Undermining Patient Values: The ASCO Value in Cancer Care Task Force Framework

2015 ◽  
Vol 21 (4) ◽  
Author(s):  
Peter J. Pitts ◽  
Robert Goldberg
Keyword(s):  
Cancer Care ◽  
Recent Article ◽  
Medical Oncology ◽  
Task Force ◽  
Patient Centered ◽  
Cost Of Treatment ◽  
A Value ◽  
Centered Care ◽  
Patient Values ◽  
Basic Facts

As stated in a recent article in the Journal of Clinical Oncology, ASCO established a Value in Cancer Care Task Force, with the goal of “developing a framework for comparing the relative clinical benefit, toxicity, and cost of treatment in the medical oncology setting. “  In developing this framework or tool, the Task Force runs roughshod over basic facts to create a metric that – while established to promote patient centered care – strives mightily to achieve the exact opposite outcome.

Athletic Trainers’ Viewpoints of Patient-Centered Care

2021 ◽  
Author(s):  
Carly J. Wilson ◽  
Lindsey E. Eberman ◽  
Ansley S. Redinger ◽  
Elizabeth R. Neil ◽  
Zachary K. Winkelmann
Keyword(s):  
Athletic Training ◽  
Task Force ◽  
Athletic Trainers ◽  
Core Competency ◽  
Principal Component ◽  
Patient Centered Care ◽  
International Classification Of Functioning ◽  
Patient Centered ◽  
Centered Care ◽  
Icf Model

Abstract Background The core competency of patient-centered care (PCC) states that for positive patient outcomes, the provider must respect the patient’s views and recognize their experiences. The Athletic Training Strategic Alliance Research Agenda Task Force identified a profession-wide belief that examining the extent to which athletic trainers (ATs) provide PCC in their clinical practice would benefit the profession. To first address this line of inquiry, we must study the subjectivity of how ATs view PCC. Methods We used Q methodology to allow participants to share their viewpoints while simultaneously exploring the study aim from a quantitative and qualitative perspective. A total of 115 (males = 62, females = 53, age = 37 ± 10 y, experience = 13 ± 10 y) ATs dispersed between 11 job settings volunteered for this study. Participants were asked to pre-sort (agree, disagree, neutral) 36 validated statements representing the 8 dimensions of PCC. The participants completed a Q-sort where they dragged-and-dropped the pre-sorted statements based on perceived importance in providing PCC. The Q-sorts were analyzed using QMethod software. A principal component analysis was used to identify statement rankings and factors. Factors were determined by an Eigenvalue > 1 and analyzed using a scree plot. The 6 highest selected statements per factor were assessed to create the distinguishing viewpoints. Results Two distinguishing viewpoints emerged from the Q-sorts. The statement “ATs treat patients with dignity and respect” appeared as a high ranked statement in both distinguishing viewpoints. The lowest ranked statement from viewpoint 1 was “ATs integrate the International Classification of Functioning, Disability, and Health (ICF) model as a framework for delivery of patient care.” The lowest ranked statement from viewpoint 2 was “Appointment scheduling is easy.” Conclusions ATs value patient’s preferences. However, a lack of importance was identified for incorporating the ICF model, which is a core competency and adopted framework by the NATA since 2015.

scholarly journals Design and feasibility of integrating personalized PRO dashboards into prostate cancer care

2015 ◽  
Vol 23 (1) ◽  
pp. 38-47 ◽  
Author(s):  
Andrea L Hartzler ◽  
Jason P Izard ◽  
Bruce L Dalkin ◽  
Sean P Mikles ◽  
John L Gore
Keyword(s):  
Prostate Cancer ◽  
Focus Groups ◽  
Cancer Care ◽  
Line Graphs ◽  
Patient Centered ◽  
Human Centered Design ◽  
Patient Reported ◽  
Related Quality ◽  
Centered Care ◽  
Health Related

Abstract Objective Patient-reported outcomes (PROs) are a valued source of health information, but prior work focuses largely on data capture without guidance on visual displays that promote effective PRO use in patient-centered care. We engaged patients, providers, and design experts in human-centered design of “PRO dashboards” that illustrate trends in health-related quality of life (HRQOL) reported by patients following prostate cancer treatment. Materials and Methods We designed and assessed the feasibility of integrating dashboards into care in 3 steps: (1) capture PRO needs of patients and providers through focus groups and interviews; (2) iteratively build and refine a prototype dashboard; and (3) pilot test dashboards with patients and their provider during follow-up care. Results Focus groups ( n = 60 patients) prioritized needs for dashboards that compared longitudinal trends in patients’ HRQOL with “men like me.” Of the candidate dashboard designs, 50 patients and 50 providers rated pictographs less helpful than bar charts, line graphs, or tables ( P < .001) and preferred bar charts and line graphs most. Given these needs and the design recommendations from our Patient Advisory Board ( n = 7) and design experts ( n = 7), we built and refined a prototype that charts patients’ HRQOL compared with age- and treatment-matched patients in personalized dashboards. Pilot testing dashboard use ( n = 12 patients) improved compliance with quality indicators for prostate cancer care ( P < .01). Conclusion PRO dashboards are a promising approach for integrating patient-generated data into prostate cancer care. Informed by human-centered design principles, this work establishes guidance on dashboard content, tailoring, and clinical use that patients and providers find meaningful.

Assessing patient values first: Creating a platform for advance care planning (ACP) in the adult oncology population.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 99-99
Author(s):  
Sabrina Q. Mikan ◽  
Cynthia Taniguchi ◽  
J. Russell Hoverman ◽  
Susan Ash-Lee ◽  
Deb Harrison ◽  
...  
Keyword(s):  
Metastatic Cancer ◽  
Healthcare Providers ◽  
Cancer Center ◽  
Extensive Literature ◽  
Major Step ◽  
Patient Centered ◽  
Cross Sectional ◽  
Centered Care ◽  
Patient Values ◽  
Eol Care

99 Background: Patients, families and healthcare providers can be apprehensive about having end-of-life (EOL) conversations. However, asking patients about personal values regarding their healthcare goals may create a platform for more in depth conversations. A quantitative instrument to assess patient values and ACP readiness was developed and validated to complement a process for identifying patients appropriate for ACP. Methods: Recruitment was conducted at seven cancer center sites in The US Oncology Network over a 90-day pilot study period. Of 871 identified patients, 301 Texas Oncology patients engaged in ACP. A cross-sectional descriptive design was used in 301 metastatic cancer patients. Sixty-three participants completed the questionnaire. The 13-item instrument was created after an extensive literature review regarding EOL choices and interventions using a 5-point Likert scale. Descriptive statistics were examined, in addition to analysis of the relationships between items using Pearson’s r correlations. Results: Participants were primarily female (59%) and Caucasian (95%); with a mean age of 66 years. Sixty-eight percent reported it "Very Important" to be told they were dying. There was a significant association between willingness to discuss feelings about dying and being told by their physician when dying, (r= 0.373, p<0.01). Sixty-two percent reported it "Very Important" to be able to choose their EOL care location. EOL care location and level of burden for caregivers were significantly associated (r= 0.315, p<0.05). Also, 76% reported being able to select the person who makes EOL decisions for them as "Very Important." Conclusions: Recent studies have shown the importance of assessment of patient healthcare values in the metastatic oncology population. The values and readiness instrument allows healthcare providers to understand the patient’s wishes early in the course of care. ACP can be guided through review of the validated instrument in the adult metastatic population. This provides appropriate weight to both sides of the care equation and is a major step toward creating patient-centered care. Further development of the instrument is needed in this population.

Principles of Cancer Diagnosis

2019 ◽  
Author(s):  
Samantha J. Baker ◽  
J. Bart Rose
Keyword(s):  
Cancer Care ◽  
Quality Care ◽  
High Volume ◽  
Cancer Staging ◽  
Needle Aspiration ◽  
Patient Centered ◽  
Surgical Biopsy ◽  
Cancer Pathology ◽  
Centered Care ◽  
Knowledge Of Cancer

As knowledge of cancer pathology deepens, so does the complexity of cancer care. Recommendations from the National Cancer Policy Board Cancer Care System focus on using high-volume centers for patients undergoing high-mortality procedures and clinical trials to develop evidence-based guidelines for cancer prevention, diagnosis, treatment, palliative care, and quality care. Through the implementation of many of these principles, patient-centered care has become increasingly recognized as fundamental model for healthcare. This review contains 2 figures, 1 table, and 25 references. Key Words: Cancer, Cancer staging, Core needle biopsy, Fine needle aspiration, Liquid biopsy, Lymph nodes, Sentinel lymph node(s), Surgical biopsy

Principles of Cancer Diagnosis

2019 ◽  
Author(s):  
Samantha J. Baker ◽  
J. Bart Rose
Keyword(s):  
Cancer Care ◽  
Quality Care ◽  
High Volume ◽  
Cancer Staging ◽  
Needle Aspiration ◽  
Patient Centered ◽  
Surgical Biopsy ◽  
Cancer Pathology ◽  
Centered Care ◽  
Knowledge Of Cancer

As knowledge of cancer pathology deepens, so does the complexity of cancer care. Recommendations from the National Cancer Policy Board Cancer Care System focus on using high-volume centers for patients undergoing high-mortality procedures and clinical trials to develop evidence-based guidelines for cancer prevention, diagnosis, treatment, palliative care, and quality care. Through the implementation of many of these principles, patient-centered care has become increasingly recognized as fundamental model for healthcare. This review contains 2 figures, 1 table, and 25 references. Key Words: Cancer, Cancer staging, Core needle biopsy, Fine needle aspiration, Liquid biopsy, Lymph nodes, Sentinel lymph node(s), Surgical biopsy

scholarly journals Multimorbidity: An Issue of Growing Importance for Oncologists

2011 ◽  
Vol 7 (6) ◽  
pp. 371-374 ◽  
Author(s):  
Christine S. Ritchie ◽  
Elizabeth Kvale ◽  
Michael J. Fisch
Keyword(s):  
Cancer Care ◽  
Patient Centered Care ◽  
Care Plan ◽  
Patient Centered ◽  
Centered Care ◽  
The Impact

Recognition of the impact of multiple co-occurring conditions on a patient's cancer care plan and development of strategies to address the challenges associated with multimorbidity will enable oncologists to provide higher quality, patient-centered care.

scholarly journals Insight into Patients’ Experiences of Cancer Care in Taiwan: An Instrument Translation and Cross-Cultural Adaptation Study

2018 ◽  
Vol 15 (8) ◽  
pp. 1772 ◽  
Author(s):  
Tsung-Hsien Yu ◽  
Kuo-Piao Chung ◽  
Yu-Chi Tung ◽  
Hsin-Yun Tsai
Keyword(s):  
Cancer Patient ◽  
Patient Experience ◽  
Cultural Adaptation ◽  
Cancer Care ◽  
Expert Panel ◽  
Cross Cultural ◽  
Patient Centered ◽  
Cross Cultural Adaptation ◽  
Centered Care ◽  
Experience Survey

Background: Since Taiwan launched the Cancer Prevention Act in 2003, several prevention strategies and early detection programs have been implemented to reduce the incidence, morbidity and mortality rates of cancer. However, most of the programs have concentrated on healthcare providers. Evaluations from the patient’s perspective have been lacking. Thus, in this study a cancer patient experience questionnaire was developed in the Taiwanese context and a preliminary nationwide investigation was conducted on the status of cancer care from the patient’s perspective. Methods: An extensive literature review was first conducted to collect information on the existing instruments used to measure the cancer patient’s experience. Thereafter, a multidisciplinary expert panel was convened to select an optimal instrument based on the IOM’s six domains for evaluating patient-centered care. The European Organisation for Research and Treatment of Cancer (EORTC) translation procedure was applied to the questionnaire for cross-cultural adaptation. A nationwide field test was then implemented at certificated cancer care hospitals. Results: Fifteen questionnaires were collected for the literature review. The expert panel selected the National Cancer Patient Experience Survey based on the IOM’s recommendations. After cross-cultural translation of the questionnaire, a total of 4000 questionnaires were administered in 19 certificated cancer care hospitals and two major cancer patient associations, with 1010 being returned (25.25% response rate). Most of the respondents were middle-aged, and 70% were female. The respondents reported they had a good experience with cancer care, except for “Home care and support” and “Finding out what was wrong with you”. Stratified analysis was conducted, with the results showing that the cancer patients’ experiences varied depending on their sociodemographic and cancer-related characteristics. Conclusions: A Taiwanese version of the cancer patient experience survey questionnaire was developed. Its results showed that the cancer patient’s experiences varied, depending on the patient’s age, cancer type, and cancer history. This study can be used as a basis to establish a patient-centered care model for cancer care in Taiwan.

Principles of Cancer Diagnosis

2019 ◽  
Author(s):  
Samantha J. Baker ◽  
J. Bart Rose
Keyword(s):  
Cancer Care ◽  
Quality Care ◽  
High Volume ◽  
Cancer Staging ◽  
Needle Aspiration ◽  
Patient Centered ◽  
Surgical Biopsy ◽  
Cancer Pathology ◽  
Centered Care ◽  
Knowledge Of Cancer

As knowledge of cancer pathology deepens, so does the complexity of cancer care. Recommendations from the National Cancer Policy Board Cancer Care System focus on using high-volume centers for patients undergoing high-mortality procedures and clinical trials to develop evidence-based guidelines for cancer prevention, diagnosis, treatment, palliative care, and quality care. Through the implementation of many of these principles, patient-centered care has become increasingly recognized as fundamental model for healthcare. This review contains 2 figures, 1 table, and 25 references. Key Words: Cancer, Cancer staging, Core needle biopsy, Fine needle aspiration, Liquid biopsy, Lymph nodes, Sentinel lymph node(s), Surgical biopsy

Strategies to embed palliative care into a culture of cancer care.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21678-e21678
Author(s):  
Angela Marie Taber ◽  
Susan F. Korber ◽  
Edward Martin ◽  
Anthony E. Mega
Keyword(s):  
Palliative Care ◽  
Health System ◽  
Cancer Patients ◽  
Cancer Care ◽  
Medical Oncology ◽  
National Study ◽  
Claims Analysis ◽  
Patient Centered ◽  
Medicare Claims ◽  
Multi Level

e21678 Background: In 2012, the 3 hospital Lifespan Health System launched a palliative care initiative. The hospitals and medical oncologists knew this was critical for patient centered and value-based cancer care, but recognized many barriers: physician practice patterns, lack of dedicated resources and systems, patient and family education gaps, and limited return on investment in the current environment. A multi-level inpatient and outpatient strategy was implemented and tracked over four years. Methods: External benchmarking data from a Medicare claims analysis of Vizient (academic health system consortium) member organizations and from ASCO QOPI data were used in the analysis. Internal data analysis included a study on symptom management for lung cancer patients, hospital reports on palliative care service utilization, ED visits and hospital admission trends for cancer patients. Multi-level interventions were employed: hospital investment in staff and systems, partnership with a community-based hospice and palliative care provider, a medical oncology physician champion with Board certification in palliative care, a palliative care inpatient consult service and daily ICU rounds, an oncology medical home, medical oncologist Saturday hours, electronic prompts for consults, and a cancer call triage center. Results: A Medicare claims analysis for 2012 to 2014 on cancer decedents with ICU stays in the last 30 days in the Vizient national study of health systems showed that Lifespan was at the 11th percentile, making them the 4th lowest (days in ICU) in performance (pre/post data requested). QOPI data on appropriate referrals to hospice or palliative care prior to death improved from 58% in 2010, which was below the QOPI benchmark of 61%, to 94% in 2016 which is above the QOPI benchmark of 74%. Other QOPI and hospital data will be included in the presentation. Conclusions: Palliative care, a crucial tool for the delivery of future cancer care, is challenging to implement effectively. This study shows that a hospital/medical oncology partnership can drive change to embed palliative care into the culture of cancer care and these strategies offer a roadmap for others to follow as they strive to offer patient centered and value-based cancer care.

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