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  • 1
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    Online Resource
    The power of knowledge: Sharing patient test results electronically to improve quality of care.
    American Society of Clinical Oncology (ASCO) ; 2012
    In:  Journal of Clinical Oncology Vol. 30, No. 34_suppl ( 2012-12-01), p. 305-305
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 30, No. 34_suppl ( 2012-12-01), p. 305-305
    Abstract: 305 Background: For many patients going through the cancer diagnosis journey, the time from suspicion to diagnosis or rule-out can be a confusing and anxious time. To better support patients during this time, Cancer Care Ontario (CCO) is supporting Diagnostic Assessment Programs (DAPs) and the web-based tool known as the Diagnostic Assessment Program–Electronic Pathway Solution (DAP-EPS). DAPs consist of multi-disciplinary healthcare teams who provide diagnostic and supportive care services in a patient-focused environment, improving access to care and the patient experience. DAPs help manage and coordinate a patient’s diagnostic care from testing to a definitive diagnosis and part of this support involves providing access to personal health information through the DAP-EPS. This work was undertaken to determine the best approach to sharing test results with patients, including the type of test results that should be released and the most effective method for sharing these results with patients, from both the patient and provider perspective. Methods: The exploratory project involved conducting key informant interviews with individuals who had been involved with implementing similar patient portals, a targeted literature review, and a series of engagement sessions with physicians to measure the clinical response to this new strategy. Results: Initial discussions with patients and nurses yielded a strong endorsement for releasing all results, with no time delay. Key Informant interviews yielded similar results from the majority of the hospital contacts consulted. The environmental scan did not suggest that releasing results was associated with any adverse patient or provider effects. The physician engagement sessions generated both positive and negative feedback but overall, doctors were comfortable releasing all results, provided there was a delay built into the system. Conclusions: The release of diagnostic test results is seen as a valuable component of quality of care from the perspective of informing and empowering the patient. As the DAP-EPS moves forward with this initiative, the DAP program will continue to monitor the impact that the release of results has on both patients and providers.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/jco.2012.30.34_suppl.305
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2012
    detail.hit.zdb_id: 2005181-5
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  • 2
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    Online Resource
    Driving quality improvements of radiation treatment services through a centralized performance management approach.
    American Society of Clinical Oncology (ASCO) ; 2017
    In:  Journal of Clinical Oncology Vol. 35, No. 8_suppl ( 2017-03-10), p. 188-188
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 8_suppl ( 2017-03-10), p. 188-188
    Abstract: 188 Background: Radiation treatment services are delivered in 16 facilities spread across the province of Ontario, centralized through Cancer Care Ontario’s oversight of quality of care, equipment, hospital funding, clinical and technical guidelines. Methods: In order to ensure high quality care, Cancer Care Ontario employs a systematic approach performance management, whereby facilities are held accountable to achieving provincial quality targets. For radiation treatment, the quality improvement priorities that have leveraged this approach over the last 10 years have included: reduction of wait times to consultation; reduction of wait times to start of treatment; adoption of Intensity Modulated Radiation Therapy (IMRT) where appropriate; and implementation of peer review for treatment plans. In each case, key performance indicators were developed for use in provincial scorecards designed to focus the attention of local clinical and administrative leadership. Regular performance discussions with senior leaders took place throughout implementation, and targeted intervention occurred with facilities that were lagging behind their peers. Results: See table. Conclusions: The ability to centrally monitor the implementation of quality improvement initiatives across a large jurisdiction, and to hold the leadership of each facility accountable to provincial targets through regular feedback and escalation, has been a key component of highly successful change management initiatives in radiation treatment in Ontario. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2017.35.8_suppl.188
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2017
    detail.hit.zdb_id: 2005181-5
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  • 3
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    Online Resource
    Development of a capital investment strategy for radiation (RT) equipment in Ontario.
    American Society of Clinical Oncology (ASCO) ; 2013
    In:  Journal of Clinical Oncology Vol. 31, No. 31_suppl ( 2013-11-01), p. 279-279
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 31, No. 31_suppl ( 2013-11-01), p. 279-279
    Abstract: 279 Background: To ensure appropriate access to radiation treatment (RT) for Ontario cancer patients for the next decade and that future capital investments in radiation equipment are appropriately timed and strategically placed, Cancer Care Ontario (CCO) has updated its RT Capital Investment Strategy. The strategy was designed around 4 core principles: i) recognizing treatment machine capacity should match the demand resulting from increasing cancer incidence rates and increasing utilization rates as per CCO goals; ii) keeping pace with advancing technology; iii) ensuring value for money by maximising the use of current infrastructure; and iv) minimizing costs through centralized planning and procurement processes. Methods: A multidisciplinary provincial expert panel reviewed and revised the planning parameters used to project treatment demand and required capacity (including fractions of RT per treated case, number of cases treated per hour, uptime of treatment units). The panel reviewed current practice, impact of new and emerging treatment technologies and benchmarks from other jurisdictions. To project the future demand for radiation therapy, growth in cancer incidence (by county) as well as modest improvement in RT utilization rates were assumed. Results: Recommendations included: i) moving to 12-hour treatment days in all large centres and on 50% of equipment in centres operating fewer than 6 treatment units; ii) ensuring appropriate funding for the replacement of existing RT equipment; iii) equipping constructed rooms in 4 regional cancer centers – thereby adding 6 linacs; iv) equipping swing bunkers across the province – thereby adding 10 linacs; and v) planning for the construction of new facilities to add RT capacity in 3 regions of the province. Conclusions: Funding to implement recommendations from previous capital investment strategies has resulted in an equitable distribution of RT resources across the province. We believe the planning strategies and recommendations outlined in the strategy will improve access to quality RT care as close to home as feasible for Ontario patients.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/jco.2013.31.31_suppl.279
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2013
    detail.hit.zdb_id: 2005181-5
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  • 4
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    Online Resource
    Expansion of high-quality specialized services: The gynecologic oncology experience in Ontario hospitals.
    American Society of Clinical Oncology (ASCO) ; 2018
    In:  Journal of Clinical Oncology Vol. 36, No. 30_suppl ( 2018-10-20), p. 39-39
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 36, No. 30_suppl ( 2018-10-20), p. 39-39
    Abstract: 39 Background: In Ontario’s publicly funded cancer system, patient access to Gynecological Oncology (GyneOnc) care is threatened by growing demand, waiting times and need for lengthy patient travel. Cancer Care Ontario has published organizational standards that lay out the minimum clinical elements and infrastructure needed for a high quality program. Capacity planning and readiness assessments were used to guide GyneOnc expansion into non-academic regional cancer centres to alleviate system pressure. We evaluated early expansion activities to learn about critical factors and generate recommendations for future growth of this specialized oncology service. Methods: Capacity planning for new centres factored health human resources (HHR), patient volume and travel distances, ensuring that existing programs maintain critical mass. Evaluation included review of documents and readiness assessments related to the expansion projects undertaken to date. Interviews were done with GyneOncologists and administrators working at local and provincial levels to discover areas of risk, key factors for success, and recommended strategies for future expansion. Results: Gyne Onc programs need adequate resourcing (minimum 3 GyneOncs) to meet patient demand, support on-call and offer resilience to parental/medical leaves. Programs need engagement from other surgical and medical subspecialties, and clinical services (e.g. pathology, diagnostic imaging) for integrated, multidisciplinary care. Academic appointments, residencies, fellowships, and support for research provide links with universities, important for credibility. Endorsement by senior leadership - both management and clinical - is crucial. Organizational standards need specificity around the infrastructure and multidisciplinary environment needed for program success. Conclusions: HHR planning and readiness assessment are critical enablers in the expansion of specialized services like GyneOnc beyond academic centres. New programs need to consider the adequacy and appropriateness of staffing models, broad engagement of the clinical team, and linkages to academia, in order to ensure program sustainability and acceptability.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2018.36.30_suppl.39
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2018
    detail.hit.zdb_id: 2005181-5
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  • 5
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    Online Resource
    Reducing the impact of distance on hematopoietic cell therapy patients.
    American Society of Clinical Oncology (ASCO) ; 2018
    In:  Journal of Clinical Oncology Vol. 36, No. 30_suppl ( 2018-10-20), p. 74-74
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 36, No. 30_suppl ( 2018-10-20), p. 74-74
    Abstract: 74 Background: Hematopoietic Cell Therapy (HCT) patients experience unique travel challenges and high out-of-pocket costs due to the highly specialized care required. We conducted a mixed methods study to understand current patient support programs in Ontario and other jurisdictions and a cost analysis to inform the development of recommendations to reduce the impact of remoteness on HCT patients and caregivers. Methods: Qualitative information on patient transportation and accommodation supports was gathered through informal and structured input from fourteen Ontario Regional Cancer Program Directors, Hematologists, Patient and Family Advisory Council and Aboriginal Navigators. An environmental scan of medical travel assistance programs within Ontario and in other jurisdictions was performed. A scoping literature review was conducted of published studies focused on inequities in receipt of cancer care in countries with Universal Health care. HCT patient travel patterns to each of the transplant facilities in Ontario were obtained from analysis of Cancer Care Ontario data holdings. Results: We concluded that travel assistance for cancer patients in Ontario varies considerably across the province, and that Ontario lags behind other jurisdictions in Canada and internationally. The scoping literature review revealed that patients who live far from specialist centres, for some diseases, have later stage at diagnosis, less timely access to specialist care, poorer outcomes, lower patient experience scores, and make treatment decisions based on distance. From the analysis of travel patterns for HCT patients, provincially 4 – 79% of patients travel for HCT based on their location (see table below). Conclusions: This study highlights the need to better support HCT patients in Ontario. As a result, a proposal to support accommodations for HCT patients was developed and approved by the Ontario government for implementation in 2018/19.[Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2018.36.30_suppl.74
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2018
    detail.hit.zdb_id: 2005181-5
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  • 6
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    Online Resource
    Faster and better: Improving the diagnostic phase of lung cancer at a system level.
    American Society of Clinical Oncology (ASCO) ; 2017
    In:  Journal of Clinical Oncology Vol. 35, No. 8_suppl ( 2017-03-10), p. 115-115
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 8_suppl ( 2017-03-10), p. 115-115
    Abstract: 115 Background: For many patients going through diagnostic testing for cancer, the time from suspicion to diagnosis or rule-out, can be a confusing and anxious time. In 2007, Cancer Care Ontario began investing in the implementation of diagnostic assessment programs (DAPs) across Ontario, Canada to improve the quality of care during the diagnostic phase of lung cancer. DAPs consist of multidisciplinary healthcare teams that manage and coordinate a patient’s diagnostic care from testing to a definitive diagnosis. The objectives of the DAPs are to: 1) decrease time from suspicion to diagnosis or resolution; 2) optimize the patient’s experience during the diagnostic process; 3) optimize satisfaction and experience among primary care providers and specialists; and 4) provide a sustainable solution by offering good value for money. Today over 35,000 patients have been diagnosed in one of the 18 lung DAPs that exist across the province. Methods: The implementation of DAPs featured the introduction of a patient navigator to act as the primary point of contact for patients, improve the patient experience and ensure their patients were progressing through any required diagnostic imaging and consultations in a timely manner. Cancer Care Ontario also engaged with primary care providers to refer patients with findings suspicious for lung cancer to DAPs as early as possible to ensure they benefited from organized assessment. Cancer Care Ontario has collected patient level data to measure wait times and implemented a patient survey to assess patient experience. Results: In the past five years, the median wait time from referral to a lung DAP to diagnosis or rule out has decreased by 19% to 24 days and the 90th %tile has decreased by 28% to 51 days. The large majority of patients have had a positive experience with their DAPs, with 95% of patients scoring their experience in the diagnostic process as “good” or “excellent”. Conclusions: The implementation of DAPs across the province is seen as a valuable component of quality of care by improving the diagnostic phase of cancer. The sustainability of the DAP model is demonstrated by the continued improvements in access and maintained patient experience in spite of growing volumes (91% increase in the past five years).
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2017.35.8_suppl.115
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2017
    detail.hit.zdb_id: 2005181-5
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