registry Quality Management System and Waste Reduction poster

Holden Comprehensive Cancer Center: Oncology Registry Quality Management System and Waste Reduction

University of Iowa Hospital and Clinics
Iowa City, IA
Tania Viet, CTR

Based on gap analysis it was determined standardization of workflow, reduction of process waste and development of a quality management system could benefit current and future state of Oncology Registry Program. Improvements will lessen burden on current staff, allow for setting clear individual and team goals, build strong team dynamics and assist in right sizing the staffing model to meet overall work demand. Using quality, lean and six sigma strategies analysis, improvement and system creation occurred. A total quality management system was created that meets standards and institutional goals. Continued development of dashboard metrics to best assist in program evaluation is underway and captures key performance indicators with process, satisfaction and outcome measures.

A Study on Intraoperative Radiation Therapy in Breast Cancer Patients: Does Socioeconomic Status or Race Correlate with Cure?

Rush University Medical Center
Chicago, IL
Ashley Woodfin, MD

Minority women with breast cancer have poorer outcomes and survival rates. In this study, we use the NCDB to look at breast cancer patients who have received intraoperative radiation therapy and compare them with those who have received external radiation therapy. Race, education, and socioeconomic status all appeared to play a role in the choice of IORT but it does not appear that this affected mortality.


Enhanced Navigation Improves Utilization of Recommended Services by Women with an Increased Risk of Breast Cancer

Stamford Hospital
Stamford, CT
Nicolle Burgwardt, MD

Guidelines recommend that women with an increased risk of breast cancer receive enhanced screening and additional services, but many are unaware of their risk and their education is an unmet need. Our objective is to track the outcomes of women identified at an increased risk of breast cancer who have been provided enhanced navigation for risk reduction counseling, enhanced surveillance, referral to medical oncology for chemoprevention and for genetic counseling as indicated. This pilot study was effective in identifying high-risk patients and successfully guiding them through the comprehensive high-risk breast program.

Efficacy of the Breast Cancer Navigator Role in Reducing Distress in Newly Diagnosed Breast Cancer Patients: A Pilot Study poster

Efficacy of the Breast Cancer Navigator Role in Reducing Distress in Newly Diagnosed Breast Cancer Patients: A Pilot Study

University of Vermont Health Network-Champlain Valley Physicians Hospital
Plattsburgh, New York
Patricia Johnson, BS, RN, OCN, CBCN

Breast Cancer Navigator programs (BCN) are considered best practice in cancer care, using the CoC Standard 3.1. The diagnosis of breast cancer is often accompanied by extreme distress. Studies to date on the BCN intervention have primarily examined screening practices, cost measures, or downstream effects on care. Few primary studies have examined the effect of early intervention by a Breast Navigator Nurse program on distress. We tested the effects of an early intervention by the BCN on distress. A secondary interest was how an early intervention might change practices. Findings suggest that the BCN intervention reduces distress in this population. This study helped to drive practice change at the institution, allowing the BCN to intervene shortly after the diagnosis is delivered.

Delay of Cancer Care (DoCC)—Redesigning Patient Navigation Program

Presbyterian Healthcare Services
Albuquerque, NM
John Sanchez, MS

Delay of Cancer Care (DoCC) is a significant issue for Presbyterian Healthcare Services (PHS) and Presbyterian Medical Group patients. DoCC leads to more advanced disease resulting in greater mortality and morbidity, diminished quality of life, more expensive treatments, and puts PHS at increased risk. Currently, processes do not assure timely diagnosis, and treatment initiation for all disease sites. Our goal is to design a patient navigation program that will consist of standard work for all disease sites. By having a sound navigation program, patients will be able to get the needed tests completed and providers will be able to begin treatment sooner resulting in the patient having a higher success of survivability.

Initial Outcomes of a Patient Navigation Program Satisfaction Survey poster

Initial Outcomes of a Patient Navigation Program Satisfaction Survey

Baylor Scott and White
Dallas, TX
Laura Siciliano, RN, OCN, CTR

The changing landscape of “value-based” cancer care has resulted in the need of Patient Navigation (PN) programs to measure, analyze, and report-out on patient satisfaction. With limited data available, mixed results exist on the impact of PN programs as it pertains to patient experience (1,2,3). Measuring the impact of a PN program on patient experience will demonstrate the value, efficacy, and sustainability of the growing field. Navigators from strategic locations across a large healthcare system along with leadership, the Office of Patient Experience (OPE), and Press Ganey participated in the creation of a twelve-question PN patient satisfaction survey tool. A link to the survey was sent via email to patients within 2-6 weeks after initial referral to PN.

Opportunities for Creating Direct Provider and Community Linkage at a Safety Net Hospital Through Patient Navigation

Mercy Hospital and Medical Center
Livonia, MI
Daniel Vicencio, MD

The Chinatown Patient Navigation Program is a partnership between Mercy Hospital and Medical Center, Northwestern University Feinberg School of Medicine, and Chinese American Service League, that seeks to address cultural, linguistic, and socioeconomic barriers through the implementation of a community patient navigation model. Our navigators guide patients in a complex healthcare system, acting as case managers, interpreters, educators, and advocates. Navigators develop culturally appropriate and linguistically adequate outreach and education workshops for reducing cancer risk. Simultaneously, they collaborate with healthcare providers to provide interpretation and Chinese resources for patients with limited English proficiency. We aim to investigate the health status and challenges of the community, evaluate the effectiveness of the program, and inform future directions.


Overcoming SCPs Barriers: Creative Staffing Solution

Fort Collins, CO
Emma Bootle, MBA

In looking at implementing treatment summary/survivorship care plan (TS/SCP) within the clinical setting, one of the barriers at UCHealth Cancer Care was insufficient staffing to prepare the TS/SCP. A TS/SCP can, on an uncomplicated patient, take 30 minutes to prepare, but on a complex patient can take hours. A research project at the University of Colorado Hospital, found that it took an average of 81 minutes to prepare a treatment summary and care plan for breast cancer survivors. Nationally, programs that are currently providing TS/SCP’s are often doing so by having a mid-level provider or a Registered Nurse (RN) to prepare the TS/SCP and conduct the survivorship visit. The Oncology Service Line felt that this took valuable time from patient care and was not financially feasible since there was no reimbursement for TS/SCP development.

Closing the Loop on SCP Development and Distribution with Technology

Tulane Comprehensive Cancer Clinic
New Orleans, LA
Lisa Ganem, CTR

Cancer programs across the country are struggling with working survivorship care plans (SCPs) into their programs. We have identified three key areas to address to make our program successful: staffing issues, timely notification of end of treatment, and physician education and buy-in of the importance of the SCP. We have utilized technology through eCW and Metriq cancer registry software to implement triggers to the cancer registry and to the SCP navigator that have resulted in the timely development and delivery of SCPs. We rely on several of our clinical staff to accomplish the completion of the plans as we are in the same position as many centers without the resources to hire a dedicated SCP staff.

Providing Structure to Survivorship Care Delivery: A Process Improvement Project

Providing Structure to Survivorship Care Delivery: A Process Improvement Project

Northside Hospital Cancer Institute—Atlanta, GA
Dawn Hayes PT, PhD, GCS

Delivery of survivorship care plan (SCP) using a multidisciplinary approach optimizes attention to the components of survivorship care (Hewitt et al, 2006). Institutions continue to be challenged by implementation barriers (Dulko et al, 2013; Mayer, 2014; Eshelman-Kent et al, 2011). A large CCCP in the Southeast consisting of three hospitals, 34 outpatient infusion centers, and six radiation oncology centers treated more than 10,000 analytic cancer cases in 2017. The size of this program as defined by analytic volume and geographic footprint of 44 counties creates significant challenges to survivorship care delivery process. A gap analysis highlighted components of the survivorship program recommended for process improvement.

Examination of Outcomes for Cancer Survivors Participating in the Clinical Evidence-based Exercise Program, Boot Camp for Cancer poster

Examination of Outcomes for Cancer Survivors Participating in the Clinical Evidence-based Exercise Program, Boot Camp for Cancer

Advocate South Suburban Hospital
Hazel Crest, IL
Peggy Kupres, RN, BSN, MA

Aerobic exercise is known to reduce stress and alleviate fatigue, the most common complaint of cancer survivors. The impetus of this research is to increase self-reported function and quality of life through aerobic activity during a weekly exercise program. This study utilized a prospective observational design, collecting information from a convenience sample of 79 adult cancer survivors that participated in an evidence-based, 7-week exercise program at Advocate South Suburban Hospital. The survey tools, FACT-B and APTA (AMERICAN PHYSICA L THERAPY ASSOCIATION) OPTIMAL FORM), were administrated at the first and last session of the exercise program, to assess the outcomes related to function and quality of life.

Stage II-III Colon Cancer: A Comparison of Survival Calculators

Stage II-III Colon Cancer: A Comparison of Survival Calculators

Mayo Clinic
Jacksonville, FL
Osayande Osagiede, MBBS, MPH

Individualized postoperative survival calculators for patients with cancer can be an aid for predicting prognosis and clinical decision making, such as the use of adjuvant chemotherapy. The aim of this study was to compare existing survival calculators for colon cancer and determine their performance using an independent cohort of patients. A retrospective analysis of a multi-site institutional experience was performed on patients diagnosed with stage II-III colon cancer between January 2012 and March 2013. After the application of inclusion and exclusion criteria, a total of 97 patients were included in the analysis. Prognostic models incorporating a more comprehensive amount of patient and tumor specific variables may provide a more accurate estimate of individual patient survival rates. These tools can be an aid in the clinical practice, allowing physicians to personalize treatment and follow-up for patients with colon cancer.
Bridging the Distance: Survivorship Telephone Encounters poster

Bridging the Distance: Survivorship Telephone Encounters

Sylvester Comprehensive Cancer Center
Miami, FL
Chinny Trivedi, MPA, LSSBB

It is often challenging for patients to return to clinics physically for non-treatment related visits. Challenges include availability of parking, tolls, traffic, and location of campus. Our 2016 survivorship clinic data shows a high number of patients who refuse the visit or cancel. We believe this is indicative of the constraints placed on patients in the geographic location where we are located. The CoC approved our inquiry to provide a copy of the survivorship care plan (SCP) and resources to our patients via a telephone encounter with stipulation that the patient have a copy of the information during the phone call. Our objective was to provide more patients with the flexibility to receive a SCP and resources.

Impact of Team Based Surveillance on Outcomes for Patients with Melanoma

Impact of Team Based Surveillance on Outcomes for Patients with Melanoma

University Surgical Oncology
Knoxville, TN
Andrew Ward, MSN, FNP-BC

At the University of TN—Knoxville, a Melanoma And Soft Tissue Tumor (MASTT) team was created in 2013 to improve the quality of care for patients with melanoma. This team assumed responsibility for the long-term surveillance and navigation once melanoma treatment was complete. Surveillance intervals were determined based on histologic characteristics and clinical concern. All newly diagnosed patients with melanoma were evaluated from 2011–2015 using our prospectively maintained tumor database. Patients were stratified by stage, histology, recurrence, and final disease status. Time to recurrence was calculated as well. We found that coordinated care for survivorship is beneficial for detecting recurrence of melanoma. A coordinated team approach to survivorship may improve early detection and decrease the time to biopsy, diagnosis and referral for systemic therapy.

Using NCDB Data for Quality Improvement

Utilizing CP3R Results to Improve Patient Outcomes Locally: A Focus on Lung Cancer

Sutter Roseville Medical Center
Roseville, CA
Deborah Dix, MS, RN

CP3R measures accountability, Quality Improvement and Surveillance Measures. Reviewing CP3R reporting, it was noted lung metrics met or exceeded the required reporting except for "At least 10 regional lymph nodes are removed and examined for AJCC Stage IA, IB, IIA, IIB for resected NCSLC". six cases since work group with pathology and thoracic surgery. Five cases had more than 10 nodes removed, one case had nine nodes removed. All patients with stage I, II, or III lung cancer who received EBUS or Mediastinoscopy with a subsequent surgery were assessed for: Were total lymph node numbers combined and did patients exceed 10 lymph nodes?

The Power of Low Dose CT Lung Screening in the Battle against Lung Cancer: Finding the Early Stage Lung Cancers In Our Local Community

The Power of Low Dose CT Lung Screening in the Battle against Lung Cancer: Finding the Early Stage Lung Cancers In Our Local Community

Essentia Health
Brainerd, MN
Dianne Kendall, MD

We attempted smoking cessation, early childhood tobacco awareness and individual physician to patient counseling with little impact to our lung cancer stage at diagnosis statistics compared to NCDB. We had more stage IV lung cancers and less earlier stage lung cancers. We needed to try something more effective. With help of our administrative team, radiology department, pulmonologist, nurse oncology navigators and primary care physicians, we developed a program to refer high risk patients for low dose CT lung screening. We identified low stage unexpected clinically silent tumors that would not have otherwise been identified. Identifying lung cancer at an earlier stage results in significantly improved survival.

Implementation of an Early Alert System Using RQRS Tools to Improve Cancer Care poster

Implementation of an Early Alert System Using RQRS Tools to Improve Cancer Care

City of Hope National Medical Center
Duarte, CA
Kelli Olsen, MS, CTR

At City of Hope National Medical Center, the Cancer Registry Director submits data to the Rapid Quality Reporting System (RQRS) twice per month. The alerts are downloaded monthly and tracked for compliance. If a patient is still non-compliant with a metric and does not have a follow-up appointment scheduled within 30 to 60 days, the treating physician will be notified by email, describing the metric, the terms of compliance and the pertinent patient information. Through this process, it was found that one clinician was waiting to initiate endocrine therapy until after adjuvant Herceptin was completed in Her2 positive breast cancer patients, putting them out of compliance on the HT measure. This was an excellent learning opportunity for the clinical staff and the clinician changed the timing of the care in the future, therefore following the Evidence-Based guidelines. This process of regularly monitoring the RQRS data proved to be extremely beneficial to patient care and ensured compliance to Standard 4.4: Accountability Measures.