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cancer care coordination

H G Schnürch, S Ackermann, C D Alt, J Barinoff, C Böing, C Dannecker, F Gieseking, A Günthert, P Hantschmann, L C Horn, R Kürzl, P Mallmann, S Marnitz, G Mehlhorn, C C Hack, M C Koch, U Torsten, W Weikel, L Wölber, M Hampl
Purpose: This is an official guideline, published and coordinated by the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO, Study Group for Gynecologic Oncology) of the Deutsche Krebsgesellschaft (DKG, German Cancer Society) and the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG, German Society for Gynecology and Obstetrics). The number of cases with vulvar cancer is on the rise, but because of the former rarity of this condition and the resulting lack of literature with a high level of evidence, in many areas knowledge of the optimal clinical management still lags behind what would be required...
October 2016: Geburtshilfe und Frauenheilkunde
Anshu K Jain, Mary L Fennell, Anees B Chagpar, Hannah K Connolly, Ingrid M Nembhard
Effective communication is a requirement in the teamwork necessary for improved coordination to deliver patient-centered, value-based cancer care. Communication is particularly important when care providers are geographically distributed or work across organizations. We review organizational and teams research on communication to highlight psychological safety as a key determinant of high-quality communication within teams. We first present the concept of psychological safety, findings about its communication effects for teamwork, and factors that affect it...
October 18, 2016: Journal of Oncology Practice
Melissa C Brouwers, Marija Vukmirovic, Jennifer R Tomasone, Eva Grunfeld, Robin Urquhart, Mary Ann O'Brien, Melanie Walker, Fiona Webster, Margaret Fitch
OBJECTIVE: To report on the findings of the CanIMPACT (Canadian Team to Improve Community-Based Cancer Care along the Continuum) Casebook project, which systematically documented Canadian initiatives (ie, programs and projects) designed to improve or support coordination and continuity of cancer care between primary care providers (PCPs) and oncology specialists. DESIGN: Pan-Canadian environmental scan. SETTING: Canada. PARTICIPANTS: Individuals representing the various initiatives provided data for the analysis...
October 2016: Canadian Family Physician Médecin de Famille Canadien
Julie Easley, Baukje Miedema, June C Carroll, Donna P Manca, Mary Ann O'Brien, Fiona Webster, Eva Grunfeld
OBJECTIVE: To explore health care provider (HCP) perspectives on the coordination of cancer care between FPs and cancer specialists. DESIGN: Qualitative study using semistructured telephone interviews. SETTING: Canada. PARTICIPANTS: A total of 58 HCPs, comprising 21 FPs, 15 surgeons, 12 medical oncologists, 6 radiation oncologists, and 4 GPs in oncology. METHODS: This qualitative study is nested within a larger mixed-methods program of research, CanIMPACT (Canadian Team to Improve Community-Based Cancer Care along the Continuum), focused on improving the coordination of cancer care between FPs and cancer specialists...
October 2016: Canadian Family Physician Médecin de Famille Canadien
Julie Easley, Baukje Miedema, June C Carroll, Mary Ann O'Brien, Donna P Manca, Eva Grunfeld
OBJECTIVE: To explore patient perspectives on and experiences with the coordination and continuity of cancer care. DESIGN: Qualitative study using semistructured telephone interviews. SETTING: Canada. PARTICIPANTS: Thirty-eight breast and colorectal cancer survivors 1 to 4 years after diagnosis. METHODS: Using a constructivist grounded theory approach, semistructured telephone interviews were conducted with the participants...
October 2016: Canadian Family Physician Médecin de Famille Canadien
Jeffrey Sisler, Genevieve Chaput, Jonathan Sussman, Emmanuel Ozokwelu
OBJECTIVE: To offer FPs a summary of evidence-based recommendations to guide their follow-up survivorship care of women treated for breast cancer. QUALITY OF EVIDENCE: A literature search was conducted in MEDLINE from 2000 to 2016 using the search words breast cancer, survivorship, follow-up care, aftercare, guidelines, and survivorship care plans, with a focus on review of recent guidelines published by national cancer organizations. Evidence ranges from level I to level III...
October 2016: Canadian Family Physician Médecin de Famille Canadien
Lesly A Dossett, Janella N Hudson, Arden M Morris, M Catherine Lee, Richard G Roetzheim, Michael D Fetters, Gwendolyn P Quinn
Although they are critical to models of coordinated care, the relationship and communication between primary care providers (PCPs) and cancer specialists throughout the cancer continuum are poorly understood. By using predefined search terms, the authors conducted a systematic review of the literature in 3 databases to examine the relationship and communication between PCPs and cancer specialists. Among 301 articles identified, 35 met all inclusion criteria and were reviewed in-depth. Findings from qualitative, quantitative, and disaggregated mixed-methods studies were integrated using meta-synthesis...
October 11, 2016: CA: a Cancer Journal for Clinicians
J Dunn, G Garvey, P C Valery, D Ball, K M Fong, S Vinod, D L O'Connell, S K Chambers
PURPOSE: Globally, lung cancer is the most common cancer and the leading cause of cancer death. Problematically, there is a wide variation in the management and survival for people with lung cancer and there is limited understanding of the reasons for these variations. To date, the views of health professionals across relevant disciplines who deliver such care are largely absent. The present study describes Australian health professionals' views about barriers to lung cancer care to help build a research and action agenda for improving lung cancer outcomes...
October 10, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Yvonne Bombard, Linda Rozmovits, Anne Sorvari, Corinne Daly, June C Carroll, Erin Kennedy, Linda Rabeneck, Nancy N Baxter
PURPOSE: Population-based reflex testing of colorectal tumors can identify individuals with Lynch syndrome (LS), but there is debate regarding the type of patient discretion such a program warrants. We examined health-care providers' views and experiences to inform the design of a reflex-testing program and their perspectives regarding an opt-out option. METHODS: We interviewed providers managing LS or colorectal cancer patients, including surgeons, genetic counselors, oncologists, primary-care physicians, and gastroenterologists...
October 6, 2016: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Ana Martins, Susie Aldiss, Faith Gibson
PURPOSE: To describe the development and implementation of the specialist nurse key worker role across 18 children's cancer centres in the United Kingdom, and draw out significant factors for success to inform future development of the role across a range of specialities. METHOD: Data were obtained through 42 semi-structured interviews and a focus group with 12 key workers. Framework analysis revealed two main themes: models of care and key workers' perspectives of the role...
October 2016: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
Vasu Divi, Li Tao, Alice Whittemore, Ingrid Oakley-Girvan
BACKGROUND: Advanced head and neck cancer (HNC) is a complex group of diseases that requires the input and coordination of multiple providers. While there are general guidelines for treatment, there is also considerable variation in how patients are treated, and how long they survive after treatment. It is unclear how the treatment variations relate to treatment costs and survival. METHODS: We identified 3678 Medicare patients with advanced HNC treated in 12 US regions between 2004 and 2009 using the linked database containing Medicare and Surveillance Epidemiology and End Results (SEER) data...
October 2016: Oral Oncology
Robert P Feehan, Lisa M Shantz
Nonmelanoma skin cancer (NMSC) is the most common cancer worldwide and the incidence continues to rise, in part due to increasing numbers in high-risk groups such as organ transplant recipients and those taking photosensitizing medications. The most significant risk factor for NMSC is ultraviolet radiation (UVR) from sunlight, specifically UVB, which is the leading cause of DNA damage, photoaging, and malignant transformation in the skin. Activation of apoptosis following UVR exposure allows the elimination of irreversibly damaged cells that may harbor oncogenic mutations...
October 1, 2016: Biochemical Journal
Loïc Dagorne, Tania Bruckner, Bruno Gaudry, Sarah Dumont, Nathalie Gaspar
The medical-psycho-socio-educational characteristics of adolescents and young adults affected by cancer require adapted management. Dedicated programmes and life spaces, as well as the availability of a mobile and transversal multidisciplinary team allow care to be customised. In this context, the coordinating nurse is an essential linchpin in the care team.
September 2016: Soins. Pédiatrie, Puériculture
Raymond U Osarogiagbon, Hector P Rodriguez, Danielle Hicks, Raymond S Signore, Kristi Roark, Satish K Kedia, Kenneth D Ward, Christopher Lathan, Scott Santarella, Michael K Gould, Mark J Krasna
The complexity of lung cancer care mandates interaction between clinicians with different skill sets and practice cultures in the routine delivery of care. Using team science principles and a case-based approach, we exemplify the need for the development of real care teams for patients with lung cancer to foster coordination among the multiple specialists and staff engaged in routine care delivery. Achieving coordinated lung cancer care is a high-priority public health challenge because of the volume of patients, lethality of disease, and well-described disparities in quality and outcomes of care...
September 20, 2016: Journal of Oncology Practice
Nathan J McNeese, Nandita Khera, Sara E Wordingham, Noel Arring, Sharon Nyquist, Amy Gentry, Brian Tomlinson, Nancy J Cooke, Ayan Sen
Hematopoietic cell transplantation (HCT) is an important and complex treatment modality for a variety of hematologic malignancies and some solid tumors. Although outcomes of patients who have undergone HCT and require care in intensive care units (ICUs) have improved over time, mortality rates remain high and there are significant associated costs. Lack of a team-based approach to care, especially during critical illness, is detrimental to patient autonomy and satisfaction, and to team morale, ultimately leading to poor quality of care...
September 20, 2016: Journal of Oncology Practice
Dominique Tremblay, Jean Latreille, Karine Bilodeau, Arnaud Samson, Linda Roy, Marie-France L'Italien, Christine Mimeault
This article discusses the case of a 47-year-old woman who underwent primary therapy with curative intent for breast cancer. The case illustrates a number of failure events in transferring information and responsibility from oncology to primary care teams. The article emphasizes the importance of shared leadership, as multiple team members, dispersed in time and space, pursue their own objectives while achieving the common goal of coordinating care for survivors of cancer transitioning across settings. Shared leadership is defined as a team property comprising shared responsibility and mutual influence between the patient and the patient's family, primary care providers, and oncology teams, whereby they lead each other toward quality and safety of care...
September 20, 2016: Journal of Oncology Practice
Katia Noyes, John R T Monson, Irfan Rizvi, Ann Savastano, James S A Green, Nick Sevdalis
Teamwork is essential for addressing many of the challenges that arise in the coordination and delivery of cancer care, especially for the problems that are presented by patients who cross geographic boundaries and enter and exit multiple health care systems at various times during their cancer care journeys. The problem of coordinating the care of patients with cancer is further complicated by the growing number of treatment options and modalities, incompatibilities among the vast variety of technology platforms that have recently been adopted by the health care industry, and competing and misaligned incentives for providers and systems...
September 20, 2016: Journal of Oncology Practice
Sun Hee Rim, Gery P Guy, K Robin Yabroff, Kathleen A McGraw, Donatus U Ekwueme
This systematic review examines the excess cost of chronic conditions on the economic burden of cancer survivorship among adults in the US. Areas covered: Twelve published studies were identified. Although studies varied substantially in populations, comorbidities examined, methods, and types of cost reported, costs for cancer survivors with comorbidities generally increased with greater numbers of comorbidities or an increase in comorbidity index score. Survivors with comorbidities incurred significantly more in total medical costs, out-of-pocket costs, and costs by service type compared to cancer survivors without additional comorbidities...
October 6, 2016: Expert Review of Pharmacoeconomics & Outcomes Research
Vignesh Raman, Larry R Kaiser, Cherie P Erkmen
BACKGROUND: Clinical pathways reduce hospitalization and costs in colorectal and pancreatic cancer. We describe creating an esophagectomy pathway and analyze its implementation and effects. METHODS: We documented the process of developing an esophagectomy clinical pathway. We performed a retrospective review of prospectively collected data on 12 patients before pathway implementation and 12 patients after. RESULTS: Pathway Implementation: more patients were presented at tumor board (9 pathway vs...
September 2016: Healthcare
Siva Narayanan, Emily Hautamaki
BACKGROUND: The cost of cancer care in the United States continues to rise, with pressure on oncologists to provide high-quality, cost-effective care while maintaining the financial stability of their practice. Existing payment models do not typically reward care coordination or quality of care. In May 2014, the American Society of Clinical Oncology (ASCO) released a payment reform proposal (revised in May 2015) that includes a new payment structure for quality-of-care performance metrics...
July 2016: American Health & Drug Benefits
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