scholarly journals Digital Tumor Board Solutions Have Significant Impact on Case Preparation

2020 ◽  
pp. 757-768
Author(s):  
Richard D. Hammer ◽  
Donna Fowler ◽  
Lincoln R. Sheets ◽  
Athanasios Siadimas ◽  
Chaohui Guo ◽  
...  
Keyword(s):  
Care Center ◽  
Tumor Board ◽  
Preparation Time ◽  
Implementation Phase ◽  
Health Care Center ◽  
Multiple User ◽  
Tumor Boards ◽  
User Groups ◽  
The Impact ◽  
Nose And Throat

PURPOSE Multidisciplinary tumor boards (TBs) are the gold standard for decision-making in cancer care. Variability in preparation, conduction, and impact is widely reported. The benefit of digital technologies to support TBs is unknown. This study evaluated the impact of the NAVIFY Tumor Board solution (NTB) on TB preparation time across multiple user groups in 4 cancer categories: breast, GI, head and neck (ie, ear, nose, and throat, or ENT), and hematopathology. METHODS This prospective study evaluated TB preparation time in multiple phases pre- and post-NTB implementation at an academic health care center. TB preparation times were recorded for multiple weeks using a digital time tracker. RESULTS Preparation times for 59 breast, 61 GI, 36 ENT, and 71 hematopathology cancer TBs comparing a pre-NTB phase to 3 phases of NTB implementation were evaluated between February 2018 and July 2019. NTB resulted in significant reductions in overall preparation time (30%) across 3 TBs pre-NTB compared with the final post-NTB implementation phase. In the breast TB, NTB reduced overall preparation time by 28%, with a 76% decrease in standard deviation (SD). In the GI TB, a 23% reduction in average preparation time was observed for all users, with a 48% decrease in SD. In the ENT TB, a 33% reduction in average preparation time was observed for all users, with a 73% decrease in SD. The hematopathology TB, which was the cocreation partner and initial adopter of the solution, showed variable results. CONCLUSION This study showed a significant impact of a digital solution on time preparation for TBs across multiple users and different TBs, reflecting the generalizability of the NTB. Adoption of such a solution could improve the efficiency of TBs and have a direct economic impact on hospitals.

Utility of a multidisciplinary tumor board in the management of pancreatic diseases.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 319-319
Author(s):  
David G. Brauer ◽  
Matthew S. Strand ◽  
Dominic E. Sanford ◽  
Maria Majella Doyle ◽  
Faris Murad ◽  
...  
Keyword(s):  
Treatment Plan ◽  
Diagnostic Testing ◽  
Retrospective Chart Review ◽  
Multidisciplinary Care ◽  
Tumor Board ◽  
Cancer Center ◽  
Common Diagnosis ◽  
Tumor Boards ◽  
Cancer Network ◽  
The Impact

319 Background: Multidisciplinary Tumor Boards (MTBs) are a requirement for comprehensive cancer centers and are routinely used to coordinate multidisciplinary care in oncology. Despite their widespread use, the impact of MTBs is not well characterized. We studied the outcomes of all patients presented at our pancreas MTB, with the goal of evaluating our current practices and resource utilization. Methods: Data were prospectively collected for all patients presented at a weekly pancreas-specific MTB over the 12-month period at a single-institution NCI-designated cancer center. The conference is attended by surgical, medical, and radiation oncologists, interventional gastroenterologists, pathologists, and radiologists (diagnostic and interventional). Retrospective chart review was performed at the end of the 12-month period under an IRB-approved protocol. Results: A total of 470 patient presentations were made over a 12-month period. Average age at time of presentation was 61.5 years (range 17 – 89) with 51% males. 61.7% of cases were presented by surgical oncologists and 26% by medical oncologists. 174 cases were the result of new diagnoses or referrals. 78 patients were presented more than once (average of 2.3 times). Pancreatic adenocarcinoma was the most common diagnosis (37%), followed by uncharacterized pancreatic mass (16%), and pancreatic cyst (7%). The treatment plan proposed by the presenting clinician was known or could be evaluated prior to conference in 402 cases. Presentation of a case at MTB changed the plan of management 25% (n = 100) of the time, including MTB recommendation against a planned resection in 46 cases. When the initial plan changed as a result of MTB discussion, the most common new plan was to obtain further diagnostic testing such as biopsy and/or endoscopy (n = 24). Conclusions: MTBs are required and resource-intensive but offer the opportunity to discuss a wide array of pathologies and influence management decisions in a sizable proportion of cases. Additional investigations evaluating adherence rates to MTB decisions and to published guidelines (i.e. National Comprehensive Cancer Network) will further enhance the assessment and utility of MTBs.

Nursing Perception of the Impact of Medication Carts on Patient Safety and Ergonomics in a Teaching Health Care Center

2012 ◽  
Vol 26 (2) ◽  
pp. 131-137 ◽  
Author(s):  
Élise Rochais ◽  
Suzanne Atkinson ◽  
Jean-François Bussières
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Focus Group ◽  
Point Of Care ◽  
Care Center ◽  
Drug Distribution ◽  
University Hospital ◽  
Cross Sectional ◽  
Health Care Center ◽  
The Impact

Objectives: In our Quebec (Canada) University Hospital Center, 68 medication carts have been implemented as part of a nationally funded project on drug distribution technologies. There are limited data published about the impact of medication carts in point-of-care units. Our main objective was to assess nursing staff’s perception and satisfaction of medication carts on patient safety and ergonomics. Method: Quantitative and qualitative cross-sectional study. Data were gathered from a printed questionnaire administered to nurses and an organized focus group composed of nurses and pharmacists. Results: A total of 195 nurses completed the questionnaire. Eighty percent of the nurses agreed that medication carts made health care staff’s work easier and 64% agreed that it helped to reduce medication incidents/accidents. Only 27% and 43% agreed that carts’ location reduces the risk of patients’ interruptions and colleagues’ interruptions, respectively. A total of 17 suggestions were extracted from the focus group (n = 7 nurses; n = 3 pharmacist) and will be implemented in the next year. Conclusions: This descriptive study confirms the positive perception and satisfaction of nurses exposed to medication carts. However, interruptions are a major concern and source of dissatisfaction. The focus group has revealed many issues which will be improved.

scholarly journals Pengaruh pelatihan tenaga gizi puskesmas terhadap program keluarga sadar gizi di Kota Samarinda Provinsi Kalimantan Timur

2007 ◽  
Vol 4 (2) ◽  
pp. 78
Author(s):  
Sri Sedono Iswandi ◽  
Endy Paryanto Prawirohartono ◽  
Abidillah Mursyid
Keyword(s):  
Health Workers ◽  
Care Center ◽  
Sampling Technique ◽  
Cross Sectional ◽  
Health Care Center ◽  
Related Information ◽  
The Family ◽  
Cross Sectional Design ◽  
Nutrition Problem ◽  
The Impact

Background: Under nutrition remains a major malnutrition problem in Indonesia. In dealing with the problem, the Indonesian government has already implemented strategies including empowering health workers and families. It is very likely that the nutrition problem and the family awareness on nutrition are closely related. Families that practice balanced nutrition are able to recognize and cope with their nutrition problems are defined as nutritionally aware or better known as Kadarzi.Objective: To study the impact of nutrition training on family awareness on nutrition in Samarinda province of East Kalimantan.Method: This observational study was carried out using cross-sectional design. The study population was household with under five years old children in Samarinda. A hundred and thirty two households were drawn from the population with cluster random sampling technique. The data gathered in the study were Kadarzi indicators, achievement program on Kadarzi, and related information that was collected by inter-viewing Head of Primary Health Care Center (puskesmas) and Integrated Health Service Center (posyandu) cadres at the village level.Result: The training on nutrition had an effect to attainment of the family awareness (Kadarzi) in Samarinda (OR=6,9; 95 % CI =1,98 – 23,82). Other variable which playing a part in of the influence was mother education.Conclusion: Nutrition staff who were well trained had an effect to attainment of the family awareness.

scholarly journals NCOG-75. ESTIMATED PHYSICIAN COST OF A NEURO-ONCOLOGY MULTIDISCIPLINARY TEAM (MDT) TUMOR BOARD MEETING AT A SINGLE ACADEMIC CENTER

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii146-ii146
Author(s):  
Brett Schroeder ◽  
Jerome Graber ◽  
Emmanuel Cuevas
Keyword(s):  
Performance Metrics ◽  
Tumor Board ◽  
Multidisciplinary Teams ◽  
Radiation Oncologists ◽  
Annual Salary ◽  
Academic Center ◽  
Tumor Boards ◽  
The Mean ◽  
Patient Prognosis ◽  
The Impact

Abstract BACKGROUND Multidisciplinary teams (MDTs) to improve coordination across disciplines have become commonplace in oncology. Quantifying the impact of MDTs is challenging, and they carry significant costs. Weekly neuro-oncology tumor boards are attended by neuro-oncologists, neurosurgeons, radiation-oncologists, neuro-radiologists, neuro-pathologists, and support staff including mid-level practitioners, research coordinators, social workers, nurses and trainees. Our aim was to estimate costs associated with neuro-oncology MDTs. METHODS The estimated physician cost of MDT meetings were calculated from reported salaries of each physician specialty. Annual salaries from the Doximity 2019 Physician Compensation Report (PCR) included data for 4 neurosurgeons, 4 radiation-oncologists, 2 radiologists, 2 oncologists, and 2 neurologists. Medscape 2019 PCR data was compiled for 4 general surgeons, 2 radiologists, 2 oncologists, 2 pathologists, and 2 neurologists. The Physician Wages Across Specialties by Leigh in 2011 (JAMA) was utilized for 4 neurosurgeons, 4 radiation oncologists, 2 oncologists, and 2 neurologists. Annual salary data was divided by annual hours per specialty as reported by the Annual Work Hours Across Specialties, 2011. These values were then applied to an MDT for one patient, one hour, weekly, and annually. RESULTS The Doximity 2019 PCR yielded a per meeting cost of $2,520.84, and an annual cost of $131,083.68. The Medscape 2019 PCR produced a cost of $1,570.60 weekly, and $81,671.20 annually. JAMA data estimated a per meeting cost of $1,448.06, and $75.299.12. The mean per meeting and annual costs were $1846.50, and $96,018.00, respectively. With 6-10 cases per MDT, the mean costs per patient were $184.65 to $307.75. CONCLUSIONS Costs of MDT are not negligible. The impact of MDTs on patient outcomes are harder to quantify, but evidence exists that organized MDTs improve patient prognosis, and unorganized MDTs may negatively affect prognosis. Processes to streamline MDTs could help answer outcomes research questions, improve efficiency, and generate clinically relevant performance metrics.

Efficacy of Liraglutide: GLP 1 Receptor Agonist on Glycemic Control and Weight Loss among Patients with Type 2 Diabetes

2020 ◽  
Author(s):  
Fatima Jehangir
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Glycemic Control ◽  
Care Center ◽  
Standards Of Care ◽  
P Value ◽  
Diabetic Patients ◽  
Health Care Center ◽  
The Impact

Background: American Diabetes Association (ADA) made conspicuous changes in its 2019 Standards of Care Diabetes guidelines by choosing Glucagon like Polypeptide 1 (GLP1) receptor agonists and Sodium Glucose co-transporter 2 (SGLT2) inhibitors as the second line treatment options after metformin because both classes of drugs are cardiovascular friendly as proved in the Cardiovascular Outcome Trials (CVOT) trials. GLP analogs show massive weight loss benefits apart from offering good glycemic control. We aimed to determine the impact of liraglutide on correction of hyperglycemia and body weight in Asian population. Methods: A cross sectional pre-post observational study enrolling 49 Type 2 diabetic patients with uncontrolled blood glucose, 15 years and above who agreed to use liraglutide apart from standard care, for glycemic control were recruited in the study. Study site was general practice clinic in Clifton and family medicine health care center Ziauddin University. Pre and post treatment HbA1C and BMI were observed after adding on Liraglutide 1.8 mg to metformin 1 gm bid, over a period of 12 weeks. Differences in the changes in BMI and HbA1C were examined using McNemar’s test. Results: Mean age of the participants was 44.4 years. Duration of Diabetes was 65.1 months i.e. 5.4 years. At week 12, liraglutide 1.8 mg significantly reduced HbA1C levels by 0.94% (8.53+1.07 vs. 7.56+1.04 p-value <0.05) and BMI by 6.2kg (37.23+ 5.3 vs. 31.27.6+5.5 p-value <0.05) statistically significant. Conclusion: Liraglutide 1.8 mg over a period of 12 weeks, significantly reduced body weight (6.2kg p-value 0.05) and improved glycemic control (0.94% p-value<0.05) without causing hypoglycemia.

The impact of a digital solution on tumor board preparation time for nurse navigators.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18020-e18020
Author(s):  
Donna Fowler ◽  
Lincoln R Sheets ◽  
Matthew S Prime ◽  
Athanasios Siadimas ◽  
Yariv Z Levy ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Interdisciplinary Approach ◽  
Tumor Board ◽  
P Value ◽  
Preparation Time ◽  
Time Saving ◽  
University Of Missouri ◽  
Oncology Nurse ◽  
Before And After ◽  
The Impact

e18020 Background: A multidisciplinary tumor board (MTB) provides an interdisciplinary approach for decision-making in cancer care. Oncology nurse navigators (NN) have been introduced to facilitate patient access to services and resources, and to improve continuity and coordination of care. Little is known about how digital technologies support this role. Methods: A prospective IRB approved cohort study was undertaken to evaluate NN time preparation for MTBs before and after the implementation of the NAVIFY Tumor Board (NTB) solution at University of Missouri Health Care (MU). Data was collected using a digital time-tracking application. The NTB manual version was implemented via a phased roll-out (Hematology – Apr 9, 2018; Breast May 18, 2018; Gastrointestinal Jul 11, 2018). Subsequently, the integrated version was introduced (Oct 4, 2018). Results: Time preparation for 101 MTBs (828 cases) were evaluated throughout 2018 (35 Breast; 213 cases / 32 GI; 302 cases / 34 Hematology; 313 cases). Data showed NN meeting preparation time decreased for each MTB after the introduction of NTB; further time saving was achieved with NTB integrated version (Table 1). For the Breast MTB there was statistical significance between time preparation pre- & post-NTB (p-value = 0.011) but not between the manual and integrated versions (p-value = 0.118). For the Gastrointestinal MTB, there was no statistical significance between pre- & post-NTB (p-value = 0.214). For Hematology MTB there was statistical significance between the change from the NTB manual version vs. integration (p-value = 0.004). Note before NTB implementation Hematology MTB was not supported by NN. Conclusions: Introduction of the NTB reduced time spent by NNs preparing for 3 different MTBs, EMR integration delivered further time-savings. No discernable learning curve was observed suggesting user-training was sufficient and NTB was easy to learn. A reduction in variance (SD & IQR) for time preparation across all MTBs was seen. This suggests the NTB solution standardized the process for MTB preparation. Less time spent preparing for MTBs gives NNs more time to support patients.

Nursing Perception of the Impact of Automated Dispensing Cabinets on Patient Safety and Ergonomics in a Teaching Health Care Center

2013 ◽  
Vol 27 (2) ◽  
pp. 150-157 ◽  
Author(s):  
Élise Rochais ◽  
Suzanne Atkinson ◽  
Mélanie Guilbeault ◽  
Jean-François Bussières
Keyword(s):  
Health Care ◽  
Nursing Staff ◽  
Care Center ◽  
Medication Administration ◽  
Cross Sectional ◽  
Safe Delivery ◽  
Health Care Center ◽  
Safe Patient Care ◽  
Medication Incidents ◽  
The Impact

Purpose: To evaluate how nursing staff felt about the impact of automated dispensing cabinets (ADCs) on the safe delivery of health care and workplace ergonomics. To identify the main issues involved in the use of this technology and to describe the corrective measures implemented. Methods: Cross-sectional descriptive study with quantitative and qualitative components. A questionnaire that consisted of 33 statements about ADC was distributed from May 24 to June 3, 2011. Results: A total of 172 (46%) of 375 nurses completed the questionnaire. Nursing staff considered the introduction of ADC made their work easier (level of agreement of 90%), helped to safely provide patients with care (91%), and helped to reduce medication incidents/accidents (81%). Nursing staff was particularly satisfied by the narcotic drugs management with the ADCs. Nursing staff were not satisfied with the additional delays in the preparation and administration of a medication dose and the inability to prevent a medication from being administered when stopped on the medication administration record (48%). Conclusion: The nursing staff members were satisfied with the use of ADC and believed it made their work easier, promoted safe patient care, and were perceived to reduce medication incidents/accidents.

scholarly journals Scaling up safe motherhood program at Dang district: Impact of programmatic intervention

2014 ◽  
Vol 3 (2) ◽  
pp. 21-25
Author(s):  
Shrawan K Chaudhary
Keyword(s):  
District Hospital ◽  
Care Center ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Community Level ◽  
Safe Motherhood ◽  
Birth Preparedness ◽  
Health Care Center ◽  
Birth Attendance ◽  
The Impact

Introduction: Safe motherhood has been a national priority programme and this article highlights the impact of a good programmatic approach to improve safe motherhood services in a district of mid west region of Nepal. Method: Interventions included strengthening of program- Emergency Obstetric Care Services (EmOC) at district hospital and Primary Health Care Center level (basic and comprehensive), Skilled Birth Attendance (SBA) at Health Post level and Community Based Safe Motherhood interventions at community level. In addition, improved family/community practices for birth preparedness and referral of mothers through building the capacity of individuals and families to demand and utilize health services were also implemented. Results: Met need of Emergency Obstetric Care increased from 2% in 2000 to 27.58 % in 2005/06. Number of births increased in hospital from 1078 (2003/2004) to 1753 (2005/2006). Number of caesarean sections was 10 in 2003/04 whereas it has risen to 174 in 2005/06. Similar trends were noticed in other obstetric procedures such as instrumental deliveries and manual removal of placenta. There has also been a significant increase in utilization of EmOC services among the poorest castes- Dalits and Janjatis (from 6.3% in 2000/01 to 12.7% in 2003/04). Twenty four hours blood transfusion services are made available at district hospital. EmOC fund has saved the life of 676 women who utilized EmOC fund and watch group has referred total 559 women to health facilities. Conclusion: Data from Dang district suggests that if interventions are delivered simultaneously and effectively at community level and health facility level, there is definite impact on various indicators of safe motherhood program. However, frequent turnover of staff, vacant post, lack of provision of 24 hours SBA services, limited budget for construction, training and equipment supports, lack of transportation and communication in remote Village Development Committees are barriers of effective safe motherhood program. DOI: http://dx.doi.org/10.3126/njog.v3i2.10827   Nepal Journal of Obstetrics and Gynaecology Vol.3(2) 2008; 21-25

Use of the Internet to connect radiation oncologists and medical oncologists with disease site-specific experts: 3-year outcomes of chartrounds.com.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 241-241 ◽  
Author(s):  
Patricia H. Hardenbergh ◽  
Brigitta Gehl ◽  
Kimberly Anne Lyons-Mitchell
Keyword(s):  
Radiation Oncology ◽  
Cancer Care ◽  
Medical Oncology ◽  
Tumor Board ◽  
Site Specific ◽  
Radiation Oncologists ◽  
Medical Oncologists ◽  
Tumor Boards ◽  
Disease Site ◽  
The Impact

241 Background: The purpose of this project is to improve the quality of cancer care by connecting disease site-specific experts with community oncologists through web-based technology. Methods: Chartrounds.com is a conferencing web-site developed to allow community oncologists to present real cases to disease site specialists in oncology on a scheduled basis. Chartrounds was developed initially for radiation oncologists and subsequently has expanded to include multidisciplinary tumor boards and medical oncology specific sessions. Presently 43 disease site expert oncologists including surgeons, medical oncologists and radiation oncologists from 38 academic institutions in the US host sessions. Feedback reports following the completion of each session were designed to assess the impact of the project. Results: Since its inception in December 2010, 43 disease site-specialists have lead 366 sessions, connecting 3,793 participating oncologists from all 50 US states and 24 countries.Broken down by specialty, 348 radiation oncology sessions have linked 3,632 participants, 14 medical oncology specific and multidisciplinary tumor board sessions have included 161 participants. On a 5 point Likert scale with 5 representing the greatest possible impact, the mean response to feedback questions is as follows: session quality: 4.7 for radiation oncology, 4.6 for multidisciplinary; time used effectively: 4.6 for radiation oncology, 4.5 for multidisciplinary; discussions relevant to daily practice: 4.6 for radiation oncology, 4.6 for multidisciplinary; session is likely to result in a change of practice: 4.0 for radiation oncology, 4.0 for multidisciplinary. Chartrounds sessions qualify for 1 CME credit and is approved for a practice quality improvement project by the American Board of Radiology. Conclusions: Chartrounds.com is impacting oncology practices which results in changes in community practice. Future directions of this project include providing chartrounds sessions for oncology nurses and providing a library of video recorded archived sessions. This work has been funded by the Improving Cancer Care Grant of the ASCO Conquer Cancer Foundation.

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