Effective Communication for Newly Diagnosed Pediatric Patients With Cancer: Considerations for the Patients, Family Members, Providers, and Multidisciplinary Team

2019 ◽  
pp. 573-581 ◽  
Author(s):  
Sarah Dobrozsi ◽  
Amy Trowbridge ◽  
Jennifer W. Mack ◽  
Abby R. Rosenberg
Keyword(s):  
Communication Skills ◽  
Pediatric Cancer ◽  
Multidisciplinary Team ◽  
Cancer Care ◽  
Care Delivery ◽  
Effective Communication ◽  
Well Being ◽  
Medical Team ◽  
High Quality ◽  
Personalized Care

Hearing that a child has been diagnosed with cancer is invariably difficult for both patients and their caregivers. Effective communication among patients, caregivers, and medical teams is necessary not only to deliver information and facilitate cancer care delivery but also to support patient and family coping and well-being. In this review, we focus on early communication in pediatric oncology care to (1) highlight the importance of communication between clinicians and patients and within the medical team and (2) describe resources and opportunities for clinicians to improve communication skills. For example, communication between patients and the medical team has several core functions, including the development of shared knowledge and decision-making and the formation of a therapeutic relationship. High-quality communication, regardless of the news being shared, supports and facilitates patient and parent adjustment to diagnosis, hope, and trust. Communication within the medical team supports the delivery of high-quality, personalized care. Despite these critical roles of communication in pediatric cancer care and evidence suggesting communication skills can be learned, formal training is limited. Resources include educational efforts, practical tools, and specific strategies to enhance systematic multidisciplinary team communication. Taken together, continued recognition of the importance of communication in pediatric cancer care has the potential to improve patient, family, and clinician experiences.

scholarly journals American Society of Clinical Oncology Road to Recovery Report: Learning From the COVID-19 Experience to Improve Clinical Research and Cancer Care

2021 ◽  
Vol 39 (2) ◽  
pp. 155-169
Author(s):  
Nathan A. Pennell ◽  
Melissa Dillmon ◽  
Laura A. Levit ◽  
E. Allyn Moushey ◽  
Ajjai S. Alva ◽  
...  
Keyword(s):  
Clinical Research ◽  
Cancer Care ◽  
Care Delivery ◽  
Well Being ◽  
Lessons Learned ◽  
Scientific Integrity ◽  
High Quality ◽  
Quality Cancer Care ◽  
American Society ◽  
Made In

This report presents the American Society of Clinical Oncology’s (ASCO’s) evaluation of the adaptations in care delivery, research operations, and regulatory oversight made in response to the coronavirus pandemic and presents recommendations for moving forward as the pandemic recedes. ASCO organized its recommendations for clinical research around five goals to ensure lessons learned from the COVID-19 experience are used to craft a more equitable, accessible, and efficient clinical research system that protects patient safety, ensures scientific integrity, and maintains data quality. The specific goals are: (1) ensure that clinical research is accessible, affordable, and equitable; (2) design more pragmatic and efficient clinical trials; (3) minimize administrative and regulatory burdens on research sites; (4) recruit, retain, and support a well-trained clinical research workforce; and (5) promote appropriate oversight and review of clinical trial conduct and results. Similarly, ASCO also organized its recommendations regarding cancer care delivery around five goals: (1) promote and protect equitable access to high-quality cancer care; (2) support safe delivery of high-quality cancer care; (3) advance policies to ensure oncology providers have sufficient resources to provide high-quality patient care; (4) recognize and address threats to clinician, provider, and patient well-being; and (5) improve patient access to high-quality cancer care via telemedicine. ASCO will work at all levels to advance the recommendations made in this report.

scholarly journals Playful strategies to foster the well-being of pediatric cancer patients in the Brazilian Unified Health System: a design thinking approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leandro Miletto Tonetto ◽  
Valentina Marques da Rosa ◽  
Priscila Brust-Renck ◽  
Megan Denham ◽  
Pedro Marques da Rosa ◽  
...  
Keyword(s):  
Health System ◽  
Cancer Patients ◽  
Pediatric Cancer ◽  
Cancer Care ◽  
Design Thinking ◽  
Care Delivery ◽  
Well Being ◽  
Subjective Well Being ◽  
Unified Health System ◽  
Pediatric Cancer Patients

Abstract Background Cancer care can negatively impact children’s subjective well-being. In this research, well-being refers to patients’ self-perception and encompasses their hospital and care delivery assessment. Playful strategies can stimulate treatment compliance and have been used to provide psychosocial support and health education; they can involve gamification, virtual reality, robotics, and healthcare environments. This study aims to identify how playfulness, whenever applicable, can be used as a strategy to improve the subjective well-being of pediatric cancer patients in the Brazilian Unified Health System. Methods Sixteen volunteers with experience in pediatric oncology participated in the study. They were physicians, psychologists, child life specialists, and design thinking professionals. They engaged in design thinking workshops to propose playful strategies to improve the well-being of pediatric cancer patients in the Brazilian Unified Health System. Data collection consisted of participatory observations. All activities were video recorded and analyzed through Thematic Analysis. The content generated by the volunteers was classified into two categories: impact of cancer care on children’s self-perception and children’s perceptions of the hospital and the care delivery. Results Volunteers developed strategies to help children deal with time at the hospital, hospital structure, and care delivery. Such strategies are not limited to using playfulness as a way of “having fun”; they privilege ludic interfaces, such as toys, to support psychosocial care and health education. They aim to address cancer and develop communication across families and staff in a humanized manner, educate families about the disease, and design children-friendly environments. Volunteers also generated strategies to help children cope with perceptions of death, pain, and their bodies. Such strategies aim to support understanding the meaning of life and death, comprehend pain beyond physicality, help re-signify cancer and children’s changing bodies, and give patients active voices during the treatment. Conclusions The paper proposes strategies that can improve the well-being of pediatric cancer patients in the Brazilian Unified Health System. Such strategies connect children’s experiences as inpatients and outpatients and may inform the implementation of similar projects in other developing countries.

scholarly journals Evolution of Cancer Care Delivery Research in the NCI Community Oncology Research Program

2019 ◽  
Vol 112 (6) ◽  
pp. 557-561 ◽  
Author(s):  
Ann M Geiger ◽  
Ann M O’Mara ◽  
Worta J McCaskill-Stevens ◽  
Brenda Adjei ◽  
Priyanga Tuovenin ◽  
...  
Keyword(s):  
Research Program ◽  
National Cancer Institute ◽  
Cancer Care ◽  
Care Delivery ◽  
Well Being ◽  
Practice Change ◽  
Evidence Based ◽  
Oncology Research ◽  
Community Oncology ◽  
Robust Portfolio

Abstract Research seeking to improve patient engagement with decision-making, use of evidence-based guidelines, and coordination of multi-specialty care has made important contributions to the decades-long effort to improve cancer care. The National Cancer Institute expanded support for these efforts by including cancer care delivery research in the 2014 formation of the National Cancer Institute Community Oncology Research Program (NCORP). Cancer care delivery research is a multi-disciplinary effort to generate evidence-based practice change that improves clinical outcomes and patient well-being. NCORP scientists and community-based clinicians and organizations rapidly embraced the addition of this type of research into the network, resulting in a robust portfolio of observational studies and intervention studies within the first 5 years of funding. This commentary describes the initial considerations in conducting this type of research in a network previously focused on cancer prevention, control, and treatment studies; characterizes the protocols developed to date; and outlines future directions for cancer care delivery research in the second round of NCORP funding.

Areas for quality improvement in pediatric supportive oncology services.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e22022-e22022
Author(s):  
Jennifer Reichek ◽  
Christine B. Weldon ◽  
Rani Ganesan ◽  
Eugene Suh ◽  
Dipti Dighe ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Pediatric Cancer ◽  
Cancer Care ◽  
Care Delivery ◽  
Institute Of Medicine ◽  
Supportive Services ◽  
Care Community ◽  
Pediatric Cancer Patients ◽  
Survey Results ◽  
Supportive Oncology

e22022 Background: In 2013, the Institute of Medicine report recommended that supportive oncology services be initiated at time of diagnosis. Providers of pediatric cancer care in the Chicagoland community, supported by The Coleman Foundation, sought to define areas for quality improvement of supportive oncology delivery to children. Methods: Focus groups and surveys with clinicians providing pediatric cancer care and supportive services at 14 sites were used to prioritize areas needing improvement. Results: 100% (14/14) of sites participated. Of the eligible sites, 6 were pediatric cancer treatment sites and 8 cancer care community organizations. Sites demonstrated consistent agreement for 8 of the 12 areas of focus for improvement. Over 50% of sites reported areas of focus (table) as important or very important. Conclusions: Sites identified the need for quality improvement in delivery of psychosocial, survivorship and palliative care for pediatric cancer patients. Survey results demonstrate a need for collaboration and efforts to guide care delivery improvement across sites. [Table: see text]

Cancer survivorship care in rural community: Provider perspective.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 50-50
Author(s):  
Katia Noyes ◽  
David Holub ◽  
Irfan Rizvi ◽  
Alex Swanger ◽  
Coty Reisdorf ◽  
...  
Keyword(s):  
Primary Care ◽  
Focus Group ◽  
Focus Groups ◽  
Multidisciplinary Team ◽  
Cancer Care ◽  
Financial Incentives ◽  
Primary Care Physicians ◽  
Performance Metrics ◽  
Care Delivery ◽  
Successful Implementation

50 Background: Advances in oncologic sciences have resulted in successful treatments for many cancers with improved survival for millions of patients. Efficient delivery of cancer care now requires not only skills and professionalism of each provider but also well-orchestrated performances of multiple oncology, primary care and social services providers acting as one multidisciplinary team. It is unknown, however, whether providers are prepared for and accept their new roles in patient cancer care teams across region. This study assessed perspectives of providers involved in care for patients with cancer about their changing roles. Methods: We conducted a focus group with a diverse group of stakeholders involved in cancer care (2 primary care physicians, 1 rural surgeon, 2 rural oncologists, 2 oncology nurses, 2 cancer patients and a caregiver). The focus group was conducted using ThinkTank software, a collaborative tool that allows participants to communicate virtually in real time, screen share, express preferences and confidentially rank each other responses. We also conducted two traditional focus groups with rural care managers, nurses, social workers and public health providers. Results: The focus groups identified significant differences in attitudes and beliefs toward regional team-based cancer care between various providers. PCPs ranked oncology issues as less important to their practices compared to other chronic conditions associated with performance metrics and financial incentives. APPs ranked care coordination issues as more important compared to PCP rankings from the same practices. Rural providers identified limited staffing, outdated health IT systems, and lack of expertise as major barriers to multidisciplinary team care. Both patients and providers highlighted importance of trust and face-to-face communication in treatment adherence and choice of care setting. Conclusions: Current health information systems, performance metrics and payment models represent significant barriers to integrated care delivery in oncology and survivorship. Successful implementation of efficient and sustainable regional oncology program will require a multi-dimensional intervention to address each of these barriers.

Pediatric cancer care in Armenia: The results of a qualitative analysis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19002-e19002
Author(s):  
Saten Hovhannisyan ◽  
Ruzanna Papyan ◽  
Lilit Sargsyan ◽  
Samvel Danielyan ◽  
Lala Vagharshakyan ◽  
...  
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
Pediatric Oncology ◽  
Pediatric Cancer ◽  
Multidisciplinary Team ◽  
Cancer Care ◽  
Care Center ◽  
High Dose ◽  
Pediatric Oncologist ◽  
The Government

e19002 Background: In Armenia the incidence of pediatric cancer accounts for around 80-100 cases per year. This qualitative study was conducted in 2018 to evaluate the needs and challenges in a provision of pediatric cancer care in Armenia. Comparative qualitative study was conducted in 2020 to evaluate the progress in the field. Methods: Qualitative research methods were incorporated to evaluate the achievements, needs and challenges in a provision of childhood cancer care in Armenia. Semi-structured in-depth interviews were conducted with selected study participants including pediatric oncologist/hematologists, pediatric surgeons, who also treat cancer patients, and radiation oncologists. Purposive sampling technique and qualitative conventional content analysis methods were used. Results: Data collected in January 2020 has shown significant improvements in the field of pediatric oncology in Armenia. In the 2018 study, some of the major issues included lack of centralized pediatric cancer care, pediatric cancer registry, palliative care center, possibility of providing high-dose methotrexate, limited nursing training, multidisciplinary team approaches and use of central catheters. Within two years, majority of these problems were solved or are in the process. In 2019 all 3 pediatric oncology and hematology units were merged and the Pediatric Cancer and Blood Disorders of Armenia was created; with the support from charitable foundations all children with cancer receive free medical and psychosocial coverage; a 25 year data has been collected from all the possible sites, the first pediatric cancer palliative care is under construction, 4 multidisciplinary cancer teams were created, pediatric oncology and hematology fellowship was created at the Yerevan State Medical University to prepare for the first time "pediatric oncologist-hematologist" as a one profession. The existing major problems include very limited provision of pediatric cancer medications by the government, as well as lack of the official registration of the number of essential drugs included in the WHO list. Conclusions: Twinning programs, multidisciplinary team discussions with international experts, improvement in availability of several resources, professional development of the staff are major tools for the progress of pediatric oncology in Armenia. Poor provision and official registration of anti-neoplastic medications by the government still remain a major obstacle.

Successful Strategies to Address Disparities: Insurer and Employer Perspectives

2020 ◽  
pp. 292-300
Author(s):  
Manali I. Patel ◽  
Richard Snyder ◽  
Otis Brawley
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Low Income ◽  
Cancer Care ◽  
Care Delivery ◽  
The United States ◽  
Cancer Disparities ◽  
Care Providers ◽  
High Quality ◽  
Quality Cancer Care

Disparities in cancer have been documented for decades and continue to persist despite clinical advancements in cancer prevention, detection, and treatment. Disparate cancer outcomes continue to affect many populations in the United States and globally, including racial and ethnic minorities, populations with low income and education, and residents of rural areas or low socioeconomic neighborhoods, among others. Addressing cancer disparities requires approaches that are multilevel. Addressing social determinants of health, such as removing obstacles to health (e.g., poverty, discrimination, access to housing and education, jobs with fair pay, and health care) can reduce cancer disparities. However, to achieve cancer health equity, multilevel approaches are required to ensure that access to high-quality cancer care and equitable receipt of evidence-based services can reduce cancer disparities. Policy, health system interventions, and innovative delivery and health care coverage approaches by private and public payers, employer-based payers, and labor union organizations can assist in ensuring access to and receipt of high-quality cancer care while addressing the high costs of care delivery. Partnerships among patients, caregivers, employers, health care providers, and health care payers can make impactful changes in the way in which cancer care is delivered and, in turn, can assist in reducing cancer disparities.

Transforming Cancer Care: Are Transdisciplinary Approaches Using Design-Thinking, Engineering, and Business Methodologies Needed to Improve Value in Cancer Care Delivery?

2014 ◽  
Vol 10 (2) ◽  
pp. e51-e54 ◽  
Author(s):  
Manali I. Patel ◽  
David Moore ◽  
Douglas W. Blayney ◽  
Arnold Milstein
Keyword(s):  
Cancer Care ◽  
Design Thinking ◽  
Care Delivery ◽  
High Quality ◽  
Quality Cancer Care

Although design-thinking and engineering methodologies have not been used in cancer care delivery transformation, there are opportunities for these methodologies to improve interventions aimed at delivering high-quality cancer care.

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