SLIDE 11 11
Cancer Program Updates
Coleman Supportive Oncology Collaborative (CSOC)
CSOC branding, logo, communications, website CSOC Cycle 2 - ten hospital partners CSOC- CC Children with Cancer
31 BOD Meeting March 1, 2017
A consolidated screening tool for supportive oncology needs and distress.
Christine B. Weldon1, Nancy Vance2, Amy Scheu3, Lauren Allison Wiebe4, Shelly S. Lo5, Catherine Deamant6, Betty Roggenkamp1, Urjeet Patel7, Pam Khosla8, Patricia A. Robinson5, Frank J. Penedo 9, James Gerhart4, Teresa Lillis4, William Dale10, Ana Gordon11, Eileen Knightly11, Rosa Berardi12, Julia Rachel Trosman1
1Center for Business Models in Healthcare, Chicago, IL; 2Northwestern Medicine, Chicago, IL; 3Advocate Health Care, Oak Brook, IL; 4Rush University Medical Center, Chicago, IL;5Loyola University Medical Center Stritch School of Medicine, Maywood, IL; 6JourneyCare, Chicago, IL; 7The John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; 8The Mount Sinai Comprehensive Cancer Center, Chicago, IL; 9 Northwestern University Feinberg School of Medicine, Chicago, IL; 10University of Chicago Medicine, Chicago, IL; 11University of Illinois at Chicago, Chicago, IL; 12The Coleman Foundation, Chicago, IL
The IOM 2013 Report recommends that supportive oncology care start at cancer diagnosis; the Commission on Cancer (CoC) Standard 3.2 requires distress screening and indicated action. Screening tools are not standardized across institutions and often address only a portion of patients’ supportive oncology needs. A collaborative of 100+ clinicians, funded by The Coleman Foundation, developed a patient-centric consolidated screening tool based on validated instruments (NCCN Distress, PHQ-4, PROMIS) and IOM and CoC.
- The screening tool was piloted at 6 practice improvement cancer centers in the Chicago area (3
academic, 2 safety-net, 1 public).
- Patients, providers assessing patients’ screening results (assessors), and providers receiving
referrals (providers) were surveyed after use of the screening tool.
- Descriptive statistics were used to assess effectiveness of the tool.
- Use of a consolidated supportive oncology screening tool across multiple institutions is
feasible, identified unmet patient needs, and was beneficial for assessors and providers.
- As the tool is adopted by collaborating institutions, variability in supportive oncology
screening practices may decline, thus improving patient care.
- The tool has implications for quality improvements and national dissemination.
Funded by The Coleman Foundation, Chicago, IL. For more info, contact weldon@centerforbusinessmodels.com Responders included 175 patients, 81 assessors and 26 referral providers (social workers, chaplains, subspecialists).
- The majority of patients (160/175, 91%) completed the screening in < 10 minutes, across all
patients the screening tool averaged 4 ½ minutes.
- Most assessors (59/77, 76%) spent < 5 minutes reviewing screening results.
- Most patients, assessors, and providers reported the screening tool asked the “right questions”.
- Assessors reporting partial relevance of some screening questions for 34% (26/77) of patients
also uncovered one or more relevant needs for 96% (25/26) of those patients (p = 0.002).
B A CK GRO UND ME T HO DS RE S ULTS CO NCL US IO NS
Patient Screening Questions for Supportive Care
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Indicate if any of the following has been a concern for you in the past 7 days, please check Yes or No for each. Over the last 14 days, how often have you been bothered by the following problems? 1 All patients are asked to complete this questionnaire as part of their standard of care. Please take a few minutes to answer the following questions to help us better address your needs. Page 2
Other problems or concerns 2: ________________________________________________________________ _________________________________________________________________________________________ *This tool is adapted from: (1) the PHQ-4 developed by Drs. Robert L. Spitzer, Janet B.W. Wiliams, Kurt Kroenke and colleagues; (2) The National Comprehensive Cancer Network, NCCN Guidelines version 2.2014 Distress Management; (3) Kaiser, M.J., et al., Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging, 2009. 13(9): p. 782-8.; (4) Living Well Cancer Resource Center Distre ss Tool. (5) Munoz, A. R., et al. (2015). "Reference values of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being: a report from the American Cancer Society's studies of cancer survivors." Cance r 121(11 ): 1838-1844. (6) PROMIS Item Bank v1.0 Pain Intensity Short Form 3a; (7) PROMIS Item Bank v1.0 Fatigue Short Form 4a; (8) PROMIS Item Bank v1.0 Physical Function Short Form 4a; and PROMIS item bank The development of this tool was supported by The Coleman Foundation Please answ er these questions to help us address w hat y
S UP P ORT IVE & DI S T RESS S CR E ENING TO O L
10 20 30 40 50 60 70 80 90 100 Right questions / uncovered relevant issues for a specific patient Partial relevance: some questions not important / not relevant to a specific patient I have training or resources to address patient needs
Patients Assessor Referral Provider Assessor Referral Provider Patients Assessor RP
Coleman Supportive Oncology Collaborative for Children with Cancer (CSOC-CC)
Accomplishments Cycle 1
Defined supportive oncology for children with cancer Piloted assessment tool at 5 children’s cancer centers:
Loyola, UIC, University of Chicago, Lurie, and Rush
Developed “follow up” documents to be used by social
workers, child life specialist and parents/caregivers
Generated enhanced list of Patient and Family Resources Created “reasons list for referral to palliative specialist” and
“reasons list for referral to hospice”
Identified preventable vs. not preventable hospitalization list
to reduce readmissions
Produced fifteen training modules for clinicians and staff 33 BOD Meeting March 1, 2017
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