2016 ANNUAL REPORT. A Comprehensive Community Cancer Program (CCCP) American College of Surgeons Commission on Cancer

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1 2016 ANNUAL REPORT Olympic Medical Cancer Center 844 N. 5th Avenue, Sequim, WA Olympic Medical Center 939 Caroline Street, Port Angeles, WA A Comprehensive Community Cancer Program (CCCP) American College of Surgeons Commission on Cancer

2 INTRODUCTION In This Report 4 OMC Cancer Committee 5 Survivorship Care Plans 6 Hospice Study 6 Prostate Cancer and Bone Health Study Cancer Conference and Tumor Board A tumor board conference is a multidisciplinary team of medical specialists that discuss patient cases to decide on the best course of treatment. This is designed to share each team member s expertise in their area and recommend the optimal treatment for each specific patient. Brief history, diagnostic imaging, and pathology slide reviews are accomplished twice monthly throughout the year. In 2016, 87 cases were presented, representing 15% of OMC analytical cases. 22 of 24 scheduled tumor boards occurred. 7 Patient Navigation Program Site Table 10 Recommended Screenings for Adults 11 OMC Comparison to Washington State & the US OMC Top 10 Most Common Cancers 2016 The OMC tumor board team consists of: Medical Oncology Radiation Oncology Oncology Nursing Radiation Oncology Nursing Administration Patient Navigation Nutrition Rehabilitation Surgery Diagnostic Imaging/Radiology Pathology Items discussed during case review include: Stage Use of NCCN Guidelines in Treatment Planning Clinical Trials Palliative Care Genetic Testing Psychosocial Care Rehabilitation Services Nutrition 2

3 LETTER FROM THE CHAIR Dear Colleagues, Staff, and Community Members On behalf of The Cancer Committee of Olympic Medical Center (OMC), I am proud to submit our 2016 Annual Report. The data contained in this report reflect information obtained from the diagnosis and treatment of patients seen at OMC. The oncology program is dedicated to providing comprehensive, multi-faceted treatment to the communities of the Olympic Peninsula ensuring that patients do not have to travel into Seattle in order to receive state-of-the-art therapies in cancer care. In 2016, there were 525 new cases submitted to the State of Washington for the OMC cancer registry. These cases were diagnosed and/or treated with curative intent at OMC. From a statistical standpoint, OMC found a slightly higher rate of lung and bladder cancer than that of both Washington State and the nation as a whole. The rates for breast and prostate are similar to that of Washington State, but higher for prostate when compared to the US. Regarding colorectal cancers, OMC is lower than the state, and only marginally higher than the nation. The annual accreditation survey for the American College of Surgeons Commission on Cancer was accomplished in 2016, in which OMC received a three-year accreditation approval with contingency. The Cancer Committee has met on a quarterly basis in order to address all ACoS Cancer Program Standards to assure full compliance for the year We have added several new pieces of equipment in radiation oncology including a radiological treatment positioning unit and fiber optic head and neck imaging nasopharyngolaryngoscope. OMC staff completed several quality improvements and clinical educational courses, securing the promise of the highest level of care for our patients. On behalf of the Cancer Committee, our sincere thanks go out to the skilled and compassionate staff and physicians at OMC who have provided outstanding care this year. Matthew Levy, MD Cancer Committee Chair 3

4 CANCER COMMITTEE The Olympic Medical Center (OMC) Cancer Committee is a multidisciplinary collection of healthcare professionals and administrators that are responsible for the development and coordination of the cancer program at OMC. OMC is voluntarily accredited and monitored through the American College of Surgeons Commission on Cancer (ACoS CoC), a medical organization that establishes national standards to ensure cancer patients are afforded full access to state-of-the-art diagnosis, treatment, rehabilitation, and support during their journey with cancer. OMC must adhere to the standards set forth in the CoC Program Standards, currently the 2016 edition. The mission of the CoC is to improve the survival and the quality of life for cancer patients through those standards. Meetings are held quarterly in Port Angeles, Washington and 75% attendance is expected from each member. OMC last had an accreditation survey in July of 2016 in which OMC received a three-year accreditation approval with contingency. Items Addressed by CoC Standards Monitoring program activity Evaluating patient outcomes/comparison to state and national statistics Improving cancer patient care Programmatic and clinical goals Screening and prevention programs Professional staff education Quality improvements Standards for healthcare professionals Strategic planning 2016 OMC Cancer Committee Members Name, Title and Department Position on Cancer Committee Thomas Kummet, MD, Medical Oncology Cancer Committee Chair, January to mid-august 2016 Matthew Levy, MD, General Surgery Cancer Committee Chair, mid- August to December 2016 Sandra Tatro, MD, General Surgery Cancer Liaison Physician Sue Kinney, CTR, Cancer Registry Cancer Registry Quality Coordinator Michael Fishman, MD, Diagnostic Imaging Diagnostic Radiology Alfonso Masangkay, MD, Pathology Pathology Patrick Jewell, MD, Radiation Oncology Radiation Oncology Deborah Turner, PA-C, Medical Oncology Medical Oncology Stacie Neff, MPH, Quality Management Quality Management Byron Russell, MD, Urology/Surgery Designated Alternate Chair Ken Berkes, MSPT, Director, Cancer Center Cancer Program Administrator / Community Outreach Coordinator Betsi Thompson, Director, Quality Management Quality Improvement Coordinator Vicki Everett, RD CDE, Supervisor, Nutritional Counseling Nutrition Services Kay C. Hobbs, RN, AOCN, Supervisor Medical Oncology Nursing Medical Oncology Nursing / Clinical Research Coordinator Susan Clements, LICSW, Patient Navigation Psychosocial Services Coordinator Karen Rushby, Physical Therapy/Rehabilitation Physical & Rehabilitation Services Tatyana Buzdnitskaya, RN, Radiation Oncology Radiation Oncology Nursing Sheryl Greer, CTR Cancer Registry R. Scott Kennedy, MD Administration Marcia Limoges, RN, BSN, OCN Medical Oncology Nursing 4

5 SURVIVORSHIP CARE PLANS Survivorship Care Plans In 2012, the American College of Surgeons Commission on Cancer developed Standard 3.3, Survivorship Care Plans (SCPs) and their intent to fully implement SCPs over the coming years for accredited facilities. Standard 3.3 states, Cancer programs must develop and implement processes to monitor the formation and dissemination of a SCP for analytic cases with Stage I, II, or III cancers that are treated with curative intent for initial cancer occurrence and who have completed active therapy. In 2016, 25% of patients were expected to have a SCP completed, and by the end of 2017, accredited facilities are expected to meet a 50% compliance rate for all patients who have completed curative treatment. Olympic Medical Center was compliant in delivering Survivorship Care Plans to its patients that completed curative treatment. SCPs are designed to provide patients with a synopsis of their diagnosis and treatment of their cancer. It provides patients with the following items: Diagnosis specifics including histopathology and stage Results of genetic testing if conducted Dates, modalities, and locations of surgical procedures Dates and types of chemotherapy, including potential ongoing toxicity Dates, modalities, location, and dosage of radiation therapy Dates and types of hormonal therapy Dates and types of biological response modifiers Potential long-term side effects of any treatment given Follow-up care plans Oncology team member contact information Location of treatment facilities Need for adjuvant therapy including duration of treatment and potential side effects Schedule of clinical follow up including who will provide services Recommendation of cancer surveillance testing for recurrence The SCPs must be presented to the patient in person and in a timely manner after completion of curative treatment. Olympic Medical Center utilizes registered nurses to compile and present the Survivorship Care Plans to patients. In 2016, OMC far exceeded the benchmark of 25% SCPs delivered to patients. 5

6 2016 STUDIES Hospice Study In 2014, a study was done by Thomas Kummet, MD, to assess if hospice programs do in fact reduce the number of in-hospital deaths. Of 253 patients who died while receiving cancer care at Olympic Medical Center facilities, 97 deaths occurred in patients that were not referred to hospice. Of the 97 non-referred patients, 41 died in the hospital. 156 patients were referred to hospice, and only 10 of those referred patients died in the hospital. An educational summary was compiled utilizing the 2014 Hospice Study data and ed to OMC providers. Of the +/- 95 providers, 15 responses were received. The responses were compiled and presented to the cancer committee as potential roadblocks to the effective utilization of local hospice agencies. Prostate Cancer and Bone Health Study In 2015 the Cancer Committee completed a study to assess the rate at which men on hormone therapy for prostate cancer have their bone density assessed and therapeutic interventions applied. This study looked at 93 prostate cancer patients (of all stages and any therapy) diagnosed between January 1, 2013 and December 31, 2014, at Olympic Medical Center and looked for evidence of bone density testing. The results showed that not a single man with prostate cancer during calendar years 2013 or 2014 had a bone density test done in the Olympic Medical Center system. For advanced and metastatic prostate cancer, androgen deprivation therapy (ADT) is the mainstay of treatment. Awareness of the potential bone-health complications consequent to ADT use is increasing. Bone health and maintenance of bone integrity are important components of comprehensive cancer care. Many of the therapies used for the treatment of prostate cancer are associated with bone density loss, which in turn leads to an increased risk of fracture. An educational summary was compiled utilizing the 2015 Prostate Cancer and Bone Health Study and ed to OMC providers. Of the +/-95 providers, 14 responses were received. A subsequent evaluation will be completed to review the use of bone density testing in men with prostate cancer undergoing androgen deprivation therapy. 6

7 PATIENT SUPPORT Patient Navigation Program The Patient Navigator program works with patients in an effort to provide peripheral support for optimal treatment outcomes through: Patient Navigator Fund services Nutrition supplements for those patients who have limited access to adequate nutrition throughout the course of treatment Transportation assistance for those patients who have difficulty with cost or accessibility to treatment Oral chemotherapy copay assistance Volunteer services and dog therapy Support groups and integrative therapy modalities In this upcoming year, the Patient Navigator program is working toward bolstering even more integrative programs to offer our patients and their families the best treatment experience possible. Our Patient Navigator program works with: American Cancer Society Catholic Community Services Kathleen Sutton Fund Seattle Cancer Care Alliance Seattle Cancer Lifeline Mad Hatters Relay for Life Harmony Hill Olympic Medical Center Foundation Clallam Jefferson Fund We worked with numerous other community partners and hospitals as well. Architectural Rendering of a Proposed Cancer Center Expansion 7

8 2016 Site Table 2016 SITE TABLE Stage Stage Stage Stage Stage Total 0 I II III IV 88 Unk Blank Tongue Salivary Glands Floor of Mouth Gum & Other Mouth Tonsil Esophagus Stomach Small Intestine Colon Excluding Rectum Rectum & Rectosigmoid Anus, Anal Canal & Anorectum Liver & Intrahepatic Bile Duct Gallbladder Other Biliary Pancreas Other Digestive Organs Nose, Nasal Cavity & Middle Ear Larynx Lung & Bronchus Bones & Joints Soft Tissue (including Heart) Melanoma -- Skin Other Non-Epithelial Skin Breast

9 Stage Stage Stage Stage Stage Total 0 I II III IV 88 Unk Blank Cervix Uteri Corpus & Uterus, NOS Ovary Vulva Other Female Genital Organs Prostate Testis Urinary Bladder Kidney & Renal Pelvis Ureter Other Urinary Organs Brain Cranial Nerves/Other Nervous System Thyroid Other Endocrine including Thymus Hodgkin Lymphoma Non-Hodgkin Lymphoma Myeloma Lymphocytic Leukemia Myeloid & Monocytic Leukemia Other Leukemia Mesothelioma Miscellaneous TOTAL

10 CANCER SCREENINGS Recommended Screenings for Adults Test Type of Cancer Gender Age Frequency Colon M & F 50+ Every 10 years CT Every 5 years Every 5 years Colonoscopy or CT Colonography or Sigmoidoscopy Fecal occult blood test Colon M & F 50+ Annually PSA Prostate M 50+ Annually Pap/Pelvic Pap/HPV Cervical, Uterine, Ovarian F Annually or for any sexually active woman Every 5 years Clinical breast exam Breast F Mammogram Breast F Every 3 years Annually Baseline Annually Every 2 years 10

11 INCIDENCE RATES OMC Comparison to Washington State & The US 2016 Site Olympic Medical Center 252 total Percent Total Case of Total Washington State 377,770 estimated total Percent Total Cases of Total United States 1,685,210 estimated total Percent Total Cases of Total Lung % 4, % 224, % Breast % 5, % 249, % Prostate % 4, % 180, % Bladder % 1, % 76, % Colorectal % 2, % 95, % Rounded to the nearest 1/10. Washington State and US estimated numbers based on American Cancer Society Cancer Facts & Figures OMC data based on OMC cancer registry data OMC Top 10 Most Common Cancers 2016 Type # of Cases Lung & Bronchus 81 Breast 79 Prostate 67 Urinary Bladder 34 Colon Excluding Rectum 31 Miscellaneous 25 Non-Hodgkin Lymphoma 22 Corpus & Uterus, NOS 17 Cranial Nerves / Other Nervous System 13 Myeloid & Monocytic Leukemia 12 11

12 By demonstrating compliance with national standards for health care quality and safety, Olympic Medical Center has earned DNV Healthcare accreditation. Olympic Medical Cancer Center is voluntarily accredited by the American College of Surgeons Commission on Cancer Standards as a Community Cancer Program. NETWORK MEMBER Our affiliation with the Seattle Cancer Care Alliance provides local patients access to leading edge therapies. 844 N. 5th Avenue Sequim, WA

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