Quality Improvement

Baseline Patient-Reported Care Metrics in a VA Hematology/Oncology Clinic Prior to Implementation of the 4R (Right Information and Right Care for the Right Patient at the Right Time) Oncology Model


 

Background

The Jesse Brown Veterans Affairs Medical Center (JBVAMC) serves predominantly Black American veterans, many with significant psychosocial needs, who live in Chicago’s South and West sides and Northwest Indiana. The JBVAMC hematology/oncology clinic is adopting the 4R Oncology Model (Right Info/ Care/Patient/Time) for patient-facing care planning and self-management, to enhance supportive and health maintenance care delivery. In order to guide the integration of the 4R model, baseline data were collected regarding patients’ understanding of their disease, social determinants of health, and use of services offered by JBVAMC.

Methods

Patients at JBVAMC were surveyed from February 2023 to September 2023. As a small incentive, these veterans received a $25 gift card for their participation. Analysis was conducted using descriptive statistics.

Results

Survey response rate was 67% (30/45). Median age was 66 (range 38-80). The population was 93% male, 83% black, 57% with highest level of education being high school or less, 59% with annual income less than $30k, and 47% living alone. Less than half (43%) of respondents knew their stage of cancer at diagnosis, and only 63% were aware of their treatment goals. Furthermore, only 17% remember receiving recommendations for support services that may be available through JBVAMC such as transportation assistance and home care. Information regarding “emotional distress or worry support recommendations” was acquired by 24% of veteran respondents. More than half, 57%, of veterans were encouraged to talk to their primary care provider about routine health maintenance during cancer treatment. Just over a quarter, 27%, were referred to a dietician.

Conclusions

This survey uncovered gaps in care planning, supportive services, and health maintenance care. These data will serve as a baseline to assess the effectiveness of the 4R care plan model. The implementation of the 4R Oncology Model is designed to address these gaps by providing a personalized care sequence that establishes a clear roadmap through the patient’s care trajectory, ultimately enhancing patient-centered care. Post-intervention survey results will be shared when available.

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