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Colorectal Cancer Awareness Fair – Make Your Bottom Your Top Priority
Background: The Comprehensive Cancer Program held a community Colorectal Cancer Awareness Fair on March 5, 2019 at the VAMC. The goal was to increase awareness of Colorectal Cancer and to engage veterans in educational opportunities about Colorectal Cancer.
Methods: The VAMC purchased an in atable “Megacolon” for veterans to walk through guided by nurses from the GI department. Cubicles were set-up for nursing education sessions, a provider station, a scheduling station, and a colonoscope table. A video loop “Before and After Colonoscopy” by Mechanisms in Medicine, Inc. (Thornhill, Ontario, Canada) played continuously in the waiting area by the provider and nurse’s cubicles. Providers in the GI department offered 2 educational presentations: “How to Stop Colon Cancer Before It Starts” by Carol Macaron, MD; and “Colonoscopy: The Good, Bad, and Ugly” by Edith Ho, MD. Additional education information was provided at staffed tables from VA General Surgery, GI, MOVE! Nutrition & Food Services, and Smoking Cessation. Also, in attendance were Crohn’s and Colitis Foundation, and the American Cancer Society. External Affairs advertised the fair on Facebook and Twitter. Medical Media created publicity posters and event flyers.
Results: The event was attended by 244 people—68 veterans, 170 employees, and 6 guests. Six colonoscopies were scheduled onsite. At least 7 veterans had questions regarding their colonoscopy surveillance in which reminder dates were given.
Background: The Comprehensive Cancer Program held a community Colorectal Cancer Awareness Fair on March 5, 2019 at the VAMC. The goal was to increase awareness of Colorectal Cancer and to engage veterans in educational opportunities about Colorectal Cancer.
Methods: The VAMC purchased an in atable “Megacolon” for veterans to walk through guided by nurses from the GI department. Cubicles were set-up for nursing education sessions, a provider station, a scheduling station, and a colonoscope table. A video loop “Before and After Colonoscopy” by Mechanisms in Medicine, Inc. (Thornhill, Ontario, Canada) played continuously in the waiting area by the provider and nurse’s cubicles. Providers in the GI department offered 2 educational presentations: “How to Stop Colon Cancer Before It Starts” by Carol Macaron, MD; and “Colonoscopy: The Good, Bad, and Ugly” by Edith Ho, MD. Additional education information was provided at staffed tables from VA General Surgery, GI, MOVE! Nutrition & Food Services, and Smoking Cessation. Also, in attendance were Crohn’s and Colitis Foundation, and the American Cancer Society. External Affairs advertised the fair on Facebook and Twitter. Medical Media created publicity posters and event flyers.
Results: The event was attended by 244 people—68 veterans, 170 employees, and 6 guests. Six colonoscopies were scheduled onsite. At least 7 veterans had questions regarding their colonoscopy surveillance in which reminder dates were given.
Background: The Comprehensive Cancer Program held a community Colorectal Cancer Awareness Fair on March 5, 2019 at the VAMC. The goal was to increase awareness of Colorectal Cancer and to engage veterans in educational opportunities about Colorectal Cancer.
Methods: The VAMC purchased an in atable “Megacolon” for veterans to walk through guided by nurses from the GI department. Cubicles were set-up for nursing education sessions, a provider station, a scheduling station, and a colonoscope table. A video loop “Before and After Colonoscopy” by Mechanisms in Medicine, Inc. (Thornhill, Ontario, Canada) played continuously in the waiting area by the provider and nurse’s cubicles. Providers in the GI department offered 2 educational presentations: “How to Stop Colon Cancer Before It Starts” by Carol Macaron, MD; and “Colonoscopy: The Good, Bad, and Ugly” by Edith Ho, MD. Additional education information was provided at staffed tables from VA General Surgery, GI, MOVE! Nutrition & Food Services, and Smoking Cessation. Also, in attendance were Crohn’s and Colitis Foundation, and the American Cancer Society. External Affairs advertised the fair on Facebook and Twitter. Medical Media created publicity posters and event flyers.
Results: The event was attended by 244 people—68 veterans, 170 employees, and 6 guests. Six colonoscopies were scheduled onsite. At least 7 veterans had questions regarding their colonoscopy surveillance in which reminder dates were given.
National Comprehensive Cancer Network Distress Thermometer Versus Veteran Symptom Assessment Screen: Year in Review at the Cleveland VAMC
Purpose: To address concerns of the cancer committee (CC) and facility regarding the transition use of the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) to the Veteran Symptom Assessment Screen (VSAS).
Background: The Cleveland VA Medical Center (CVAMC) had used the NCCN DT since 2012. In March 2016, in conjunction with the Durham VAMC, the CVAMC began to pilot the VSAS screening tool to replace the NCCN DT. This initiative was an attempt to use one tool that could be used across all VAs to satisfy both The American College of Surgeon’s (ACOS) Commission of Cancer (CoC) accreditation as well as the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) Certification. The CVAMC locally added social elements of transportation, housing and insurance to the VSAS tool.
Methods: In March 2016 the Ear Nose and Throat (ENT) clinic continued to use the NCCN DT while the Oncology Clinics (OC) began to initiate the VSAS. In the CVAMC OC, Veterans that scored a 4 or greater on the VSAS tool in depression, anxiety, or distress or answered yes to transportation, housing, or insurance concerns had a Distress Screening Outpatient Consult entered into CPRS by the intake RN/LPN in clinic. The consultation was then signed off by the provider in clinic delivering care to Veteran that day. The consult was received, reviewed and completed by the oncology social worker (OSW) or the oncology behavioral health (OBH).
Results: In 2016 there were 162 NCCN DT distress screenings that were completed. 38% scored a 4 or above and required referral to OBH/OSW. Only 53% had complete documentation in CPRS. In contrast the VSAS in 2016 had 107 screenings that were completed. 31% required referral to OBH/OSW. 97% had complete documentation in CPRS.
Conclusions/Implications: This pilot project at the CVAMC allowed clear comparison between NCCN DT and VSAS tools. At our institution, the completion rate of the VSAS, referral and documentation process clearly was more effective than the NCCN DT process. Due to these outcomes the CC and facility made the decision to transition our distress screening process to the VSAS from the NCCN DT.
Purpose: To address concerns of the cancer committee (CC) and facility regarding the transition use of the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) to the Veteran Symptom Assessment Screen (VSAS).
Background: The Cleveland VA Medical Center (CVAMC) had used the NCCN DT since 2012. In March 2016, in conjunction with the Durham VAMC, the CVAMC began to pilot the VSAS screening tool to replace the NCCN DT. This initiative was an attempt to use one tool that could be used across all VAs to satisfy both The American College of Surgeon’s (ACOS) Commission of Cancer (CoC) accreditation as well as the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) Certification. The CVAMC locally added social elements of transportation, housing and insurance to the VSAS tool.
Methods: In March 2016 the Ear Nose and Throat (ENT) clinic continued to use the NCCN DT while the Oncology Clinics (OC) began to initiate the VSAS. In the CVAMC OC, Veterans that scored a 4 or greater on the VSAS tool in depression, anxiety, or distress or answered yes to transportation, housing, or insurance concerns had a Distress Screening Outpatient Consult entered into CPRS by the intake RN/LPN in clinic. The consultation was then signed off by the provider in clinic delivering care to Veteran that day. The consult was received, reviewed and completed by the oncology social worker (OSW) or the oncology behavioral health (OBH).
Results: In 2016 there were 162 NCCN DT distress screenings that were completed. 38% scored a 4 or above and required referral to OBH/OSW. Only 53% had complete documentation in CPRS. In contrast the VSAS in 2016 had 107 screenings that were completed. 31% required referral to OBH/OSW. 97% had complete documentation in CPRS.
Conclusions/Implications: This pilot project at the CVAMC allowed clear comparison between NCCN DT and VSAS tools. At our institution, the completion rate of the VSAS, referral and documentation process clearly was more effective than the NCCN DT process. Due to these outcomes the CC and facility made the decision to transition our distress screening process to the VSAS from the NCCN DT.
Purpose: To address concerns of the cancer committee (CC) and facility regarding the transition use of the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) to the Veteran Symptom Assessment Screen (VSAS).
Background: The Cleveland VA Medical Center (CVAMC) had used the NCCN DT since 2012. In March 2016, in conjunction with the Durham VAMC, the CVAMC began to pilot the VSAS screening tool to replace the NCCN DT. This initiative was an attempt to use one tool that could be used across all VAs to satisfy both The American College of Surgeon’s (ACOS) Commission of Cancer (CoC) accreditation as well as the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) Certification. The CVAMC locally added social elements of transportation, housing and insurance to the VSAS tool.
Methods: In March 2016 the Ear Nose and Throat (ENT) clinic continued to use the NCCN DT while the Oncology Clinics (OC) began to initiate the VSAS. In the CVAMC OC, Veterans that scored a 4 or greater on the VSAS tool in depression, anxiety, or distress or answered yes to transportation, housing, or insurance concerns had a Distress Screening Outpatient Consult entered into CPRS by the intake RN/LPN in clinic. The consultation was then signed off by the provider in clinic delivering care to Veteran that day. The consult was received, reviewed and completed by the oncology social worker (OSW) or the oncology behavioral health (OBH).
Results: In 2016 there were 162 NCCN DT distress screenings that were completed. 38% scored a 4 or above and required referral to OBH/OSW. Only 53% had complete documentation in CPRS. In contrast the VSAS in 2016 had 107 screenings that were completed. 31% required referral to OBH/OSW. 97% had complete documentation in CPRS.
Conclusions/Implications: This pilot project at the CVAMC allowed clear comparison between NCCN DT and VSAS tools. At our institution, the completion rate of the VSAS, referral and documentation process clearly was more effective than the NCCN DT process. Due to these outcomes the CC and facility made the decision to transition our distress screening process to the VSAS from the NCCN DT.
Use of the Community Needs Assessment (CNA) to Identify Barriers and Improve Access to Cancer Care for Veterans
Purpose: To disseminate information regarding The American College of Surgeons Commission on Cancer (ACOS COC) requirements of Patient Navigation that can be used across VAMCs.
Background: The ACOS COC requires that each facility determine a patient navigation process. The process must focus on a barrier to care identified within a Community Needs Assessment (CNA) that is administered at least every 3 years. From the results of the CNA, a patient navigation process can be developed to address patient, provider, or system barriers to care. These results are also presented to the Cancer Committee (CC) to compile a report summarizing the findings and implementing a plan to improve the quality of cancer care delivered.
Methods: A CNA questionnaire was reviewed by an interdisciplinary group consisting of oncology social worker, oncology psychologist, medical oncologist, survivorship advanced practice nurse, 3 oncology nurse care coordinators and the Cancer Center Program Administrator. The questionnaire was formatted for ease of reading and comprehension. The group presented the CNA questionnaire to the CC for review and approval. The questionnaire was distributed and completed by Veteran’s at varying stages along the cancer trajectory.
Data Analysis: The questionnaire was distributed and completed by 50 Veterans from Feb 2014-Sept 2014. The questionnaires were distributed and collected in the chemotherapy infusion clinic, during outpatient clinic visits, and during the Louis Stokes Cleveland VAMC (LSCVAMC) annual Cancer Fair.
Results: The top rated concern was found to be travel. According the National Cancer Data Base (NCDB) generated in May 2015 shows that from the years of 2007-2012, 34% of Veterans receiving their care at the LSCVAMC traveled between 50-99 miles to receive their cancer care. The data were presented to the CC, and plans were made to further look at travel resources and community services available to our Veterans. A comprehensive report addressing resources was compiled and presented to the CC.
Implications: Identifying and breaking down barriers to transportation is vital to improving access to Veteran’s cancer care.
Purpose: To disseminate information regarding The American College of Surgeons Commission on Cancer (ACOS COC) requirements of Patient Navigation that can be used across VAMCs.
Background: The ACOS COC requires that each facility determine a patient navigation process. The process must focus on a barrier to care identified within a Community Needs Assessment (CNA) that is administered at least every 3 years. From the results of the CNA, a patient navigation process can be developed to address patient, provider, or system barriers to care. These results are also presented to the Cancer Committee (CC) to compile a report summarizing the findings and implementing a plan to improve the quality of cancer care delivered.
Methods: A CNA questionnaire was reviewed by an interdisciplinary group consisting of oncology social worker, oncology psychologist, medical oncologist, survivorship advanced practice nurse, 3 oncology nurse care coordinators and the Cancer Center Program Administrator. The questionnaire was formatted for ease of reading and comprehension. The group presented the CNA questionnaire to the CC for review and approval. The questionnaire was distributed and completed by Veteran’s at varying stages along the cancer trajectory.
Data Analysis: The questionnaire was distributed and completed by 50 Veterans from Feb 2014-Sept 2014. The questionnaires were distributed and collected in the chemotherapy infusion clinic, during outpatient clinic visits, and during the Louis Stokes Cleveland VAMC (LSCVAMC) annual Cancer Fair.
Results: The top rated concern was found to be travel. According the National Cancer Data Base (NCDB) generated in May 2015 shows that from the years of 2007-2012, 34% of Veterans receiving their care at the LSCVAMC traveled between 50-99 miles to receive their cancer care. The data were presented to the CC, and plans were made to further look at travel resources and community services available to our Veterans. A comprehensive report addressing resources was compiled and presented to the CC.
Implications: Identifying and breaking down barriers to transportation is vital to improving access to Veteran’s cancer care.
Purpose: To disseminate information regarding The American College of Surgeons Commission on Cancer (ACOS COC) requirements of Patient Navigation that can be used across VAMCs.
Background: The ACOS COC requires that each facility determine a patient navigation process. The process must focus on a barrier to care identified within a Community Needs Assessment (CNA) that is administered at least every 3 years. From the results of the CNA, a patient navigation process can be developed to address patient, provider, or system barriers to care. These results are also presented to the Cancer Committee (CC) to compile a report summarizing the findings and implementing a plan to improve the quality of cancer care delivered.
Methods: A CNA questionnaire was reviewed by an interdisciplinary group consisting of oncology social worker, oncology psychologist, medical oncologist, survivorship advanced practice nurse, 3 oncology nurse care coordinators and the Cancer Center Program Administrator. The questionnaire was formatted for ease of reading and comprehension. The group presented the CNA questionnaire to the CC for review and approval. The questionnaire was distributed and completed by Veteran’s at varying stages along the cancer trajectory.
Data Analysis: The questionnaire was distributed and completed by 50 Veterans from Feb 2014-Sept 2014. The questionnaires were distributed and collected in the chemotherapy infusion clinic, during outpatient clinic visits, and during the Louis Stokes Cleveland VAMC (LSCVAMC) annual Cancer Fair.
Results: The top rated concern was found to be travel. According the National Cancer Data Base (NCDB) generated in May 2015 shows that from the years of 2007-2012, 34% of Veterans receiving their care at the LSCVAMC traveled between 50-99 miles to receive their cancer care. The data were presented to the CC, and plans were made to further look at travel resources and community services available to our Veterans. A comprehensive report addressing resources was compiled and presented to the CC.
Implications: Identifying and breaking down barriers to transportation is vital to improving access to Veteran’s cancer care.
The Veteran Symptom Assessment Screen (VSAS) as an Alternate for the National Comprehensive Cancer Network (NCNDT) Distress Thermometer
Purpose: To utilize a distress screening tool that can be used across VAMCs that fulfills cancer center requirements and accreditation standards.
Background: The American College of Surgeon’s (ACOS) Commission on Cancer (COC), Standard 3.2 Distress Screening requires all new cancer diagnoses be screened at diagnosis and at pivotal points across the cancer care continuum. The Louis Stokes Cleveland VAMC (LSCVAMC) used the NCCN DT from May 2012 through March 2016. Collaborating with the Durham VAMC, the LSCVAMC began to pilot the VSAS screening tool in place of the NCCN DT. This initiative was an attempt to use 1 tool that could satisfy both ACOS COC accreditation standards as well as the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) Certification.
Methods: An interdisciplinary team composed of an oncology social worker, oncology psychologist, medical oncologist, survivorship advanced practice nurse and the Cancer Center Program Administrator gathered to compare elements of both the NCCN DT and the VSAS tool. Social elements of distress related to transportation, housing and insurance deemed important to our veteran population were incorporated into the existing VSAS tool.
Data Analysis: During March through June 2016 there have been 47 VSAS tools completed on 47 unique patients. Nursing staff administer, document, and order applicable consults for the screening process. The time required to complete the screen is approximately 2-4 minutes depending on the complexity of the patient. Preliminary data regarding specific elements of the VSAS will be forthcoming at the time of poster presentation.
Results: Patients with a new diagnosis of cancer were asked to complete the form at their initial visit. Initial results from the team piloting the VSAS found that the tool actually allowed providers to hone in on more of the areas that were causing the Veteran the most distress. Whereas, with DT only having 1 thermometer made narrowing down what was causing the most distress more difficult.
Implications: Finding tools that can be implemented across VA facilities for both COC and QOPI initiatives will streamline processes and allow for multicenter data collection benefiting the VA as a whole and decreasing variability in cancer care between facilities.
Purpose: To utilize a distress screening tool that can be used across VAMCs that fulfills cancer center requirements and accreditation standards.
Background: The American College of Surgeon’s (ACOS) Commission on Cancer (COC), Standard 3.2 Distress Screening requires all new cancer diagnoses be screened at diagnosis and at pivotal points across the cancer care continuum. The Louis Stokes Cleveland VAMC (LSCVAMC) used the NCCN DT from May 2012 through March 2016. Collaborating with the Durham VAMC, the LSCVAMC began to pilot the VSAS screening tool in place of the NCCN DT. This initiative was an attempt to use 1 tool that could satisfy both ACOS COC accreditation standards as well as the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) Certification.
Methods: An interdisciplinary team composed of an oncology social worker, oncology psychologist, medical oncologist, survivorship advanced practice nurse and the Cancer Center Program Administrator gathered to compare elements of both the NCCN DT and the VSAS tool. Social elements of distress related to transportation, housing and insurance deemed important to our veteran population were incorporated into the existing VSAS tool.
Data Analysis: During March through June 2016 there have been 47 VSAS tools completed on 47 unique patients. Nursing staff administer, document, and order applicable consults for the screening process. The time required to complete the screen is approximately 2-4 minutes depending on the complexity of the patient. Preliminary data regarding specific elements of the VSAS will be forthcoming at the time of poster presentation.
Results: Patients with a new diagnosis of cancer were asked to complete the form at their initial visit. Initial results from the team piloting the VSAS found that the tool actually allowed providers to hone in on more of the areas that were causing the Veteran the most distress. Whereas, with DT only having 1 thermometer made narrowing down what was causing the most distress more difficult.
Implications: Finding tools that can be implemented across VA facilities for both COC and QOPI initiatives will streamline processes and allow for multicenter data collection benefiting the VA as a whole and decreasing variability in cancer care between facilities.
Purpose: To utilize a distress screening tool that can be used across VAMCs that fulfills cancer center requirements and accreditation standards.
Background: The American College of Surgeon’s (ACOS) Commission on Cancer (COC), Standard 3.2 Distress Screening requires all new cancer diagnoses be screened at diagnosis and at pivotal points across the cancer care continuum. The Louis Stokes Cleveland VAMC (LSCVAMC) used the NCCN DT from May 2012 through March 2016. Collaborating with the Durham VAMC, the LSCVAMC began to pilot the VSAS screening tool in place of the NCCN DT. This initiative was an attempt to use 1 tool that could satisfy both ACOS COC accreditation standards as well as the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) Certification.
Methods: An interdisciplinary team composed of an oncology social worker, oncology psychologist, medical oncologist, survivorship advanced practice nurse and the Cancer Center Program Administrator gathered to compare elements of both the NCCN DT and the VSAS tool. Social elements of distress related to transportation, housing and insurance deemed important to our veteran population were incorporated into the existing VSAS tool.
Data Analysis: During March through June 2016 there have been 47 VSAS tools completed on 47 unique patients. Nursing staff administer, document, and order applicable consults for the screening process. The time required to complete the screen is approximately 2-4 minutes depending on the complexity of the patient. Preliminary data regarding specific elements of the VSAS will be forthcoming at the time of poster presentation.
Results: Patients with a new diagnosis of cancer were asked to complete the form at their initial visit. Initial results from the team piloting the VSAS found that the tool actually allowed providers to hone in on more of the areas that were causing the Veteran the most distress. Whereas, with DT only having 1 thermometer made narrowing down what was causing the most distress more difficult.
Implications: Finding tools that can be implemented across VA facilities for both COC and QOPI initiatives will streamline processes and allow for multicenter data collection benefiting the VA as a whole and decreasing variability in cancer care between facilities.