Thomas M

Purpose: To examine the feasibility of establishing a biobanking program at a tertiary VA facility

Background/Rationale: Biobanking holds promise for the discovery of new biomarkers and development of targeted therapy through access to large amounts of molecular and electronic health record data. The Department of Defense’s (DOD) John P. Murtha Cancer Center (MCC), of the Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, provided funding for a pilot biobanking implementation at a VA facility in hopes of facilitating a VA-wide biobank network to support federal research initiatives.

Methods: After funding and staff resources were secured, four months were required to complete contract negotiation, regulatory review, and a comprehensive assessment of inter-departmental operational requirements. We initiated with two different surgical specialties—thoracic and gastrointestinal oncology—for the initial stage to establish the system and process flow of the tissue procurement protocol, from pre-operative case screening and consenting to specimen collection (blood, urine, tissue) and tissue storage.

Results: From its inception in March 2018 through May 2018, monthly consent numbers were 1, 2, and 7, respectively. From these, fresh specimen collection occurred in most (6 patients with 8 tumor aliquots). Blood collection and questionnaire completion were obtained in all patients. All samples were shipped safely to the long-term storage facility of the MCC and therefore ready for distribution for researchers.

Conclusions: We are now ready to move beyond the pilot stage by including other cancer types. Our goal is to collect biospecimens on 2 cases per week or 100 cases per year. From preparation to implementation, we learned the success of the program relies heavily on adequate funding, supportive leadership with surgery, pathology, and oncology buy-in and proactive communication among the team members. We conclude that establishing a VA nationwide oncology biobanking program that mirrors that of the DOD is feasible, with high potential merit for veterans and civilians alike.

Purpose: To examine the feasibility of establishing a biobanking program at a tertiary VA facility

Background/Rationale: Biobanking holds promise for the discovery of new biomarkers and development of targeted therapy through access to large amounts of molecular and electronic health record data. The Department of Defense’s (DOD) John P. Murtha Cancer Center (MCC), of the Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, provided funding for a pilot biobanking implementation at a VA facility in hopes of facilitating a VA-wide biobank network to support federal research initiatives.

Methods: After funding and staff resources were secured, four months were required to complete contract negotiation, regulatory review, and a comprehensive assessment of inter-departmental operational requirements. We initiated with two different surgical specialties—thoracic and gastrointestinal oncology—for the initial stage to establish the system and process flow of the tissue procurement protocol, from pre-operative case screening and consenting to specimen collection (blood, urine, tissue) and tissue storage.

Results: From its inception in March 2018 through May 2018, monthly consent numbers were 1, 2, and 7, respectively. From these, fresh specimen collection occurred in most (6 patients with 8 tumor aliquots). Blood collection and questionnaire completion were obtained in all patients. All samples were shipped safely to the long-term storage facility of the MCC and therefore ready for distribution for researchers.

Conclusions: We are now ready to move beyond the pilot stage by including other cancer types. Our goal is to collect biospecimens on 2 cases per week or 100 cases per year. From preparation to implementation, we learned the success of the program relies heavily on adequate funding, supportive leadership with surgery, pathology, and oncology buy-in and proactive communication among the team members. We conclude that establishing a VA nationwide oncology biobanking program that mirrors that of the DOD is feasible, with high potential merit for veterans and civilians alike.

Purpose: To examine the feasibility of establishing a biobanking program at a tertiary VA facility

Background/Rationale: Biobanking holds promise for the discovery of new biomarkers and development of targeted therapy through access to large amounts of molecular and electronic health record data. The Department of Defense’s (DOD) John P. Murtha Cancer Center (MCC), of the Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, provided funding for a pilot biobanking implementation at a VA facility in hopes of facilitating a VA-wide biobank network to support federal research initiatives.

Methods: After funding and staff resources were secured, four months were required to complete contract negotiation, regulatory review, and a comprehensive assessment of inter-departmental operational requirements. We initiated with two different surgical specialties—thoracic and gastrointestinal oncology—for the initial stage to establish the system and process flow of the tissue procurement protocol, from pre-operative case screening and consenting to specimen collection (blood, urine, tissue) and tissue storage.

Results: From its inception in March 2018 through May 2018, monthly consent numbers were 1, 2, and 7, respectively. From these, fresh specimen collection occurred in most (6 patients with 8 tumor aliquots). Blood collection and questionnaire completion were obtained in all patients. All samples were shipped safely to the long-term storage facility of the MCC and therefore ready for distribution for researchers.

Conclusions: We are now ready to move beyond the pilot stage by including other cancer types. Our goal is to collect biospecimens on 2 cases per week or 100 cases per year. From preparation to implementation, we learned the success of the program relies heavily on adequate funding, supportive leadership with surgery, pathology, and oncology buy-in and proactive communication among the team members. We conclude that establishing a VA nationwide oncology biobanking program that mirrors that of the DOD is feasible, with high potential merit for veterans and civilians alike.

Introduction: The Commission on Cancer (COC), the New Mexico VA Health Care System (NMVAHCS) accrediting body for cancer care, mandates 25% of nurses maintain oncology nurse certification (OCN) to validate competency. However, the NMVAHCS remains deficient: threatening facility ability to maintain accreditation. Per the Oncology Nursing Certification Corporation, Albuquerque maintains 160 OCNs. However, 50% have retired and the remaining 50% are over 52. Leaving approximately 40 OCN nurses in a population of 500,000. This problem was not only a NMVAHCS problem, but a community problem: affecting quality of oncology care.

Problem: Not only is certification required for COC accredited facilities, it represents validation of expertise and skill set. Validation serves to build trust of Veterans, enables superior clinical judgment, and contributes to improved outcomes. With the Choice Program, many Veterans can leave the VAHCS. Certification serves to build necessary confidence required to keep Veterans within the VAHCS.

Methods: Barriers prohibiting certification were identified through survey of oncology nurses. Nurses reported fear related to failure, study material costs, exam fees, lack of mentors, and lack of internal leadership encouragement and support as barriers of certification. Funding was sought to provide a review course for 40 nurses, study guides, reimbursement of course and exam fees and held June 2017 in Albuquerque, New Mexico. A second review course, held during the 2017 AVAHO meeting, was conducted for another 24 nurses. The courses aimed to build confidence and decrease barriers. Both exceeded capacity.

Results: As a result of the Albuquerque course, VISN 22 and non-VA nurses attended from several states. Each received
a 30% reduction in exam fees and were eligible for exam reimbursement after passing: 50% of attendees are now OCNs.

The AVAHO course, to date, has resulted in an additional 2 OCNs, 2 certification renewals, and an additional 5 are registered for the exam. Those not taking the exam cite lack of leadership support and encouragement as the main
barrier.

Implications: Certification validates care provided and builds Veterans trust: necessary with Choice. Facilities that retain a strong foundation of OCNs, mentor staff, and maintain leadership support remain more apt to produce and sustain certified nurses. Therefore, leadership buy-in remains essential.

Introduction: The Commission on Cancer (COC), the New Mexico VA Health Care System (NMVAHCS) accrediting body for cancer care, mandates 25% of nurses maintain oncology nurse certification (OCN) to validate competency. However, the NMVAHCS remains deficient: threatening facility ability to maintain accreditation. Per the Oncology Nursing Certification Corporation, Albuquerque maintains 160 OCNs. However, 50% have retired and the remaining 50% are over 52. Leaving approximately 40 OCN nurses in a population of 500,000. This problem was not only a NMVAHCS problem, but a community problem: affecting quality of oncology care.

Problem: Not only is certification required for COC accredited facilities, it represents validation of expertise and skill set. Validation serves to build trust of Veterans, enables superior clinical judgment, and contributes to improved outcomes. With the Choice Program, many Veterans can leave the VAHCS. Certification serves to build necessary confidence required to keep Veterans within the VAHCS.

Methods: Barriers prohibiting certification were identified through survey of oncology nurses. Nurses reported fear related to failure, study material costs, exam fees, lack of mentors, and lack of internal leadership encouragement and support as barriers of certification. Funding was sought to provide a review course for 40 nurses, study guides, reimbursement of course and exam fees and held June 2017 in Albuquerque, New Mexico. A second review course, held during the 2017 AVAHO meeting, was conducted for another 24 nurses. The courses aimed to build confidence and decrease barriers. Both exceeded capacity.

Results: As a result of the Albuquerque course, VISN 22 and non-VA nurses attended from several states. Each received
a 30% reduction in exam fees and were eligible for exam reimbursement after passing: 50% of attendees are now OCNs.

The AVAHO course, to date, has resulted in an additional 2 OCNs, 2 certification renewals, and an additional 5 are registered for the exam. Those not taking the exam cite lack of leadership support and encouragement as the main
barrier.

Implications: Certification validates care provided and builds Veterans trust: necessary with Choice. Facilities that retain a strong foundation of OCNs, mentor staff, and maintain leadership support remain more apt to produce and sustain certified nurses. Therefore, leadership buy-in remains essential.

Introduction: The Commission on Cancer (COC), the New Mexico VA Health Care System (NMVAHCS) accrediting body for cancer care, mandates 25% of nurses maintain oncology nurse certification (OCN) to validate competency. However, the NMVAHCS remains deficient: threatening facility ability to maintain accreditation. Per the Oncology Nursing Certification Corporation, Albuquerque maintains 160 OCNs. However, 50% have retired and the remaining 50% are over 52. Leaving approximately 40 OCN nurses in a population of 500,000. This problem was not only a NMVAHCS problem, but a community problem: affecting quality of oncology care.

Problem: Not only is certification required for COC accredited facilities, it represents validation of expertise and skill set. Validation serves to build trust of Veterans, enables superior clinical judgment, and contributes to improved outcomes. With the Choice Program, many Veterans can leave the VAHCS. Certification serves to build necessary confidence required to keep Veterans within the VAHCS.

Methods: Barriers prohibiting certification were identified through survey of oncology nurses. Nurses reported fear related to failure, study material costs, exam fees, lack of mentors, and lack of internal leadership encouragement and support as barriers of certification. Funding was sought to provide a review course for 40 nurses, study guides, reimbursement of course and exam fees and held June 2017 in Albuquerque, New Mexico. A second review course, held during the 2017 AVAHO meeting, was conducted for another 24 nurses. The courses aimed to build confidence and decrease barriers. Both exceeded capacity.

Results: As a result of the Albuquerque course, VISN 22 and non-VA nurses attended from several states. Each received
a 30% reduction in exam fees and were eligible for exam reimbursement after passing: 50% of attendees are now OCNs.

The AVAHO course, to date, has resulted in an additional 2 OCNs, 2 certification renewals, and an additional 5 are registered for the exam. Those not taking the exam cite lack of leadership support and encouragement as the main
barrier.

Implications: Certification validates care provided and builds Veterans trust: necessary with Choice. Facilities that retain a strong foundation of OCNs, mentor staff, and maintain leadership support remain more apt to produce and sustain certified nurses. Therefore, leadership buy-in remains essential.