Accepted Abstracts
*** Indicates accepted for podium presentation
Congratulations to our Podium Presenters!
Title: Adaptation of Survivorship Care Plans in the Age of EMR's
First Author: Anna Schaal, ARNP
DHMC - Norris Cotton Cancer Center
1 medical Center Drive
Lebanon, New Hampshire 03756
anna.d.schaal@hitchcock.org
Co-Authors: Elizabeth McGrath, DNP, D-H, Claire Pace, APRN, D-H, Jennifer Snide, D-H
Background: Cancer survivors and their Primary Norris Cotton Cancer Center (NCCC) has been providing such documents in select clinics, on only a small percentage of patients for the last 8 years, with little consistency among disease management groups (DMG). In 2014 a cancer survivorship subcommittee was formed to explore methods to expand the SCP program and develop continuity within the DMG. Care Providers (PCP’s) are faced with unique challenges following the completion of cancer therapy including complying with recommendations specific for cancer survivors and coordinating this care across multiple health care providers. It has been recommended by the Institute of Medicine and ASCO that patients be presented with a Survivorship Care Plan (SCP) at the completion of cancer care which outlines the specific therapies as well as a detailed plan of follow-up care.
Methods: Using the DMAIC process as a guide, the subcommittee has defined which patients will receiveSCP’s and have developed a comprehensive template following American Society of Hematology (ASCO) guidelines that is appropriate for all DMGs.
Results: A work flow has been developed utilizing an intradiciplinary team approach. Standardized template notes have been created across the disease management groups and are captured in the EMR. Work has also been done to improve our EPIC environment to best capture data provided in the SCP to further NCCC survivorship research initiatives. Future plans of the SCP office visit will also include comprehensive symptom assessment along with distress screening and referrals.
Conclusions: Challenges have been identified. These include SCP’s for patients on chronic oral chemotherapy, data links for outcomes based research and feasibility of providers ability to deliver SCP’s in consistently.
Title: Screening processes and appropriate outcome measures for physical distress in outpatient rehabilitation referral in cancer survivorship: a case report
First Author: Ashley Tomaswick, PT
University of New England
Portland, ME
Co-Authors: Ashley Tomaswick, SPT, University of New England, Sebastian Stoltzfus, SPT, University of New England, Margaret Masiak, SPT, University of New England, Erika Lopez, SPT, University of New England, Mary Leopold, SPT, University of New England, Alyssa Grigware, SPT, University of New England, Samantha Fisk, SPT, University of New England, Matthew Denning, SPT, University of New England
Background: In 2015, there were an estimated 14.2 million cancer survivors in the United States, and 8,810 new cancer diagnoses in the state of Maine. With five-year relative survival rate estimates at an all-time high (68%) and the number of survivors growing, the need to address issues facing cancer survivors has also grown in recognition. Several studies support the need for additional wellness and rehabilitation services for cancer survivors, but there is a discrepancy between the literature and current healthcare practice. The purpose of this student-led project, in collaboration with a local community cancer center, a rehabilitation center, and a wellness center in Central Maine, was to determine which physical distress screening tools and outcome measures are most appropriate to trigger wellness and/or rehabilitation referrals.
Methods: A literature review examined the available screening tools and outcome measures used to assess the many symptoms associated with cancer diagnosis and treatment, and key stakeholder meetings were conducted. Though differences in patient status and treatment environments may necessitate or inhibit the use of specific tools, some are more comprehensive than others.
Results: The Distress Thermometer was found to be the most comprehensive screening tool due to its inclusion of overall symptom burden and individual multi-system self-report. A score ≥4 should trigger an additional screening protocol for wellness and/or rehabilitation referral.
Conclusions: Tools are available to screen for the need for rehabilitation and wellness referrals, though implementation is dependent on environment and interprofessional medical team protocol utilization.
Title: The Use of Volunteers in the Ambulatory Medical Oncology Setting***
First Author: Emma Dann, RN, MS, OCN
Dana-Farber Cancer Institute/NHOH
Londonderry, New Hampshire 03053
Background: Since cancer has touched the lives of so many, some people would like to give back by volunteering at a cancer center. There are many opportunities for a volunteer to assist in an ambulatory cancer center. This can vary from being a patient ambassador to being an administrative resource support volunteer. The Dana-Farber Cancer Institute/NHOH created a volunteer program working in conjunction with the main campus of DFCI in Boston. The program has been very well received by staff, patients and families, as well as the volunteers themselves.
Methods: The Nurse Director assessed the need and opportunity within DFCI/NHOH to have a defined volunteer program. Once determining that there was a need, the Nurse Director partnered with the Volunteer Program Director in Boston to create a plan for how to initiate a volunteer program in Londonderry, NH. Position descriptions, orientation requirements, and on-going performance requirements were all created. The staff and patients/families were informed and asked for input. Volunteer candidates applied, were interviewed and screened, and then selected for volunteer positions.
Results: The volunteer program at DFCI/NHOH has been very well received. There are currently more candidates to volunteer than we can accommodate. The volunteers value their time while in the clinic, the staff find their contributions to be very helpful and the patients and families really enjoy visiting with the volunteers.
Conclusions: After careful planning and implementation, an ambulatory cancer center can benefit greatly through the use of volunteers to assist with supporting patients as well as administrative tasks. The program does require oversight, but offers many enhancements to the care delivered to patients.
Title: Oral Chemotherapy: Promoting Adherence
First Author: Kathryn Hall, BSN, RN-BC, ONS-CCP
Lahey Oncology/Hematology at Parkland Medical Center
Derry, New Hampshire 03038
Co-Authors: Kathryn Hall, BSN, RN-BC, Barbara Umnasky, MSW, Colleen Summers, APRN
Background: In June 2015, ONS published guidelines and evidence-based recommendations to promote safe practices and improve adherence for oral chemotherapy.
Adherence to Oral Agents for Cancer (OACs) is an important topic in oncology care. OACs can have significant toxicities and pose safety risks without proper adherence. In efforts to meet this standard of care, our oncology clinic performed an Oral Oncology Program Quality PI.
Our goals were to create a formalized and consistent process, tracking all patients on oral cemotherapy.
With a collaborative approach, we provide comprehensive patient education, ensure patient's ability to obtain medication with little to no cost and monitor adherence with timely follow-up.
Methods: The Oncology Nurse Navigator designated as point person to maintain/update oral chemo spreadsheet and spearhead multi-layer process
Results:
Conclusions: Through our PI project we were able to successfully implement an Oral Chemotherapy Program focusing on promoting adherence through education, excellent communication and scheduled follow-up.
A collaborative approach with the Social Worker, Nurse Navigator and Nurse Practitioner was instrumental to our success.
Title: Informing and Engaging Patients: Guide to building an introduction packet to clinic ***
First Author: Nicholas Jaidar, Practice Supervisor
The University of Vermont Medical Center, Burlington, VT 0540
Background: During the last year, multi-disciplinary members of the cancer center collaborated on the development of an introduction packet that would provide the baseline service and support systems available. Over the last few years we have struggled to capture critical and concise information that we can provide to patients and their families outlining this information.
Methods: Our approach was to solicit feedback from providers, clinical/non-clinical staff and external departments that may be impacted. Furthermore, we decided to incorporate the thoughts and desires of the patient by conducting a patient focus group.
Results: During the activity, our marketing team put forth a draft of the document and interviewed various patients/caretakers concerning their emotional state, questions/concerns and resources/materials desired at each state of the disease process. The end result led to thoughtfully placing in patient tips and quotes within the document to drive personal engagement
We constructed a multifaceted approach to distributing the packet that included sending it in advance of the first appointment via email/mail to orient the patient, posting to our website to drive activity to the social media content and to provide to referring providers to ensure that patients have a warm introduction to clinic at the time of referral.
Conclusions: This document will now be used by patients as a reference and a repository to document their notes as they proceed through the care continuum. More importantly we created a resource to inform and engage our patients.
Title: The current dental and interprofessional management of geriatric patients undergoing head and neck cancer treatment in nursing home in the United States: Literature Review
First Author: Rashidah Wiley, DDS
University of New England College of Dental Medicine
Portland, Maine 04102
Co-Authors: Vidushi Gupta, Riddhi Daftary, Jessfor, Baugh, Ahn Tran, Lynne Cataldo, Yang Kang DDS, PhD, Takashi Komabayahi DDS, MDS, PhD - University of New England College of Dental Medicine
Background: Head and Neck squamous cell carcinoma is the sixth most common cancer worldwide. Due to the incidence and risk factors associated, a dental approach towards interprofessional management, treatment planning, and rehabilitation of diagnosed individuals undergoing cancer therapies is essential.
Methods: In consideration of this respect, the research literature review focuses primarily towards: (i.) pre-surgery oral hygiene instructions, (ii.) pre-radiology/chemotherapy dental clearance, (iii.) during-radiology/chemotherapy dental complications and management, (iv.) post-radiology/chemotherapy oral health care, and (v.) adjunctive health care.
Results: The aforementioned sections specifically aim to affirm that the inclusion of a through evaluation process is vital in understanding the overall assessment and safe management for patients undergoing oncology treatment. Furthermore, this project will assist in establishing guidelines for nursing home health care teams in regards to oral health care and interprofessional collaboration on cancer patients.
Conclusions: The implications defined will address how interprofessional health care providers can assist patients to achieve better quality of life in nursing homes.
Title: Infusion Reactions: Preparedness, Management and Safety***
First Author: Lisa Chicko, RN, BA, OCN
Dana Farber/NH Oncology Hematology
Londonderry, New Hampshire 03053
Co-Authors: Emma Dann, RN,MSN, OCN, Margaret Carney, RPh, Vincent Byron, Senior Network Technician, Jeanna Walsh, MD
Background: Head and Neck squamous cell carcinoma is the sixth most common cancer worldwide. Due to the incidence and risk factors associated, a dental approach towards interprofessional management, treatment planning, and rehabilitation of diagnosed individuals undergoing cancer therapies is essential.
Methods: In consideration of this respect, the research literature review focuses primarily towards: (i.) pre-surgery oral hygiene instructions, (ii.) pre-radiology/chemotherapy dental clearance, (iii.) during-radiology/chemotherapy dental complications and management, (iv.) post-radiology/chemotherapy oral health care, and (v.) adjunctive health care.
Results: The aforementioned sections specifically aim to affirm that the inclusion of a through evaluation process is vital in understanding the overall assessment and safe management for patients undergoing oncology treatment. Furthermore, this project will assist in establishing guidelines for nursing home health care teams in regards to oral health care and interprofessional collaboration on cancer patients.
Conclusions: The implications defined will address how interprofessional health care providers can assist patients to achieve better quality of life in nursing homes.
Title: Patient-centered Oral Chemotherapy Education Program
First Author: Colleen Poirier, RN, OCN
Portsmouth Hematology and Oncology Associates
Goal: To optimize compliance and insure best patient outcomes.
Background : Need for dedicated oral oncology nurse with increased number of oral oncology agents.
Presentation method: Poster
Methods/Process (DRAFT):
Results: Improved compliance, communication and side effect management.
Conclusion: Early and continued involvement with an oral oncology trained nurse promotes compliance and improves patient outcomes.