Nearly two hundred healthcare providers throughout the Chicagoland convened on Thursday, January 24, at Mercy Hospital and Medical Center to share insights and lessons learned from the 3-year, $3.2 million Supportive Oncology Collaborative. The collaborative was formed in 2014 by the Coleman Foundation to address what the Institute of Medicine called “the crisis of cancer care”. Over 169 providers from 44 institutions participated in the collaborative. Symposium faculty offered data and comparative experiences delivering quality supportive care at a wide range of institutions, including; safety net, academic and community hospitals, and a Veterans Administration hospital. Symposium participants received CME credit.
Rosa Berardi, Senior Program Officer at the Coleman Foundation, greeted the healthcare practitioners who came to learn how various clinics throughout the Chicagoland area deployed the supportive oncology care tools, practice models and resources and the measurable outcomes from these changes in patient care.
Supportive Oncology Collaborative Symposium Goals
The goal of this Symposium was to:
- Describe supportive oncology standards and guidelines
- Report on approaches and processes to apply supportive oncology guidelines in practice
- Compare methods to provide patients with access to supportive care services
- Generate discussions around and ideas of how to incorporate improvements in supportive care for cancer patients within each center
- Identify tools and methods to support enhanced supportive care for cancer patients
- Explain the 4R Oncology Model for patient care planning
- Assess Use of Supportive Care Tools in participant’s organizations and assess implementation of 4R Oncology model as quality improvement
Tools, Training, and Resources Co-created, Tested, and Published
With Coleman Foundation funding, the SOC created the necessary screening tools to identify patient’s needs, created follow up resources, and a 26-module online training for providers that would help them fulfill patient’s supportive care needs. Christine Weldon, Director of the Center for Business Models in Healthcare and adjunct faculty at Northwestern University Feinberg School of Medicine, shared that the SOC fulfilled the goals:
- Are regularly screened for distress, psychosocial support and palliative care needs;
- Receive appropriate services (from diagnosis through survivorship and end-of-life) from multiple, high-quality service providers that have core competencies in delivering cancer care and support
Right Information and Right Care for the Right Patient at the Right Time (4R)
Building upon this collaborative work, the Coleman Foundation funded the 4R Patient Care Sequences for Cancer and Supportive Care initiative to achieve the added goal of seeing that patients are informed and empowered, along with their families, by personalized patient care sequence document(s), which are adjusted throughout cancer treatment and supportive care.
Following Weldon’s overview, healthcare providers shared how the Supportive Oncology Collaborative work has shaped the way they treat patients today.
How the Supportive Oncology Collaborative has Shaped Patient Care
Teresa Lillis, PhD, from Rush University Medical Center shared how she and her team began implementing screening and supportive care at their academic center using tablets and EPIC (their electronic medical records system).
At Jesse Brown Veterans Affairs Medical Center (JBVA), Joanna Martin, MD, recognized that supportive care and screening was a high need for their cancer patients and working with the Collaborative, they were able to identify and refer their patients to services, either at the hospital or through partnerships.
JBVA also discussed the benefits of using the Cancer Take Charge cards, an innovative resource developed by the Collaborative. The wallet-sized card includes important details such as symptoms or side-effects that require medical assistance, who to call, the times to call and the number to call if they aren’t feeling well. The cards have been instrumental in helping reduce Emergency Room visits since it encourages patients to call before the office closes and they can get help when they need it.
Stacy Sanford, PhD is a Director of Adolescent and Young Adult Oncology at Northwestern University took the stage to address how she and the Pediatric SOC team adapted screening tools to focus on the psychosocial stressors of adolescent and young adult patients as well as tailor the follow-up documents and services for adolescents and young adults.
“How can we inform and empower people with cancer?”
Betty Roggenkamp, Coleman Supportive Oncology Collaborative and 4R Project Coordinator presented on the status of pilot testing more than 50 patient handouts created by the SOC. “Educating patients enables them to handle issues.” Patient handouts will be available free on this website as soon as SOC member finish testing them in their clinics.
Pam Khosla, MD, section chief of hematology and oncology at Sinai Health System, shared how they created a supportive oncology clinic where they schedule their patient’s supportive care appointments to coincide with their other appointments at the clinic. While screening is a key part of identifying needs, creating the clinic to provide same-day services is an important accomplishment, especially in an under-resourced setting like Sinai.
In some cases, the screening tool has identified a larger need within the community: additional staff has been needed to deliver the services their patients need. At University of Illinois Hospital and Health Sciences System, Mary Pasquinelli, DNP, and her team initially had partial access to two inpatient palliative care physicians and two inpatient advanced practice nurses, both of whom were rarely on-site or available. The results from the screening tool helped make the case for additional support, and now their clinic includes two palliative care physicians who are on-site at all times as well as two additional social workers, bringing the total to four social workers who can assist patients.
Pat Mumby, PhD, a psychiatrist at Loyola Medicine, and Lauren Rynar, PhD, a Clinical psychology fellow at Loyola University, shared how Loyola continued to evolve distress and supportive screening.
Mary Pasquinelli, DNP, from University of Illinois Hospital and Health Sciences System, discussed how supportive screening and care was improved through education and training while Ana Gordon, LCSW, OSW-C, MPA-pending, shared the need for psychosocial services in the UI Health cancer patient population and outlined the business case she used to successfully add the two additional social workers to their clinics.
Supportive Oncology Collaborative Toolkit Unveiled
Roggenkamp and Weldon unveiled the Coleman Supportive Oncology Collaborative Toolkit and let attendees know the tools and resources are available to providers everywhere free of charge, and 49 institutions around the US and internationally have begun to use them.
They thanked all the SOC participants and expressed excitement about the results from the first three cycles of funding that have already impacted hundreds of practitioners and tens of thousands of patients. The next phase, 4R, will build upon the first three phases.
Termed 4R, the Right information and Right care for the Right patient at the Right time, was developed by Weldon and Julia Trosman, PhD, of Center for Business Models in Healthcare and Northwestern University. The Coleman Foundation funded an initiative so Weldon and Trosman can work directly with seven healthcare institutions awarded the 4R Patient Care Sequence grants to design customized planning tools that focus on each type of cancer and each pathway within each cancer to align with clinical practices, flows, and structures.
The goals of 4R is that all cancer patients receive a detailed care plan. These personalized patient care documents reflect the entirety of care needed during cancer treatment. They reflect dependencies in care sequences, are adjusted throughout cancer treatment, and include supportive care. The care plan informs and empowers patients, along with their families.
Trosman shared more details about the 4R oncology model for patient care sequences while Claudia Perez, DO, a breast surgeon at Rush University Medical Center, shared how she and her team used 4R patient care sequences with breast cancer patients during surgical consult when she was a breast surgeon at Mercy Hospital and Medical Center.
A panel discussion which included Al B. Benson III, MD, oncologist at Northwestern Medical Group, Perez, Eileen Knightly, Clinic Director of Hematology Oncology Clinic at UI Health, Lauren Wiebe, MD, a specialist in Palliative Care at NorthShore University HealthSystem and Trosman, allowed each panelist to address questions around how they plan to use 4R patient care sequences in practice before Weldon and Trosman ended the symposium and shared next steps.