SAINT FRANCIS CANCER CENTER ANNUAL REPORT 2018

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Sylvia Nelson
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1 SAINT FRANCIS CANCER CENTER ANNUAL REPORT 2018

2 Since 1975, the cancer program at Saint Francis Health System has provided state-of-the-art medical oncology and radiotherapy technology to residents in eastern Oklahoma and surrounding states. Committed to advancing oncology care, Saint Francis provides an array of oncology services to meet patient needs. The cancer center s treatment practices include boardcertified physicians who provide multidisciplinary care in a professional, patient- and family-focused setting. Additionally, the cancer program is accredited by the American College of Surgeons as a Comprehensive Community Cancer Program. 1

3 2018 Annual Cancer Program Update It has been another successful year of growth and improvement for our oncology (cancer) program and services within Saint Francis Health System. Continuing to provide excellent clinical and patient-centered care and services remains our goal. Highlights of some of the major achievements and improvements for 2018 include the following: In April 2018, expansion and renovation work at the Saint Francis Cancer Center began. Radiation oncology services are being relocated to the cancer center from the hospital. Most outpatient services needed by cancer patients will now be available at the cancer center location. Completion of implementation of the newest technology available in Breast Health Services, tomosynthesis mammography (3D), at all the Saint Francis Tulsa area locations (Natalie Building, Broken Arrow and Glenpool) as well as Warren Clinic McAlester. Over $12,000,000 in outpatient oncology drug patient assistance obtained to help deter the costs of cancer treatment through drug replacement and/or drug co-pay cards. One additional Warren Clinic medical oncologist joined Saint Francis Health System as well as an additional Warren Clinic breast surgeon and oncologic general surgeon. Sponsorship or hosting of multiple oncology community events for oncology patients/survivors such as Saint Francis Cancer Survivor Night at the Tulsa Drillers; Blood and Marrow Transplant Survivors Party; American Cancer Society Relay for Life; American Cancer Society Cattle Barron s Ball; American Cancer Society s Strides Against Breast Cancer; and Get Your Rear in Gear Colon Cancer Coalition Race/Walk. Saint Francis remains the only nationally recognized Lung Cancer Alliance Screening Center of Excellence in the state of Oklahoma. Implemented a lung nodule clinic weekly whereby patients found to have incidental lung nodules on imaging studies can be seen and evaluated by a pulmonologist as deemed appropriate with a determination for any needed further testing. The radiation oncology department at Saint Francis was recognized at a national patient satisfaction (experience) conference (PRC) as being the Top Radiation Department in the Country for patient satisfaction for the second year in a row. Warren Clinic Medical Oncology entered its third year as a participant in the CMS Oncology Care Model (A national program designed to promote improved care coordination and services for oncology patients while reducing costs of care.) Saint Francis Health System remains committed to being a leader in oncology care and services for eastern Oklahoma as we continue to be focused on improving the health and outcomes of our patients. This standard supports our health system as we carry out our mission: To extend the presence and healing ministry of Christ in all that we do. NANCY N. THOMAS, M.A., RHIA, CPHQ Director, Oncology Service Line Saint Francis Health System In the first 10 months of 2018, Saint Francis provided 580 breast health services to Oklahoma Project Woman patients (screening mammograms, diagnostic mammograms, ultrasounds, biopsies and MRI). These are female patients in Oklahoma who have no health insurance and/or limited financial resources. 2

4 Commission on Cancer Since 1978, the cancer program at Saint Francis Hospital has been continually accredited by the American College of Surgeons Commission on Cancer (CoC). The CoC is the only multidisciplinary accreditation program for cancer programs in the U.S. and recognizes cancer care programs for their commitment to providing comprehensive, high-quality and multidisciplinary patient-centered care. Membership and accreditation is voluntary for healthcare organizations with cancer programs. Saint Francis Hospital has a dedicated multidisciplinary cancer committee that meets quarterly to ensure the highest quality of care is being provided to our patients. This dedicated committee sets annual program and clinical goals, and implements improvement projects that focus on quality of care and services. Ancillary and Support Services Ancillary services include: Nurse navigation navigators serve as a coordinators of care and the central point of contact for patients and families throughout the oncology journey. Oncology social worker assistance and guidance in linking patients with appropriate resources in the community. Oncology financial counselor assists patients with accessing any financial assistance available to them such as drug replacement, drug co-pay cards, patient foundation assistance funds, Medicaid, charity care, etc. Genetic counselor access to genetic counselors for understanding of genetic testing results and how it affects the patient individually, as well as potential implications for family members. Oncology registered dietitian available to assist patients with addressing nutritional needs, concerns and issues to optimize patients nutritional status. Oncology rehabilitation physical, occupational and speech therapy services, including a lymphedema clinic provided by the oncology department with specifically trained therapists to help patients achieve improved functional status, decreased pain, etc. Pharmacy registered pharmacists oversee technicians who prepare all the chemotherapy drugs to be administered intravenously to patients as well as oral drugs dispensed through our outpatient pharmacy. Pastoral care members of the pastoral care/religion department are available to all oncology patients (as well as their family) on an outpatient or inpatient basis to provide support and minister to them as needed/ requested, including providing Holy Communion. Hospice the Saint Francis hospice team provides physical, psychological, social and spiritual support to terminally ill patients and their families. The hospice team also serves as consultants for end-of-life care discussion. Laureate Psychiatric Clinic and Hospital licensed clinical psychologists and psychiatrists provide counseling and therapy services on both inpatient and outpatient basis. American Cancer Society Resource Room services available at the Saint Francis Cancer Center (free wigs for female patient, patient assistance with transportation, lodging, etc.). Diagnostic services include: Tomosynthesis (3D) digital mammography Automated Whole Breast Ultrasound (ABUS) Hand-held breast ultrasound CT (computerized axial tomography) scan MRI and Breast MRI (magnetic resonance imaging) PET scan (positron emission tomography) Nuclear medicine Diagnostic radiology Laboratory and pathology services Genetics lab 3

5 About Saint Francis Cancer Center The Saint Francis Cancer program was established in honor of Natalie Warren Bryant, second daughter of hospital founders Mr. and Mrs. William K. Warren, Sr. Natalie passed away from breast cancer at age 49. Originally, cancer services were only provided to patients at Saint Francis Hospital, however, in 2013 outpatient cancer services were expanded to the newly acquired Saint Francis Cancer Center located at East 48th Street in Tulsa. Services provided through the cancer program are multidisciplinary in nature and are patient-centered and -focused. Quality Patient-centered Cancer Care Maintaining a state-of-the-art, quality cancer treatment center requires teamwork among many different disciplines. Our multidisciplinary team approach is the key to providing excellent quality care for patients and their families. By combining the cancer center s medical and other clinical teams expertise and specialized knowledge, a comprehensive care management plan is developed to meet the individual patient s needs. The cancer center provides patients with the convenience of receiving most all ambulatory services needed in one location. Our cancer treatment center physicians and providers have access to the extensive resources of Saint Francis Hospital, including an acute inpatient oncology unit. Post-treatment care is available through Saint Francis Home Health as well as hospice and palliative care services. Cancer Treatment Center with a Family Focus As advanced as our treatments are, we understand one of the most powerful tools in our patients fight against cancer is the support of their family and friends. We have support groups for both patients and caregivers that are facilitated by our outpatient oncology social workers. Prevention and Screening Programs Offered through Saint Francis Saint Francis Hospital offers a variety of annual prevention and screening programs to the community. The Saint Francis Cancer Committee is committed to developing programs that have a direct impact on health. These programs provide early detection and promote a healthy lifestyle. 4

6 2018 Prevention Programs/Outcomes Prevention programs identify risk factors and use strategies to modify attitudes and behaviors to reduce the chance of developing cancer. Prevention programs include: Saint Francis WellNow in 2018, 2,423 (43 percent) of Saint Francis health plan-covered employees participated in the WellNow wellness program. The program rewards covered members in making healthy lifestyle choices and provides education and support to make wellness a lifestyle. The program includes members participating in a health assessment, which involves answering questions about specific lifestyle habits, generating a risk level and health index score. Biometric screenings are offered, including cholesterol (total, HDL, LDL), triglycerides, cardiac risk, glucose, blood pressure, height, weight, BMI and waist measurement. Points are awarded to employees for participation in the member health assessment, biometric screening, tobacco cessation program (as applicable), preventive care compliance and program activities offered. Annual Health Zone Fitness and Wellness Expo hundreds of people (approximately 700) participated in various screenings and community education about wellness and prevention programs associated with Saint Francis, including screening mammography and lung cancer screening. American Cancer Society Resource Center at Saint Francis Cancer Center 320 patients received resources, including: Provided 73 patients information through National Cancer Information Center Provided 214 personal health manager packets 25 women attended a Look Good Feel Better session 96 women received a free wig 48 patients were provided 1,089 rides to and from treatment in the Road to Recovery program 7 patients received 44 nights of lodging through the hotel partners program 72 patients were connected to other community resources through the resource referral program 66 patients received a gift item (head covering, blanket, etc.) Clear Direction tobacco cessation program 13 participants completed the program with 100 percent success in quitting use of tobacco products Health Zone 33 participants in the adult weight loss program with 250 pounds of weight loss Shape Down pediatric/adolescent weight loss program had 30 participants with 44 pounds of weight loss 2018 Screening Programs/Outcomes Screening programs detect cancers at an early stage, improving rates of survival. Screenings in 2018 include: Lung Cancer Screening (Low-dose CT scans) 728 screenings completed (January November 2018), representing an increase of 30.7 percent from the previous year 7 positive diagnoses for lung cancer, all referred Saint Francis Breast Center 25,114 screening mammograms performed (January November 2018) 625 biopsies (January November 2018) 281 positive diagnoses for cancer (45.0 percent), all referred Oklahoma Project Woman 513 total mammograms performed (January November 2018) 580 procedures performed (January October 2018), which included 25 biopsies performed with three being positive for cancer, all referred Colon Cancer Screening (ifobt) In coordination with Community Care Insurance Company, 1,659 patients of Warren Clinic were identified as being 50 years or older without documentation of having had any type of colon cancer screening; 1,659 fecal occult blood test kits and instructions were mailed to these patients including a postage paid envelope in order to facilitate ease of return to SFH lab for processing; 604 have been returned as of early December, 2018 with 43 (7.1 percent) being positive with all results going back to the patients primary care physician. 5

7 2018 Annual Community Activities (Outreach) Annual Health Zone Fitness and Wellness Expo approximately 700 participants; breast cancer and lung cancer screening education and promotion Sanctuary Apostolic Evangelical Church Health Fair, Tulsa, OK 50 participants (breast cancer screening education and promotion) Celebrating the Art of Healing 120 participants; breast cancer screening education and promotion Saint Francis Glenpool new facility open house 2,000 participants; breast cancer and lung cancer screening education and promotion Union Public Schools Health Fair, Tulsa, OK 225 participants; breast cancer screening education and promotion, and genetic counseling services promotion American Cancer Society s Making Strides Against Breast Cancer walk 1,000 participants; breast cancer screening education and promotion Harvest Time Ministry Women s Conference, Tulsa, OK 75 participants; breast cancer screening education and promotion Cherokee Nation Pink Party Breast Cancer Awareness Event 567 participants; breast cancer screening education and promotion St. Benedict Catholic Church Health Fair, Broken Arrow, OK 50 participants; breast cancer screening education and promotion First Annual Oncology Patient Resource Fair held at Saint Francis Cancer Center on October 22, 2018, with 12 resource organizations/departments participating: Oxford Healthcare; Assistance in Healthcare; Life Senior Services; Family and Children s Services; Hospitality House; Wyndham Hotel; Brookdale Senior Living Community; Saint Francis Hospice; Saint Francis oncology dietitian; Saint Francis Cancer Center financial counselor; Saint Francis Oncology Rehabilitation; and Saint Francis Oncology social worker. The Saint Francis oncology nurse navigators touched more than 2,038 patients, helping address barriers to care and facilitate care coordination, education regarding disease and treatment. 17 head and neck cancer patients benefited from free dental services, including teeth extractions through Catholic Charities of the Diocese of Tulsa and Eastern Oklahoma Donated Dental Services in Educational Programs Provided for Oncology Nursing Personnel: Titrating chemotherapy drugs/epic updates IV program administration Hester Davis fall scale refresher Continuous bladder irrigation IV push drug dilution and administration Tracheostomy care/types Prevalon heel boots Blood administration vital signs policy update Glucometer renewals Car-T cell therapy Cytarabine-induced keratoconjunctivitis Cod antibodies and blood warm usage 6

8 2017 Adult Age years PRIMARY SITE MALE FEMALE TOTAL (%) STG 0 STG I STG II STG III STG IV NO AJCC STAGING SCHEME ORAL CAVITY AND PHARYNX (2.6%) DIGESTIVE SYSTEM (16.4%) RESPIRATORY SYSTEM (15.1%) BONES AND JOINTS (0.1%) SOFT TISSUE (0.5%) SKIN, EXCLUDING BASAL AND SQUAMOUS (4.8%) BREAST (22.2%) FEMALE GENITAL SYSTEM (3.1%) MALE GENITAL SYSTEM (9.4%) URINARY SYSTEM (6.5%) BRAIN AND OTHER NERVOUS SYSTEM (3.0%) ENDOCRINE SYSTEM (3.5%) LYMPHOMA (4.5%) MYELOMA (1.5%) LEUKEMIA (3.1%) MESOTHELIOMA (0.0%) MISCELLANEOUS (3.7%) Total 975 1,151 2,

9 2017 Pediatric Age at Diagnosis: 0-17 years PRIMARY SITE TOTAL (%) M F ANALYTIC STG 0 STG I STG II STG III STG IV NO AJCC STAGING SCHEME DIGESTIVE SYSTEM 2 (4.5%) BONES AND JOINTS 1 (2.3%) URINARY SYSTEM 2 (4.5%) EYE AND ORBIT 2 (4.5%) BRAIN AND OTHER NERVOUS SYSTEM 9 (20.5%) ENDOCRINE SYSTEM 2 (4.5%) LYMPHOMA 12 (27.3%) LEUKEMIA 12 (27.3%) MISCELLANEOUS 2 (4.5%) Total

10 County at Diagnosis 2017 COUNTY CASES PERCENT (%) Tulsa, OK 1, % Wagoner, OK % Creek, OK % Muskogee, OK % Rogers, OK % Mayes, OK % Okmulgee, OK % Cherokee, OK % County Unknown % Pittsburg, OK % Craig, OK % Delaware, OK % Mcintosh, OK % Washington, OK % Sequoyah, OK % Ottawa, OK % Osage, OK % Adair, OK % Haskell, OK % Pawnee, OK % Payne, OK % COUNTY CASES PERCENT (%) Hughes, OK % McCurtain, OK % Lincoln, OK % Atoka, OK % Noble, OK % Montgomery, KS % Pushmataha, OK % Benton, AR % Sebastian, AR % Canadian, OK % Choctaw, OK % Cleveland, OK % Passaic, NJ % Garvin, OK % Lycoming, PA % Marshall, OK % Pontotoc, OK % Seminole, OK % Harris, TX % Tarrant, TX % Total 2, % Latimer, OK % Nowata, OK % Okfuskee, OK % Kay, OK % Le Flore, OK % 9

11 2018 Summary Prevention and Screening Program Outcomes: Ongoing success of Saint Francis WellNow, the online wellness tool Saint Francis Health Zone: Zone Fit adult weight loss program 33 participants with 350 pounds total weight loss Health Zone ShapeDown children s weight loss program 30 participants with 44 pounds total weight loss Tobacco cessation program 13 participants, 100 percent success in quitting use of tobacco products Lung screenings 799 performed; seven cancer diagnoses, all referred for treatment Oklahoma Project Woman breast screenings Saint Francis Breast Center performed 513 mammograms and Saint Francis Broken Arrow performed 12 mammograms at no cost to the patients Saint Francis Breast Center diagnosed 281 patients with breast cancer, all referred for treatment 10

12 Mission To extend the presence and healing ministry of Christ in all we do Vision Saint Francis Health System will be the leading integrated Catholic healthcare system providing high quality, comprehensive and innovative care across our regional continuum of services. Values Excellence Promoting high standards of service and performance Dignity Respecting each person as an inherently valuable member of the human community and as a unique expression of life Justice Advocating for systems and structures that are attuned to the needs of the vulnerable and disadvantaged and that promote a sense of community among all persons Integrity Encouraging honesty, consistency and predictability in all relationships Stewardship Ensuring prudent use of talents and resources in a collaborative manner 11

Annual Report Saint Francis Cancer Center

Annual Report Saint Francis Cancer Center Annual Report 2017 Saint Francis Cancer Center Since 1975, the cancer program at Saint Francis Health System has provided state-of-the-art medical oncology and radiotherapy technology to residents in eastern