LANGE-FUHS CANCER CENTER SERVICES PROVIDED

Transcription

1 2018 Annual Report

2 LANGE-FUHS CANCER CENTER SERVICES PROVIDED MEDICAL ONCOLOGY/HEMATOLOGY All types of cancers Blood disorders including, but not limited to, immune deficiencies, hemophilia, irondeficiency anemia, anemia of chronic kidney disease, polycythemia vera, lymphoma, leukemia, myelodysplastic syndrome, multiple myeloma Dedicated Medical Oncologist/Hematologist Two full-time Nurse Practitioners Oncology Certified Nurses On-Site Pharmacy Dedicated Oncology Pharmacist Nurse Navigator Social Worker Integrative Medicine Coordinator Complementary therapies: reflexology, yoga Chemotherapy education provided to patients and families prior to beginning treatment

3 LANGE-FUHS CANCER CENTER SERVICES PROVIDED TREATMENT SERVICES Infusions: chemotherapy, biotherapy/immunotherapy, IVIG, iron, hydration w/electrolyte supplementation, bone supportive infusions, and antibiotics. We provide disposable chemotherapy pumps for our patients that have to have continuous chemotherapy at home. Injections: anti-hormonal injections to treat breast and prostate cancer, bone support injections such as Prolia and Xgeva, growth factors such as Neulasta and Procrit, and B12. Care, flushing and lab draws from all central lines: PICCS, implanted ports, etc. RADIATION ONCOLOGY Full-Time Radiation Oncologist Three Radiation Therapists Radiation Oncology Registered Nurse Conventional radiation IGRT (Image Guided Radiation Therapy) IMRT (Intensity Modulated Radiation Therapy) 3D Treatment Planning On-Site Big Bore CT Simulator

4 Medical Oncology Karim Anwar, M.D. Dr. Anwar received his medical degree from King Edward Medical College. He completed his residency in internal medicine at University of Connecticut School of Medicine and completed a fellowship in oncology/hematology at the University of Massachusetts School of Medicine. He is board certified in oncology and hematology. He is a member of American Society of Clinical Oncology and American Society of Hematology. Dr. Anwar has been with the cancer center since He serves as our Medical Director and our Cancer Committee Chair. He works side-by-side with our other providers, nurses, navigator, social worker and all other disciplines to ensure our patients receive the quality care they deserve. Radiation Oncology Walter Roberts, M.D. Dr. Roberts received his medical degree and radiation oncology training from Wayne State University. He also completed additional training, including Internal Medicine, and OB/GYN. He is a member of the American Society for Therapeutic Radiation Oncology, American College of Radiology and American Association for Physicists In Medicine. He holds certifications from The American Board of Radiology and Therapeutic Radiologic Physics. Dr. Roberts has been with the cancer center since January of He brought with him a wealth of knowledge and innovative treatment strategies. He works closely with the whole radiation department, medical oncology providers, and radiologists to provide the highest quality patient care possible.

5 Oncology Nurse Practitioner Charlotte Stephenson, NP-C, OCN Charlotte had 20 years of experience as a Registered Nurse prior to completing her Masters of Science in Nursing as a Family Nurse Practitioner from Indiana Wesleyan University in Several of those years she practiced in oncology. She is a member of the American Association of Nurse Practitioners and the Oncology Nursing Society. She understands the unique needs of our cancer patients and is excellent with symptom management, pain management, and all other aspects of cancer care. She ensures the complete circle of care starting with treatment education all the way through the Survivorship Care Plan. Oncology Nurse Practitioner Dena Kamman- Rasche, MSN, MBA, APRN, FNP-C Dena has been with Memorial Hospital and Health Care Center for almost 10 years. Her nursing experience includes the Medical Unit, Intensive Care Unit, and the Emergency Department. She obtained her Masters of Science in Nursing as a Family Nurse Practitioner from University of Southern Indiana in She is a member of the American Association of Nurse Practitioners and the Oncology Nursing Society. She joined our Lange-Fuhs Cancer Center team this November. She states I feel extremely blessed to be a part of this organization and to have the opportunity to work alongside Dr. Anwar and Charlotte. I hope to be a source of support for our patients and provide for them in their time of need.

6 Oncology Nurse Navigator Melissa Knust, BSN, RN, OCN This year we were blessed with the approval to hire an Oncology Nurse Navigator. Melissa Knust has been with the cancer center for seven years and is an Oncology Certified Nurse. She is the perfect fit for this position as she has a true passion to help our patients and their families. She serves as the primary point of contact to guide newly diagnosed cancer patients through all facets of their cancer journey. She is an advocate, interpreter, and educator for patients and their families. Melissa serves as a liaison between the patient and all members of the health care team to ensure patients receive compassionate, comprehensive, quality care. Oncology Social Worker Allyson Hoffman, LSW Allyson Hoffman is our Oncology Social Worker. She has been a social worker for 30 years and has been with our cancer center for 9 of those years. She provides psychosocial services to patients and families as they face the impacts of a cancer diagnosis. Her patient centered approach helps identify individual needs, whether it is insurance concerns, financial issues, or assistance with accessing community resources. Her role is to help reduce patients stress and improve their coping mechanisms as they adjust to living with cancer. She is a vital part of our patients and their families support system, available to them throughout their journey.

7 Registered Dietitian Jessica Sitzman, RD Jessica Sitzman, RD is our dietitian at the Lange-Fuhs Cancer Center. She provides expert nutrition counseling services to patients and their caregivers as an integral part of cancer care. She works with individual patients and their families to assess for nutrition risk, determine their nutritional goals, provide practical suggestions to help meet their nutritional needs, and give assistance with nutrition related problems. Every patient has the opportunity to meet with her during and after cancer care. Integrative Medicine Coordinator Connie Egloff Connie has been with the cancer center for nine years. Transitioning to the Integrative Medicine Coordinator position a year ago, she took the solid foundation of complementary programs and expanded it into a full array of services. She has great compassion for her patients and believes in keeping their lives as normal as possible under the most stressful of circumstances. Her belief in our Mission and Vision statements empowers her to individually meet the needs and wants of her patients. Connie has developed and implemented seven new programs, including reflexology and Yoga: Pray. Breathe. Move. She oversees the cancer center volunteers, donations, snacks, patient gifts, hospital visits to our patients, monthly calendars, and all support programs.

8 INTEGRATIVE MEDICINE: Our Integrative Medicine Program encompasses complimentary services that give our patients, families, and caregivers a sense of belonging and acceptance within the cancer center community. Through five components of our integrative medicine program, we aim to bring patients to their optimal level of well-being. We provide ways to deepen emotional, spiritual, and physical well-being and enhance communication and dynamics of patients relationships. Our focus is on reaching patients while they are here for appointments and infusions. Reflexology is the most popular of our complementary services. Patients have stated they can walk better, feel relaxed, and worry less after a session with one of our compassionate reflexologists. All weekend, I look forward to coming Mondays for my chemotherapy because I know I get a foot massage (reflexology). Lange-Fuhs Cancer Center patient, September, 2018.

9 Special Programs and Events On the Patio: A series of events for patients and their families to showcase their artistic talents. A side benefit allows people to connect or reconnect with friends and family. We give them time and space to just BE and enjoy. Our inaugural event in July, 2018 hosted Timepeace, a sixties band. We also hosted a tattoo artist, rock painter, knitters, and outdoor yoga. All events are outside our cancer center entrance weather-permitting. Patient and Caregiver Resource Days: The Psychosocial Coordinator and Integrative Medicine Coordinator periodically host events that give patients and caregivers information and help on their cancer journey. Our most recent appreciation event in November provided snacks, bottled water, cookbooks, cancer information, and caregiver information. The Jasper High School Boys Soccer team donated succulent plants that our patients enjoyed. National Office Furniture in Santa Claus donated bags filled with men s and women s hats, hard candies, tissues, hand sanitizers, and other necessary personal items. Each patient received a bag and a Creating Hope art calendar.

10 INTEGRATIVE MEDICINE Programs: Creating Hope Art Group Women s Support Group Men s Discussion Group Jazz It Up, formerly Look Good Feel Better Celebrate Today Annual retreat for Women s Support Group Yoga: Pray. Breathe. Move. Reflexology for active treatment patients Volunteer visits in chemotherapy infusion room Pastoral Care Presence: scheduled and unscheduled visits Monthly calendars with programs and events Visits to patients in hospital (unless restrictions in place) Afghan & card given to hospice patients Puzzles and cards

11 Reporting of Outcomes Research- Standard 1.9 and ER9 In 2018, we had 10 patients being monitored in Clinical Trials. Cancer Program Studies of Quality and Quality Improvements Standard 4.7 and Standard 4.8 Each year the Cancer Program conducts studies on our processes and quality of care. In 2018 we conducted two studies: one was on colonoscopies before or within six months of curative colorectal cancer resection or completion of primary adjuvant chemotherapy. The second was the percent of patients undergoing chemotherapy, who were assessed for the presence or absence of fatigue during a cancer related visit. We also implemented two quality improvements in It was determined that Advanced Care Planning was not being documented in patients record. Our goal is to include questions in our Integrative Assessment to determine if patients have an Advanced Care Plan or would like information about one. By improving this process, it will further allow us to obtain a copy if they have one, document they do not wish to have information about one, or make a referral to one of our Advanced Care Plan Facilitators for further discussion. A process has been put into place providing a prompt for physicians to dictate complete staging on patients. Staging enables the physician to classify patients, which leads to better treatment decisions and development of a common language barrier that aids in the creation of clinical trials. It is a guide for treatment and prognosis, and a comparison of end results for cancer management Cancer Quality Improvement Program (CQIP), Standard 1.8, Standard 4.1, Standard 4.2 CQIP is a data driven, process and outcomes-based quality improvement initiative. The following graphs show data from Memorial Hospital and Health Care Center compared with data from other Commission on Cancer accredited facilities. Our screening and prevention programs for 2018 focused on melanoma of skin. Prevention Event: Understanding Skin Cancer and the Importance of Prevention & Screening May 22, 2018 Washington, Daviess County, Indiana by Karim Anwar, MD Prevention Event: Skin Cancer Prevention Booth On the Patio July 10, 2018 Jasper, Dubois County, Indiana by Integrative Medicine Coordinator & Volunteers Screening Event: Understanding Skin Cancer and the Importance of Prevention & Screening May 22, 2018 Washington, Daviess County, Indiana by Karim Anwar, MD

12 Stage Distribution - Melanoma Cancer Diagnosed in 2015 My Facility vs. All CoC

13 In/Out Migration Melanoma Cancer, My Facility

14 Distance Traveled - Melanoma Cancer, My Facility

15 Radiation Oncology Service Report Type of cancer and number of patients treated with radiation in 2017 Site # treated Bile Duct 1 Bladder 1 Brain primary and prophylactic 5 Breast 30 Carcinosarcoma 1 Esophageal 2 GYN: Cervix, Endometrium 2 Head & Neck 9 Lung 20 Lymphoma 4 Multiple Myeloma 3 Pancreas 3 Plasmacytoma 3 Prostate 24 Rectum 5 Skin, including melanoma 8 Thymoma 1 Metastasis: Bone 26 Metastasis: Brain 7 Metastasis: Chest Wall 1 Metastasis: Liver 1 Metastasis: Neck Node 1

16 2017 Incidence Female Site Memorial Cases National Cases Breast % % Lung % % Colon, Rectum % % All other Sites % % Non- Hodgkin Lymphoma % % Corpus Uteri % % Urinary Bladder % % Kidney % % Melanoma Skin % % Cervix % % Ovary % % Leukemia % % Other Digestive Organs % % Pancreas % % Lip, Oral Cavity, Pharynx, Larynx % % Esophagus % % Stomach % % Brain & Nervous System % % Prostate % % TOTALS % % National statistics 2017 estimated new cases based on rates published by the American Cancer Society Cancer Facts & Figures Memorial Hospital and Health Care Center cases are based on analytic cases only.

17 2017 Incidence Male Site Memorial Cases National Cases Breast % % Lung % % Colon, Rectum % % All other Sites % % Non- Hodgkin Lymphoma % % Corpus Uteri % % Urinary Bladder % % Kidney % % Melanoma Skin % % Cervix % % Ovary % % Leukemia % % Other Digestive Organs % % Pancreas % % Lip, Oral Cavity, Pharynx, Larynx % % Esophagus % % Stomach % % Brain & Nervous System % % Prostate % % TOTALS % % National statistics 2017 estimated new cases based on rates published by the American Cancer Society Cancer Facts & Figures Memorial Hospital and Health Care Center cases are based on analytic cases only. Memorial Hospital and Health Care Center total cancer cases by year Year of Diagnosis TOTAL TOTAL 4216

18 2017 YEAR CASES ACCESSIONED BY COUNTY Cases accessioned by counties of residence at diagnosis Cases include analytic and non-analytic % of county based on total number of cases (436) Monroe 1 (.2%) Gibson 2 (.5%) Daviess 34 (7.8%) Pike 28 (6.4%) Dubois 208 (47.7%) Warrick 2 (.5%) Spencer 29 (6.7%) Martin 60 (13.8%) Lawrence 3 (.7%) Orange 38 (8.7%) Perry 10 (2.3%) Crawford 13 (3%) Washington 1 (.2%) Richland, IL 1 (.2%) Hamilton, TN 1 (.2%) Somerset, ME 1 (.2%) Breckenridge, KY 1 (.2%) Unknown 3 (.7%)

19 ALL SITES Crawford Daviess Dubois Martin Orange Perry Pike Spencer Warrick, Gibson, Monroe, Washington Other counties Blood & Bone marrow Brain/Spinal Cord Breast Colon/Rectum, Anus Esophagus Female Genital Gallbladder 1 Kidney Larynx, Pharynx, Nasal Cavity Lip/Oral Cavity 1 1 Liver Lung Lymphoma Melanoma of Skin Pancreas Prostate Small Intestine Soft Tissue Sarcoma Stomach 1 1 Testis 1 2 Thyroid Unknown Primary Site Urinary Bladder, Renal pelvis Other TOTAL

20 TUMOR REGISTRY GENERAL SUMMARY January 1, December 31, 2017 Analytic Cases Non-Analytic Cases Total Cases 2017 (analytic and non-analytic) 436 Total cases in registry Total includes analytic and non-analytic patients re-admitted with subsequent primary sites and patients admitted for the first time with more than one primary site. Analytic cases are cases diagnosed and/or administered any of the first course of treatment at the accessioning facility. Non-analytic cases are not usually included in routine treatment or survival statistics. These cases are not required to be abstracted or follow these cases. Memorial Hospital and Health Care Center Registry Reference Date- January 1, 1987

21 WHO OVERSEES THE ACTIVITIES OF THE CANCER PROGRAM? Each year, the Cancer Committee of Memorial Hospital is responsible for monitoring, assessing, and identifying changes needed to maintain compliance with the American College of Surgeons Commission on Cancer standards for accreditation. Accreditation ensures that quality care is provided to patients in a safe environment. Physician Committee Members: Karim Anwar, M.D. Medical Oncology, Cancer Committee Chair Charles Tollett, Jr., M.D. General Surgery Joseph Munning, M.D. Internal Medicine, ACoS Liaison Daniel Weaver, M D.. Pathology, Cancer Conference Coordinator Michael Wohlberg, M.D. Radiology Donald Vennekotter, M.D., FACS General Surgery (alternate) Stanley Tretter, M.D. VP Medical Affairs and CMO Jonathan Day, M.D. Radiology (alternate) Walter Roberts, M.D. Radiation Oncology (locum) Ancillary Committee Members: Allyson Hoffman, BSW/LSW Social Services, Psychosocial Coordinator Marla Haas, BSN, RN, OCN Medical Oncology Denise Myers, BSN, RN Palliative Care Dana Verkamp, BSN, RN, OCN Quality Improvement Medical Oncology Shawna Verkamp, RHIT, CTR Cancer Registrar, Cancer Registry Quality Coordinator Tana Scott, BSN, RN, OCN Cancer Center Manager, Navigation Charlotte Stephenson, NP-C, OCN Oncology Research and Survivorship, Clinical Research Representative Karly Broerman, MA Manager- Medical Practice Management, Community Outreach coordinator Angela Hoagland, Pharm D., MHA Director of Pharmacy and Oncology Services Cheri Houchin, RN Medical Oncology, Case Manager (alternate) Shanique Dillon, BSN, RN Medical Oncology (alternate) Shannon Stillwell, BSN, RN Palliative Care (alternate) Paula Carlisle, BSN, RN, OCN Medical Oncology (alternate) Cathy Schroering, BSN, RN, OCN Medical Oncology, Case Manager (alternate) Ashley Erny, Pharm.D. Pharmacy (alternate) Susan Weisheit, BS Director of Medical Practice Management