UnityPoint Health Trinity Regional Medical Center Cancer Care Annual Report

Transcription

1 UnityPoint Health Trinity Regional Medical Center Cancer Care 2015 Annual Report

2 Having a strong presence in our community by providing cancer screenings, educational programs, and access to prevention is very important. A few words from our Cancer Center Manager Trinity Cancer Center is committed to excellence in healthcare by providing highly trained medical experts, current technology, and comprehensive interdisciplinary services, including but not limited to pharmacy, lymphedema, nutritional, palliative care, case management, social services, and pastoral care, to support our patients. We are committed to providing cancer care in a manner that is caring, structured by quality, and driven with purpose. Our goal is to provide the best outcome for every patient every time. The year 2015 has been an amazing one for both Trinity Cancer Center and for me in my new role as manager. I embarked on my journey October 21, 2014 and I haven t looked back since. I have been given the honor of leading a staff of 15 very bright and capable professionals who are truly experts in their field. Our core staff consists of registered nurses certified in administering chemotherapy and radiation therapists trained on cutting edge technologies and educated in the finest educational institutions. To support these key positions, it takes patient care techs, a patient navigator, a social worker, and clerical employees who pride themselves on providing the best patient care possible. There are many perks to working in Trinity Cancer Center. A favorite of mine is partnering with community agencies on the state and local level. The cancer center works very closely with the American Cancer Society (ACS) and the Iowa Cancer Consortium to accomplish outreach goals and other cancer-related activities focused on community awareness and prevention. Local community activities this past year include forming a team with Webster County Relay for Life (with the highest participation this past year), having a presence at RAGBRAI to provide free sunscreen and show support to the thousands of bike riders, attending and supporting the Save the TaTa s fundraising efforts, and supporting Angels Abreast Dragon Boat team in their community initiatives all to support our communities health and improve access to care. Having a strong presence in our community by providing cancer screenings, educational programs, and access to prevention is very important to the Cancer Center and bolsters our commitment to improve our community s health. Our second annual oral head and neck screening in April was very successful with area college students and adults totaling 168 participants. The screenings resulted in eight (8) immediate referrals for follow up care. For the youth of our community, Trinity Cancer Center was awarded a grant through the Iowa Cancer Consortium for three gallons of sunscreen for our local aquatic centers and ballpark. Trinity Cancer Center continues to strive for excellence, earning a three-year accreditation from the Commission on Cancer (CoC). This honor is bestowed on treatment centers that are committed to care excellence with a multidisciplinary approach to the best cancer treatment, all close to home. Sincerely yours, Beth Hiveley

3 2015 Cancer Committee Members Lyman Shane Hopkins M.D. Chairman Cancer Committee Laura Miegge M.D. Cancer Physician Liaison to the American College of Surgeons Kenneth Adams, D.O. Gastroenterology Julie Barkema, R.N., O.C.N. Oncology/Hematology Department Diane Davis, R.N., B.S.N. Clinical Performance Improvement Adrianne Peters, R.P.H. Pharmacology/Community Outreach Julie Meuler, C.T.R. Cancer Registrar Sara Tofilon M.D. Medical Oncology Beth Hiveley, L.B.S.W. Manager, Oncology Services Sister M. Gertrude Keefe, R.S.M., N.A.C.C. Chaplain Keith Lacey, M.D. Medical Imaging Troy Martens TRMC, C.O.O. Leopoldo DeLucca, M.D. ENT James Meyer, M.D. Pulmonary Ellen Lantz, R.D.,L.D Clinical Dietitian Angela McLimans, M.A.,O.T.R./L,C.L.T. Rehab Services Sara Cook, B.S.W Social Worker Steven Piercy, M.D. Urology Patty Grossnickle, R.N. Nurse Coordinator Mike DeWerff TRMC, CEO Linda Whaley, M.S.,B.S.,R.N. Administration Larry Heller, M.D. Pathology Laura Miegge, M.D. Surgery Jennie Hoover, R.N. Palliative Care/ Hospice Jessica Smith, R.N. Wellness

4 Cancer Program at a Glance Cancer Resource Room Prevention and Education Annual Oral Health and Neck Screening Treatment Smoking Cessation Program High Risk Breast Clinic Cancer Prevention - Educational Health Fairs Medical Oncology Radiation Oncology Radiation Chemotherapy Therapy Inpatient Cancer Services Outpatient and Infusion Center Care Coordination Board Certified Physicians Support Services Palliative Care Pastoral Care Pain Management Home Health Care Self Image Enhancement Room Cancer Support Group C-Club Volunteer Servies Valet Parking American Cancer Society Services Social Work Services Financial Advocate Assistance Hospice Diagnostic Services Diagnostic Radiology PET, CT, MRI Laboratory Pathology Intervention Radiology Women s Center Mammography Diagnostic Imaging Tomosenthesis, MRI Grief Berevement Services Lodging Assistance of Cancer Road to Recovery Transportation Assistance Cancer Registry Look Good Feel Better Program Emergency Services Lymphedema Wound Care Services Special Services

5 2015: A Year of Accomplishments Evaluating the quality of cancer care provided at UnityPoint Health - Trinity Regional Medical Center is a primary focus. In the year 2015 this process continues to be conducted with great vigor. Numerous patient care improvements have been implemented over the past year in order to better serve our oncology patients. These include the following. REVIEWING AND EDITING OF THE CP 3 R CASES eligible for concordance measurements with current standard-of-care guidelines for breast, colon and rectum cancer, and re-submission of data to NCDB. Monitoring the annual competency of the chemotherapy nurses at TRMC. Submitting data to the NATIONAL CANCER DATA BASE (NCDB) with the established quality criteria on initial submission. MONITORING/EVALUATING AND IMPROVING AJCC TNM staging for analytic cases diagnosed at TRMC. Implementing and monitoring of PATIENT SATISFACTION SURVEY. Evaluating CANCER REGISTRY DATA for Lung Cancer patients to determine if TRMC is following the National Comprehensive Cancer Network (NCCN) treatment guidelines. Providing CANCER SCREENING for breast, prostate, colon/rectum, and uterine, lung cancer to the lower socio-economic population of Webster County. Maintaining a FOLLOW-UP RATE for the cancer registry greater than 90%. Participating in numerous community cancer events and speaking to various community work sites. STAFF PARTICIPATION in RAGBRAI, Relay For Life, Dragon Boat Races, Save the TaTa s ride, Fall Fest, Glow Walk. DON T FRY FREDDY SUNSCREEN GRANT. Gallons of sunscreen were placed at area swimming pools and Harlan Roger Ball Park this summer. Educational information on sun damage and skin cancer available. SUPPORT EDUCATION ACTIVITIES for patient and family include C- Club and Survivorship, Cancer Care, Cancer Care Connect. Offering OUTPATIENT PALLIATIVE CARE SERVICES. Ongoing FREE FECAL OCCULT BLOOD TESTING SCREENS. OFFERING FREE SCREENING MAMMOGRAMS at The Women s Center funded by the breast cancer funds donated by Save the TaTa s. FREE CAMISOLES AND BAGS given to women prior to surgery for breast cancer with funds from Save the Ta Ta s donations and cancer center donations. High Risk Breast Clinic held 2 times monthly. Multidisciplinary Breast Conference. Multidisciplinary Breast Leadership Team. Collaboration for a community Oral Head and Neck screening. Offering various CEU and CME educational activities thoughtout the year for staff and allied Healthcare. Lung Cancer, Breast Cancer Journey from Diagnosis to Recovery 4 staff members on The Iowa Cancer Consortium 2 Care coordinators available to assist patients with various needs. Road to Recovery Services Lodging Assistance Lymphedema services Genetic Counselor Reach to Recovery

6 We don t heal in isolation, but in COMMUNITY. S. Kelley Harrell The C Club is a unique co-ed community where cancer survivors join together in a fun, educational, and understanding environment. Founded in 2010, the C Club offers support to cancer survivors who are invited to participate in art projects and, as they are able, to share in one another s struggles and triumphs. Additionally, after numerous requests the C Club has incorporated an educational component into our monthly meetings. Toward that end, the C Club has hosted Dr. Tim Ihrig with Palliative Care, Jenny Wolfe with Myokinesthetic, and Rick Maehl with the SHIIP / Medicare program, to name a few. As Harrell observed, no one heals in isolation, so C Club exists to promote healing. Community Outreach SCREENINGS Awareness and early detection are two of the most important tools in the fight against cancer. For persons who are uninsured or underinsured access to screenings is limited or nonexistent. Though foundation support we are able to help with these screenings, prostate - PSA blood test, mammograms, and colorectal blood test kits. APRIL 16 2 nd annual Oral Head and Neck Screening held in collaboration with area providers and Iowa Central Dental Health Clinic. 164 persons were seen. JUNE 19 Relay for Life $2,761 raised for American Cancer Society. JULY 19 Save the Tata s Annual Ride In collaboration with Iowa Department of Health, American Cancer Society, and Trinity Cancer Center the group was awarded a grant from the Iowa Cancer Consortium for 6 gallons of sunscreen. The Don t Fry Freddy Sunscreen Project was developed and gallon jugs of sunscreen were placed at Rosedale Rapids, Humboldt, and Gowrie Swimming pools and at Harlan Roger Ball Park. Sun damage educational materials placed by the sunscreen jugs. JULY RAGBRAI Distributed 800 Sunscreen and SPF lip balm to riders. AUGUST 7 Fighting Angels Abreast Dragon Boat race. Sun damage and skin cancer awareness information available. 400 Free sunscreen and SPF lip balms were distributed. SEPTEMBER 27 Apple Fest general cancer information available to public. 75 persons attended. SEPTEMBER 30 Active Older Adult Health Fair. With 100 adults attending and cancer information for both men and women. Free sunscreen and lip balm available. OCTOBER BREAST CANCER AWARENESS EVENTS OCTOBER 2 Education presentation on Breast Cancer Journey from Diagnosis to Recovery was presented by Dr. Miegge general Surgeon and Cancer Liaison Physician for Cancer Committee. 40 people attended the event. OCTOBER 12 Education and awareness booth in the lobby with breast cancer information and free breast cancer items. 59 people stopped at the booth. NOVEMBER 17 Education and awareness booth in the lobby with information on Lung Cancer and lung screening. NOVEMBER 19 Public announcement for the Great American Smoke Out given by American Cancer Society Represented and TRMC Wellness Coordinator. NOVEMBER 11 Free PSA testing for hospital employees.

7 Palliative Care Palliative care is an interdisciplinary medical specialty that focuses on preventing and relieving suffering and on supporting the best quality of life for patients and their families facing serious and chronic illnesses. The primary tenants of palliative care are symptom managements; establishing goals of care that are in keeping with the patient s wishes, values, and preferences; consistent and sustained communication between the patient and those involved in his or her care by the development of a caring relationship. The palliative care aims to relieve suffering in all stages of disease and is not limited to end of life care. When palliative care and oncology palliative care are able to form a partnership, as we are privileged to have accomplished in Fort Dodge, we combine two unique specialty services that are able to offer our mutual patients and families, care givers, and providers involved in that persons care an added layer of support. This somewhat atypical collaboration of palliative care and oncology allows us to establish a relationship with the patient that enhances patient trust, awareness, and satisfaction that can begin as early as initial diagnosis. The combined efforts of our two services continues throughout the patients journey and increases educational opportunities regarding disease processes and treatment choices, improves the effectiveness of symptom management, and allows us to advocate for, and empower the patient to have a voice in decisions affecting them throughout this difficult medical journey. We can then utilize the relationship and trust built to provide for smoother transitions of care, and can provide the much needed support for cancer survivors after treatments complete. We combine two unique specialty services that are able to offer our patients and families an added layer of support.

8 Lung Cancer Lung cancer (both small cell and non-small cell) is the second most common cancer in both men and women (not counting skin cancer). In men, prostate cancer is more common, while in women breast cancer is more common. Lung cancer accounts for about 13% of all new cancers. Key statistics about lung cancer The American Cancer Society estimates for lung cancer in the United States for 2015 are: About 221,200 new cases of lung cancer (115,610 in men and 105,590 in women) An estimated 158,040 deaths from lung cancer (86,380 in men and 71,660 women need) Risk factors for lung cancer A risk factor is anything that affects a person s chance of getting a disease, such as cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a person s age or family history, can t be changed. Several risk factors can make you more likely to develop lung cancer. Tobacco smoke ~ Smoking is by far the leading risk factor for lung cancer. ~ At least 80% of lung cancer deaths are thought to result from smoking. Radon ~ Radon is a naturally occurring radioactive gas that results from the breakdown of uranium in soil and rocks. It cannot be seen, tasted, or smelled. Asbestos Workplace exposure to asbestos fibers is an important risk factor for lung cancer. Other carcinogens (cancer-causing agents) found in some workplaces that can increase lung cancer risk include: Diesel exhaust Air pollution Personal or family history of lung cancer Early Detection, Diagnosis Usually symptoms of lung cancer do not appear until the disease is already in an advanced, non-curable stage. Even when symptoms of lung cancer do appear, many people may mistake them for other problems, such as an infection or long-term effects from smoking. This may delay the diagnosis. Screening is the use of tests or exams to detect a disease in people without symptoms of that disease. These factors, and others, need to be taken into account by people and their doctors who are considering whether or not screening with low dose Cat Scan (LDCT) is right for them. Patients should be asked about their smoking history. Patients who meet ALL of the following criteria may be candidates for lung cancer screening. 55 to 74 years old In fairly good health (discussed further down) Have at least a 30 pack-year smoking history Are either still smoking or have quit smoking within the last 15 years To Start a Screening If you fit all of the criteria for lung cancer screening listed above, you and your doctor (or other health care provider) should talk about starting screening. He or she will talk to you about what you can expect from screening, including possible benefits and harms, as well as the limitations of screening. Screening should only be done at facilities that have the right type of CT scanner and that have experience in LDCT scans for lung cancer screening. Trinity Regional Medical Center has a team of specialists that can provide the appropriate care and follow-up of patients with abnormal results on the scans.

9 2015 Study of Quality Each year, a physician member of the cancer committee performs a study to assess whether patients within the program are evaluated and treated according to evidence-based guidelines. The study must determine that the diagnostic evaluation is adequate and the treatment plan is concordant with recognized guidelines. Source: Lung cancer cases diagnosed at Trinity Regional Medical Center. Study Data: 2013 lung cancer cases receiving treatment at Trinity Cancer Center. Evaluation: The components of care that was evaluated include the age distribution at diagnosis, first course treatment and AJCC stage. This data was compared with data from NCDB and other CoC approved cancer programs. Lung cancer cases at Trinity Cancer Center were treated per the NCCN guidelines. Diagnosis Stage Stage IV 48.14% Stage III 37.03% Stage II (3.7%) Stage I (3.7%)

10 Lee Trinity Regional Medical Center Market Share In 2014 Trinity Cancer Center continued to see growth in oncology patient services. Trinity Cancer Center provided individualized care for 7,353 Medical Oncology visits, and 5,563 Radiation Oncology visits serving individuals in a 5 county area. Webster County BV, Calhoun, Hamilton, Humboldt, Pocahontas, Sac, Wright Patient Type Product Line Q1-Q4 Q1-Q4 Q1-Q4 Q1-Q2 Q1-Q4 Q1-Q4 Q1-Q4 Q1-Q2 Outpatient All 76.4% 74.8% 74.9% 76.3% 7.0% 7.0% 7.8% 8.2% Outpatient Cardiology 79.9% 74.7% 74.0% 76.8% 8.9% 8.7% 10.3% 8.7% Outpatient Orthopedics 55.5% 57.6% 66.1% 64.8% 8.5% 9.5% 10.8% 12.9% Outpatient Oncology 20.2% 26.7% 62.9% 69.2% 3.6% 6.2% 9.8% 14.4% Outpatient Therapeutic Radiology* 0.0% 22.7% 92.2% 87.3% 0.0% 18.8% 57.1% 61.6 Inpatient All 70.2% 71.1% 70.3% 67.7% 14.7% 14.1% 15.4% 14.2% Inpatient General Cardiology 88.7% 83.9% 82.0% 75.0% 23.2% 24.4% 24.8% 19.6% Osceola Dickinson Emmet Kossuth Winnebago Worth Mitchell Howard Inpatient Orthopedics Allamakee 37.6% 43.6% 46.7% 50.6% 7.3% 9.6% 12.9% 14.9% Winneshiek O'Brien Buena Vista Clay Palo Alto Humboldt Hancock Wright Chickasaw Cerro Gordo Floyd Inpatient Clayton Oncology 33.0% 32.0% 35.8% 39.4% 3.6% 4.4% 5.7% 9.0% Fayette Bremer Cherokee Pocahontas Franklin Butler a on Ida Crawford Shelby Sac Carroll Audubon Webster Calhoun Boone Greene Dallas Hamilton Story Polk Hardin Marshall Jasper Grundy Tama Black Hawk Benton Iowa Buchanan Linn Delaware Dubuque Jones Cedar Jackson Scott Clinton *CCS group 211 in Dimensions Outpatient All CPT HCPCS (not the Outpatient Principal CPT HCPCS from which the Pivot Tables are built) (Source is IHA Slice and Dice) Guthrie Poweshiek Johnson Muscatine Pottawattamie Cass Adair Warren Marion Mahaska Keokuk Washington Madison Louisa Montgomery Adams Lucas Monroe Jefferson Henry Mills Union Clarke Wapello Des Moines Fremont Taylor Davis Ringgold Wayne Van Buren Page Decatur Appanoose

11 Glossary of Terms TRMC: Trinity Regional Medical Center. Analytic: Analytic cases are patients who have been diagnosed and/or received all or part of the first course of therapy at TRMC. Non-Analytic: Non-Analytic cases are patients who were diagnosed and received the entire first course of therapy prior to admission to TRMC. This category also includes patients whose treatment is unknown, patients diagnosed at autopsy, and patients who were diagnosed and treated with the first course of therapy at the reporting institution before the registry s reference date. Note is made that these cases are not included in routine treatment or survival statistics. State of Disease: Extent of disease as determined at the time of first course of therapy. AJCC and SEER Summary Staging Guide are used. Our Mission To improve the health of the citizens of our communities and regions by providing quality healthcare in an efficient and cost-effective manner. Our Vision To be the preferred healthcare provider in Northwest Central Iowa. Incidence: The extent to which disease occurs in the population. Cancer incidence is the estimated number of new cases of cancer diagnosed each year. NOS: Not otherwise specified or unknown. AJCC: American Joint Committee on Cancer. SEER: Surveillance, Epidemiology and End Results. NCCN: National Comprehensive Cancer Network. Copyright 2015 UnityPoint Health. All Rights Reserved. SM trademarks of UnityPoint Health /15 CS For more information about the programs and services Trinity Cancer Center provides, visit unitypoint.org. Trinity Cancer Center 802 Kenyon Road Fort Dodge, IA 50501