2012 CoC Standards: University of Kansas Hospital Cancer Committee Goals. Tim Metcalf, BS, CTR Cancer Registry Manager

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1 2012 CoC Standards: University of Kansas Hospital Cancer Committee Goals Tim Metcalf, BS, CTR Cancer Registry Manager 1

2 Standard 4:Outcomes 4.7 Quality Improvement: QI Coordinator develops, analyzes & documents required studies that measure quality of care & outcomes Under direction of Cancer Committee 2

3 QI Steps Set study topic which identifies problem Define criteria including QI measures to answer question(s) Prepare summary of findings Compare data with national benchmarks Design/initiate action plan based on findings Establish follow-up steps to monitor action Monitor effectiveness of action plans 3

4 QI Studies by category Category Academic Community Comp Comm Freestanding Hosp Assoc NCI Network Pediatric VA # & Type of Studies 2 patient care quality/outcome 2 patient care quality/outcome 2 patient care quality/outcome 2 patient care quality/outcome 2 patient care quality/outcome 3 patient care quality/outcome 3 patient care quality/outcome 2 patient care quality/outcome 1 patient care quality/outcome; 1 study defined by Vet Integrated Service Network 4

5 2012 CoC standards now specify S.M.A.R.T. Goals Specific Measurable Achievable Reasonable Timely 5

6 2012 Cancer Committee Goals I. Palliative Care Initiative II. Patient Hand Offs 6

7 Why we chose these goals: Meet SMART requirements by Commission on Cancer Patient focused We wanted to have goals that reflected our commitment to quality improvement for our patients 7

8 I. Palliative Care Initiative

9 Palliative Goals Provide symptom management services Decreases symptom burden on patient Improve patient, staff and provider satisfaction Educational resource for patients and families to help maintain element of control Improve quality of life for patients and families as they experience advancing cancer 9

10 Initial Design Integrate as part of the cancer team to provide comprehensive cancer care starting at the initial treatment phase and then through transitions to a purely palliative care approach for those patients with disease progression Provide services at 2 locations: Westwood Campus and North Campus (one half day session per week) When indicated will participate in initial consult with Med Onc / Rad Onc 10 10

11 Patients identified by: Developed list of diagnosis and circumstances where early intervention of Palliative Care is appropriate Patients identified as appropriate during BMT interdisciplinary conference/ and or attending BMT physician/bmt nurse discussion 11

12 Current Status Seven palliative care referrals January Eight referrals in February Six return/follow up visits 12

13 Potential Long Term Goals & Outcomes Impact timeline for earlier hospice referral Reduce terminal hospitalizations Reduce terminal chemotherapy administration Impact location of death Impact emotional distress issues on family and patient related to disease process, pain and terminal illness aspects 13

14 Future Plans Six month trial Evaluate expansion to all locations As growth dictates, expanded appointments during week Evaluate outcome scores and satisfaction indicators from staff, providers and patients for modification to current program 14

15 II. Patient Hand Offs 15

16 Initial Design Using patient hand offs as a goal was selected because of the importance in improving communication among caregivers at shift changes when staffing changes. This is one of the 2012 Hospital National Patient Safety Goals. 16

17 Potential Long Term Goals & Outcomes Implement a standardized approach to hand off communications between nurses, other employees and departments This hand off provides the opportunity to ask and respond to questions and to clarify information whenever responsibility for care is transferred to another provider of care The hand off should include pertinent information that is important for the receiving caregiver to know about the patient There are various methods being considered to help the caregiver provide consistent information when transferring the care of a patient to someone else 17

18 One example is the SBAR method of reporting that includes the following elements: S Situation: Describe the situation being reported B Background: Pertinent background information including diagnosis, medications, vital signs, lab results, code status, or other information A Assessment: Caregiver assessment of current situation R Recommendations: What are the recommendations or what should happen next 18

19 Examples of hand offs would include 1. Communication at change of shifts between caregivers or when leaving for lunch break 2. Communication when transferring a patient from a procedure area back to the patient s room 3. Communication when transferring a patient from another KU outpatient facility (such as the Cancer Center) to the hospital for care 19

20 Summary of 2012 Palliative and Hand Off Initiatives The University of Kansas Hospital Cancer Committee goals were developed with the SMART goals in mind. Quality of patient care was our primary focus in establishing these specific goals 20

21 Credits Dr. Karin Porter-Williamson, Associate Professor, for Palliative Medicine Information Sabrina Korentager, RN, BS, Clinical Projects Coordinator for Palliative Medicine Information Linda Vancil, RN, MSN, Assistant Director of Nursing, QI Coordinator, for Handoff Information 21