Lapsiwala R

Purpose/Rationale: In order to improve cancer care coordination (CCC) a quality improvement pilot study was performed using a novel tracking tool for Veterans at the VA North Texas Health Care System (VANTHCS) located in Dallas, Texas.

Background: The VANTHCS is the second largest VA health care system in the country, serving over 113,000 Veterans and delivering one million outpatient episodes of care each year. Cancer is one of the leading causes of these episodes of care. This specific population faces unique needs due to the complexity of cancer care. Particularly, newly diagnosed cancer patients are at risk for being lost to follow up, receiving timeliness of care as well as having interruptions in communication among providers and Veterans. Cancer care coordination has been shown to augment the quality of cancer care. Prior to the initiation of this study, there was no cancer care tracking tool in place and no comprehensive CCC across the continuum at VANTHCS.

Methods: In April 2017, discussion was initiated among the key cancer care providing stakeholders to formulate a plan to identify all Veteran patients newly diagnosed with cancer at VANTHCS. Utilizing histopathology and cytology reports from VistA, we developed an interface that displayed Veterans with new cancer diagnoses. This system was put in place to capture initial date of diagnosis and
monitor scheduled patient appointments through the date of initial treatments. A plan-do-study-act (PDSA) was conducted to assess for any changes.

Results: From May 2017 through May 2018, data were collected and analyzed in the Cancer Care Tracking Tool by a designated registered nurse (RN); approximately 1,400 newly diagnosed cancer cases were tracked. Fifty-three cases were identified requiring an intervention. This tracking prompted discussion with key cancer stakeholders for the need of a cancer program clinical coordinator (CPCC). A full-time CPCC was appointed in February 2018.

Conclusions/Implications: This innovative study presented an original approach to improve the quality of cancer care for Veterans. Through the Cancer Care Tracking Tool the RN and CPCC actively identified and addressed barriers to cancer care. This may have numerous implications for future studies including, patient satisfaction and enhanced patient outcomes.

Purpose/Rationale: In order to improve cancer care coordination (CCC) a quality improvement pilot study was performed using a novel tracking tool for Veterans at the VA North Texas Health Care System (VANTHCS) located in Dallas, Texas.

Background: The VANTHCS is the second largest VA health care system in the country, serving over 113,000 Veterans and delivering one million outpatient episodes of care each year. Cancer is one of the leading causes of these episodes of care. This specific population faces unique needs due to the complexity of cancer care. Particularly, newly diagnosed cancer patients are at risk for being lost to follow up, receiving timeliness of care as well as having interruptions in communication among providers and Veterans. Cancer care coordination has been shown to augment the quality of cancer care. Prior to the initiation of this study, there was no cancer care tracking tool in place and no comprehensive CCC across the continuum at VANTHCS.

Methods: In April 2017, discussion was initiated among the key cancer care providing stakeholders to formulate a plan to identify all Veteran patients newly diagnosed with cancer at VANTHCS. Utilizing histopathology and cytology reports from VistA, we developed an interface that displayed Veterans with new cancer diagnoses. This system was put in place to capture initial date of diagnosis and
monitor scheduled patient appointments through the date of initial treatments. A plan-do-study-act (PDSA) was conducted to assess for any changes.

Results: From May 2017 through May 2018, data were collected and analyzed in the Cancer Care Tracking Tool by a designated registered nurse (RN); approximately 1,400 newly diagnosed cancer cases were tracked. Fifty-three cases were identified requiring an intervention. This tracking prompted discussion with key cancer stakeholders for the need of a cancer program clinical coordinator (CPCC). A full-time CPCC was appointed in February 2018.

Conclusions/Implications: This innovative study presented an original approach to improve the quality of cancer care for Veterans. Through the Cancer Care Tracking Tool the RN and CPCC actively identified and addressed barriers to cancer care. This may have numerous implications for future studies including, patient satisfaction and enhanced patient outcomes.

Purpose/Rationale: In order to improve cancer care coordination (CCC) a quality improvement pilot study was performed using a novel tracking tool for Veterans at the VA North Texas Health Care System (VANTHCS) located in Dallas, Texas.

Background: The VANTHCS is the second largest VA health care system in the country, serving over 113,000 Veterans and delivering one million outpatient episodes of care each year. Cancer is one of the leading causes of these episodes of care. This specific population faces unique needs due to the complexity of cancer care. Particularly, newly diagnosed cancer patients are at risk for being lost to follow up, receiving timeliness of care as well as having interruptions in communication among providers and Veterans. Cancer care coordination has been shown to augment the quality of cancer care. Prior to the initiation of this study, there was no cancer care tracking tool in place and no comprehensive CCC across the continuum at VANTHCS.

Methods: In April 2017, discussion was initiated among the key cancer care providing stakeholders to formulate a plan to identify all Veteran patients newly diagnosed with cancer at VANTHCS. Utilizing histopathology and cytology reports from VistA, we developed an interface that displayed Veterans with new cancer diagnoses. This system was put in place to capture initial date of diagnosis and
monitor scheduled patient appointments through the date of initial treatments. A plan-do-study-act (PDSA) was conducted to assess for any changes.

Results: From May 2017 through May 2018, data were collected and analyzed in the Cancer Care Tracking Tool by a designated registered nurse (RN); approximately 1,400 newly diagnosed cancer cases were tracked. Fifty-three cases were identified requiring an intervention. This tracking prompted discussion with key cancer stakeholders for the need of a cancer program clinical coordinator (CPCC). A full-time CPCC was appointed in February 2018.

Conclusions/Implications: This innovative study presented an original approach to improve the quality of cancer care for Veterans. Through the Cancer Care Tracking Tool the RN and CPCC actively identified and addressed barriers to cancer care. This may have numerous implications for future studies including, patient satisfaction and enhanced patient outcomes.

Purpose: Palliative care is essential to oncology. This abstract describes the AVAHO Palliative Care Research Committee, its objectives, and ongoing projects that highlight the committee’s productive multidisciplinary and interinstitutional collaboration.

Background: The American Society of Clinical Oncology recommends palliative care for patients with metastatic lung cancer and other symptomatic advanced malignancies. VA mandates inpatient palliative care services for all medical facilities. However, it is not clearly known how palliative care is integrated into standard VA outpatient oncology practice. In addition, questions remain regarding the optimal way(s) to provide palliative oncology care. Established in 2015, the AVAHO Palliative Care Research Committee currently has over a dozen members from different VA institutions. The Committee’s mission is to develop partnerships among clinicians, pharmacists, social workers, researchers, and VA leadership with the shared goal of providing optimal palliative oncology care within the VA.

Methods: Last year, we identified 2 initial approaches to address these questions, and this year we will report on our progress. First, we submitted a proposal to the VA Evidence-Based Synthesis Program (ESP) to review the evidence regarding optimal palliative care delivery methods and the feasibility of providing on-site palliative care embedded into VA oncology clinics. The ESP accepted our proposal and plans to complete their review July 2017. Second, we proposed a project to assess on-site palliative care availability in VA oncology clinics. With the support of the 2017 AVAHO Research Scholarship, we are moving forward with this project to work with VA oncology providers to understand their referral patterns, available palliative care resources, and barriers to providing optimal palliative care.

Results: At the AVAHO 2017 meeting, we will review the VA ESP results on optimal palliative oncology care delivery. In addition, we will share the progress on our ongoing project to better understand VA oncologist’s referral patterns, resources, and barriers to providing optimal palliative oncology care.

Conclusions: The AVAHO Palliative Care Research Committee represents a multidisciplinary and inter-institutional collaboration with a common goal of optimizing VA palliative oncology care. This committee is a model of how AVAHO can foster productive collaborations.

Purpose: Palliative care is essential to oncology. This abstract describes the AVAHO Palliative Care Research Committee, its objectives, and ongoing projects that highlight the committee’s productive multidisciplinary and interinstitutional collaboration.

Background: The American Society of Clinical Oncology recommends palliative care for patients with metastatic lung cancer and other symptomatic advanced malignancies. VA mandates inpatient palliative care services for all medical facilities. However, it is not clearly known how palliative care is integrated into standard VA outpatient oncology practice. In addition, questions remain regarding the optimal way(s) to provide palliative oncology care. Established in 2015, the AVAHO Palliative Care Research Committee currently has over a dozen members from different VA institutions. The Committee’s mission is to develop partnerships among clinicians, pharmacists, social workers, researchers, and VA leadership with the shared goal of providing optimal palliative oncology care within the VA.

Methods: Last year, we identified 2 initial approaches to address these questions, and this year we will report on our progress. First, we submitted a proposal to the VA Evidence-Based Synthesis Program (ESP) to review the evidence regarding optimal palliative care delivery methods and the feasibility of providing on-site palliative care embedded into VA oncology clinics. The ESP accepted our proposal and plans to complete their review July 2017. Second, we proposed a project to assess on-site palliative care availability in VA oncology clinics. With the support of the 2017 AVAHO Research Scholarship, we are moving forward with this project to work with VA oncology providers to understand their referral patterns, available palliative care resources, and barriers to providing optimal palliative care.

Results: At the AVAHO 2017 meeting, we will review the VA ESP results on optimal palliative oncology care delivery. In addition, we will share the progress on our ongoing project to better understand VA oncologist’s referral patterns, resources, and barriers to providing optimal palliative oncology care.

Conclusions: The AVAHO Palliative Care Research Committee represents a multidisciplinary and inter-institutional collaboration with a common goal of optimizing VA palliative oncology care. This committee is a model of how AVAHO can foster productive collaborations.

Purpose: Palliative care is essential to oncology. This abstract describes the AVAHO Palliative Care Research Committee, its objectives, and ongoing projects that highlight the committee’s productive multidisciplinary and interinstitutional collaboration.

Background: The American Society of Clinical Oncology recommends palliative care for patients with metastatic lung cancer and other symptomatic advanced malignancies. VA mandates inpatient palliative care services for all medical facilities. However, it is not clearly known how palliative care is integrated into standard VA outpatient oncology practice. In addition, questions remain regarding the optimal way(s) to provide palliative oncology care. Established in 2015, the AVAHO Palliative Care Research Committee currently has over a dozen members from different VA institutions. The Committee’s mission is to develop partnerships among clinicians, pharmacists, social workers, researchers, and VA leadership with the shared goal of providing optimal palliative oncology care within the VA.

Methods: Last year, we identified 2 initial approaches to address these questions, and this year we will report on our progress. First, we submitted a proposal to the VA Evidence-Based Synthesis Program (ESP) to review the evidence regarding optimal palliative care delivery methods and the feasibility of providing on-site palliative care embedded into VA oncology clinics. The ESP accepted our proposal and plans to complete their review July 2017. Second, we proposed a project to assess on-site palliative care availability in VA oncology clinics. With the support of the 2017 AVAHO Research Scholarship, we are moving forward with this project to work with VA oncology providers to understand their referral patterns, available palliative care resources, and barriers to providing optimal palliative care.

Results: At the AVAHO 2017 meeting, we will review the VA ESP results on optimal palliative oncology care delivery. In addition, we will share the progress on our ongoing project to better understand VA oncologist’s referral patterns, resources, and barriers to providing optimal palliative oncology care.

Conclusions: The AVAHO Palliative Care Research Committee represents a multidisciplinary and inter-institutional collaboration with a common goal of optimizing VA palliative oncology care. This committee is a model of how AVAHO can foster productive collaborations.