Einstein. Medical Center Montgomery Cancer Care Program 2014 Annual Report With Statistical Data From Einstein

Transcription

1 Einstein Medical Center Montgomery Cancer Care Program 214 Annual Report With Statistical Data From 213 Einstein

2 A Message from the Einstein Medical Center Montgomery Cancer Committee Chair As chair of the Cancer Committee, I have the privilege of working with the entire committee membership, representing a wide variety of clinical and ancillary services responsible for providing care for our patients. This committee is instrumental in our continual efforts to provide multidisciplinary patient-centered care at the highest level. The committee meets bi-monthly and participates in a variety of different activities, such as setting annual clinical and programmatic cancer goals, reviewing screening and educational outreach activities, and providing oversight of data managed by the oncology tumor registry team. For our program, 212 was a momentous year, with the opening of Einstein Medical Center Montgomery. 213 brought continued growth for the oncology program, as 515 analytic cases were entered in our registry in the calendar year. We continue to incorporate best practices into the treatment planning of our patients by utilizing national cancer care guidelines, and identify available clinical trials that are the most beneficial for the patients seen at Einstein Medical Center Montgomery. We are also very proud of the resources we provide to assist patients dealing with cancer. Our team of nurse navigators provides support and guidance to patients throughout the care continuum. Einstein Medical Center Montgomery s partnerships with community organizations continues to flourish and provides additional resources to patients, as evidenced by collaborations with the American Cancer Society, Unite for Her and the Young Survival Coalition Program. The above is simply a brief highlight of some of the great work being accomplished to support our mission and help our patients, as we continue the fight against cancer. On behalf of the Cancer Committee and Oncology Program, I am proud to present the Einstein Medical Center Montgomery Cancer Care Program s 214 Annual Report. William Biermann, MD, MBA Cancer Committee Chairman Chief of Medical Oncology Einstein Medical Center Montgomery 1

3 Community Outreach, Education and Prevention The oncology program at Einstein Medical Center Montgomery participates in a variety of outreach, education and prevention programs for patients, families, caregivers and the general public. OUTREACH, EDUCATION AND PREVENTION EVENTS Program & Description Participants Breast Cancer Education 35 Provided instruction on Breast Self-Exam and distributed American Cancer Society (ACS) pamphlets highlighting screening recommendations. Breast Cancer Support Group 69 Open-ended, mutual self-help/support group for all breast cancer survivors Colorectal Education 25 Distributed self- administered stool for occult blood testing kits, along with ACS pamphlets: They know how to prevent colon cancer and you can, too. General Cancer Support Group 7 Open-ended mutual self-help/support group for patients and/or family members experiencing cancer. Health and Wellness Expo at Montgomery County Community College 2 Health and wellness fair presented by the Health Sciences students at Montgomery Community College and Einstein Medical Center Montgomery, highlighting areas of prevention and screening for cancer, as well as other common health issues. Look Good Feel Better 8 Makeup and wig program for women undergoing chemotherapy sponsored by American Cancer Society, Cosmetics Toiletries and Fragrance Association, and the Cosmetology Association, providing interactive instruction in applying makeup and ways to use wigs and scarves. Lung Cancer Screening Information 7 Distributed and discussed new guidelines for lung cancer screening, including Low Dose CT screening program being offered at Einstein Medical Center Montgomery. Prostate Cancer Education 25 Distributed ACS materials about prostate cancer and screening guidelines. Freedom From Smoking Smoking Cessation 77 Smoking cessation program sponsored by Einstein Medical Center Montgomery and the American Lung Association Program, Freedom From Smoking features a step-by-step program for quitting smoking. Unite For Her Wellness Day 29 A day of complementary therapies for women undergoing breast cancer treatment to learn ways to manage side effects and symptoms, and become fully restored. 2

4 Cancer Committee: A Multidisciplinary Team Einstein Medical Center Montgomery s Cancer Committee is comprised of a wide variety of clinical and ancillary services responsible for providing care for our patients, including: Outpatient Medical Oncology and Hematology The board-certified physicians, nurse practitioner and nurses that staff Outpatient Medical Oncology and Hematology provide services five days a week and see approximately 525 patient visits per month. Through the accessibility of novel biological agents, we have expanded our armamentarium of treatments, which have improved response rates of chemotherapy without adding any more toxicity or negatively impacting quality of life. The Outpatient Medical Oncology and Hematology service continues to provide state-of-the-art therapy in a friendly setting at Einstein Medical Center Montgomery, while having the ability to provide more innovative experimental therapy via collaboration with Einstein Medical Center Philadelphia. Inpatient Medical Oncology 3 West 3 West is a 24-bed unit specializing in the care of stable ventilator patients, as well as oncology, chemo-therapy and hospice patients. Ninety-eight percent of the RNs on 3 West have their Bachelor s degrees in nursing, while the remaining two percent are in the process of receiving their degrees. Since opening in September 212, the staff on 3 West has partnered with the Hospice and Palliative Care Team for in-depth training and daily rounding on shared patients. This enables the patients on 3 West to receive collaborative care that encompasses all aspects of their needs and enhances their experience. Additionally, 3 West has partnered with our outpatient oncology group, as both a resource for education and a continuation of care for our patients who have been seen in the outpatient setting, but require hospitalization. The Oncology Nurse Navigators are available to both patients and staff, as they assist in bridging care from the outpatient to inpatient setting. Through these multidisciplinary partnerships, 3 West is able to provide the best care possible for our patients throughout all phases of their illness. Radiation Oncology The Radiation Oncology Department provides personalized services for the treatment of cancer and benign diseases. Cutting-edge technologies, such as 3D conformal external beam therapy; IMRT (Intensity Modulated Radiation Therapy) for areas such as prostate, head and neck cancers, and brain tumors; and stereotactic body radiation therapy are utilized to deliver optimal patient care. Our radiation oncologists use advanced radiation treatment planning techniques to tailor the radiation treatment program to the individual patient. These treatment and planning techniques are customized for each patient to maximize the chance for controlling the tumor while minimizing the risk of side effects. In addition, our radiation oncologists are actively involved in clinical trials that give patients access to the newest and most advanced breast cancer treatments available. In preparation for these cancer treatments, the Radiation Oncology CT scanner with 4D capabilities is utilized to monitor respiratory motion and to minimize dose to normal surrounding tissue. Additional treatment options available through the Einstein Healthcare Network include: High Dose Rate (HDR) radiotherapy for gynecological malignancies and Stereotactic Radiosurgery (SRS) for brain tumors. Breast Health The Breast Health Program at Einstein Medical Center Montgomery is home to one of the most highlyregarded breast health teams in the region, featuring distinguished breast surgery specialists and the region s top radiologists. The program is recognized for delivering a high level of care and life-saving 3

5 Cancer Committee: A Multidisciplinary Team continued treatment options through individualized services and advanced technologies. It is the program s emphasis on personal relationships and the latest techniques/technologies, including digital mammography and minimally invasive biopsies, which make EMCM s Women s Center a destination for breast health care. Breast Imaging Designated as a Breast Imaging Center of Excellence (BICOE) by the American College of Radiology (ACR) and accredited by the American College of Radiology, according to the Mammography Quality Standards Act, Einstein Medical Center Montgomery offers advanced breast imaging technologies, including: digital mammography (digital breast tomosynthesis), ultrasound, magnetic resonance imaging (MRI) and all interventional breast procedures. Digital breast tomosynthesis, the new 3D imaging technology, takes multiple low-dose images at different angles and displays them in thin multiple layers allowing our radiologists to look at smaller areas and see through breast tissue better than a 2D mammogram. Tomosynthesis reduces the number of false-positive results and the need to come back for further testing. The radiology breast team participates in research trials that are designed to enhance their diagnostic skills at finding and diagnosing breast abnormalities. Interventional Radiology Our Interventional Radiology team utilizes the most advanced technology available to perform image-guided procedures to treat a wide variety of diseases throughout the body, including cancer. Interventional Radiology treatments minimize risk, require little to no incisions, are generally performed with sedation rather than general anesthesia, and more importantly, have less pain and recovery time than conventional surgery. Hospice Einstein Medical Center Montgomery s Hospice Program is a community-centered healthcare program for individuals who are in the last phases of terminal illness and who elect not to pursue curative treatments. The hospice staff provides outpatient service to patients in their home, assisted living facilities and nursing homes. The focus of care is on pain and symptom management, psychosocial support for the patient and family, counseling for caregivers and spiritual support. Under the direction of the patient s physician, and in conjunction with our hospice medical directors, our hospice team which consists of the medical director, hospice manager, hospice RNs, home health aides, social workers, chaplain and volunteers works together to follow a personalized plan of physical, emotional and spiritual care, designed to meet the changing needs of both the patient and their family. For patients whose pain or symptoms are unable to be controlled in the home setting, short-term inpatient hospice may be an option. Our inpatient hospice service is designed to meet the needs of the terminally ill patient and their family. Hospice care is not limited to oncology, but approximately 3% of hospice patients are cancer patients. Palliative Care Our Palliative Care program is designed to meet the needs of patients who have complex pain or symptoms, but are not on hospice care. A team of professionals consult on medically complex patients to achieve symptom management, discuss advance directives and provide a holistic approach to the patient experience. Einstein Medical Center Montgomery s Home Health, Hospice and Palliative Care Program is the only agency in the region to have each Medical Director nationally certified in hospice and palliative medicine. Additionally, 3% of the nursing staff has achieved advanced certification in hospice and palliative care nursing. This high level of expertise contributes to the overall exceptional patient satisfaction ratings for the program. 4

6 Cancer Registry Summary Cancer registry is an integral part of the Einstein Medical Center Montgomery Cancer Care Program. The registry is an information system that monitors each type of cancer diagnosed and/or treated at our facility. The primary function is to provide continuum data management services under the support and leadership of the Cancer Committee. The cancer registrar collects and documents demographic information, pathological and diagnostic testing results, treatment information and follow-up data. This is done in accordance with the requirements of the following regulatory agencies: The Department of Public Health, Pennsylvania Cancer Registry, The SEER Program of the National Cancer Institute (NCI), and the Commission on Cancer (CoC) of the American College of Surgeons (ACoS). The reference date for the Einstein Montgomery Medical Center cancer data base is January 1, 23. A total of 593 cases were entered into the data base in of these cases were analytic and 78 were non-analytic cases. There have been 3,855 cases accessioned in the registry since the reference date in 23. Active follow-up is maintained on approximately 1,842 patients with a target follow-up rate of 9%. Each case is followed annually to monitor diagnostic and treatment outcomes and to provide accurate data to calculate survival rates. The cancer registry data are reviewed for accuracy, timeliness and quality by a physician member of the cancer committee. Availability of the cancer data to the Cancer Committee, Hospital Administration and physicians facilitates evaluation of outcomes of treatment and assists in the assessment of the needs of the community. The cancer registrars participated in state and nationwide cancer registry educational activities throughout 213. As required, the Einstein Medical Center Montgomery cancer registry submits data to the Pennsylvania State Cancer Registry. The state registry is a population-based registry and is a member of the Surveillance, Epidemiology and End Results Program of the National Cancer Institute. The American College of Surgeons, Commission on Cancer recognizes Einstein Medical Center Montgomery as an approved Community Hospital Cancer Program. NCDB Annual Call for Data was submitted this year, error free. Participation in NCDB Rapid Quality Reporting System (RQRS) provides information on compliance with NCCN guidelines for Breast and Colon cases, and enables registrars to add new treatment information as appropriate. A TOTAL OF 593 CASES were entered into the data base in 213 5

7 213 Top-Five Sites For Cancer TOP Sites for Einstein Medical Center Montgomery 213 Analytical and Non-Analytical 23% 6% 5% 42% 17% 7% KEY Colorectal Lung Breast Prostate Bladder All Other 6

8 213 Top-Five Sites with Stage at Diagnosis 213 Analytical Breast Cases Stage Stage I Stage II Stage III Stage IV Unk N/A Analytical Lung Cases Stage Stage I Stage II Stage III Stage IV Unk N/A 7

9 213 Top-Five Sites with Stage at Diagnosis continued Analytical Colorectal Cases 8 7 Stage Stage I Stage II Stage III Stage IV Unk N/A Analytical Bladder Cases Stage Stage I Stage II Stage III Stage IV Unk N/A 213 Analytical Prostate Cases Stage Stage I Stage II Stage III Stage IV Unk N/A 2 3 8

10 213 Primary Site Table Primary Site Total (%) Analytic Non-analytic ORAL CAVITY & PHARYNX 15 (2.5%) 12 3 Tongue 5 (.8%) 4 1 Salivary Glands 3 (.5%) 3 Floor of Mouth 2 (.3%) 2 Gum & Other Mouth 1 (.2%) 1 Tonsil 3 (.5%) 2 1 Oropharynx 1 (.2%) 1 DIGESTIVE SYSTEM 9 (15.2%) Esophagus 4 (.7%) 3 1 Stomach 13 (2.2%) 12 1 Small Intestine 1 (.2%) 1 COLON EXCLUDING RECTUM 32 (5.4%) 3 2 Cecum Appendix 2 2 Ascending Colon 8 8 Hepatic Flexure 1 1 Splenic Flexure 1 1 Descending Colon 3 3 Sigmoid Colon 6 6 Large Intestine, NOS RECTUM & RECTOSIGMOID 11 (1.9%) 9 2 Rectosigmoid Junction Rectum Anus, Anal Canal & Anorectum 1 (.2%) 1 LIVER & BILE DUCT 9 (1.5%) 5 4 Liver Intrahepatic Bile Duct 1 1 Gallbladder 1 (.2%) 1 Other Biliary 4 (.7%) 4 Pancreas 14 (2.4%) 11 3 RESPIRATORY SYSTEM 11 (17.1%) 9 11 Nose, Nasal Cavity & Middle Ear 1 (.2%) 1 Larynx 2 (.3%) 2 Lung & Bronchus 97 (16.4%) Trachea, Mediastinum & Other Res 1 (.2%) 1 SOFT TISSUE 2 (.3%) 1 1 Soft Tissue (including Heart) 2 (.3%) 1 1 SKIN EXCLUDING BASAL & SQUAMOUS 27 (4.6%) 26 1 Melanoma -- Skin 25 (4.2%) 25 Other Non-Epithelial Skin 2 (.3%) 1 1 BREAST 137 (23.2%) FEMALE GENITAL SYSTEM 2 (3.4%) 13 7 Corpus & Uterus, NOS 1 (1.7%) 9 1 Ovary 7 (1.2%) 2 5 Vulva 2 (.3%) 1 1 Other Female Genital Organs 1 (.2%) 1 MALE GENITAL SYSTEM 42 (7.1%) Prostate 37 (6.3%) Testis 4 (.7%) 4 Penis 1 (.2%) 1 URINARY SYSTEM 48 (8.1%) 41 7 Urinary Bladder 31 (5.3%) 3 1 Kidney & Renal Pelvis 14 (2.4%) 1 4 Ureter 3 (.5%) 1 2 BRAIN & OTHER NERVOUS SYSTEM 15 (2.5%) 15 Brain 6 (1.%) 6 Cranial Nerves Other Nervous System 9 (1.5%) 9 ENDOCRINE SYSTEM 2 (3.4%) 19 1 Thyroid 14 (2.4%) 13 1 Other Endocrine including Thymus 6 (1.%) 6 LYMPHOMA 19 (3.2%) 18 1 Hodgkin Lymphoma 4 (.7%) 4 Non-Hodgkin Lymphoma 15 (2.5%) 14 1 NHL - Nodal 7 7 NHL - Extranodal MYELOMA 6 (1.%) 5 1 LEUKEMIA 19 (3.2%) 13 6 Lymphocytic Leukemia 8 (1.4%) 5 3 Acute Lymphocytic Leukemia 1 1 Chronic Lymphocytic Leukemia Myeloid/Monocytic 1 (1.7%) 7 3 Acute Myeloid Leukemia 5 5 Acute Monocytic Leukemia 1 1 Chronic Myeloid Leukemia Other Leukemia 1 (.2%) 1 MESOTHELIOMA 4 (.7% 3 1 MISCELLANEOUS 26 (4.4%) 2 6 Total

11 214 Cancer Committee Membership Amber Bailey, BART (R)(T) Director, Radiation Oncology William Biermann, MD, MBA, FACP Chief, Medical Oncology Cancer Committee Chairman Shavon Boxman, MA CCC-SLP Speech Pathologist, Rehabilitation Linda Case, RHIT, CTR Certified Tumor Registrar Cancer Registry Quality Coordinator Joanne Cipollini, MSN, RN Oncology Nurse Navigator Community Outreach Coordinator Mary Galetti, RN, OCN Clinical Trials Supervisor Clinical Research Coordinator Julie Gubernick, MD, FACR Chief, Radiology Barb Heinzmann, RN, CBCN, BSN Nurse Navigator, Breast Health Program Doraid Jarrar, MD, FACS, FCCP Thoracic Surgeon, Surgery Co-Director, Lung Cancer Screening Program Ahashta Johnson, MD Palliative Care Physician, Home Health, Hospice and Palliative Care Kate Kortum Representative, American Cancer Society Jaclyn Ladden, PT, DPT, CLT-LANA Physical Therapist, Rehabilitation Briana Magill, RD, LDN Clinical Dietician, Nutrition Services Pat Modafferi, MHA Vice President, Health Care Services Cancer Conference Coordinator Mary Molnar, MBA Senior Director, Physician Liaison Services Monica Nash, RN, BSN Nurse Manager, 3 West Patricia Perosio, MD, FASCP, FCAP Pathologist, Department of Pathology Elton Richardson, LSW Social Worker, Care Management, Psychosocial Services Coordinator Robin Ryan, RN, MHA Director, Quality Management Quality Improvement Coordinator Marc Schaller, PT, DPT, MBA Director, Medical Oncology & Hematology, Cancer Program Administrator Robert Schiowitz, MD, FACS General Surgeon, Surgery Leah Sheppard, MS Senior Director, Corporate Marketing and Communications Jennifer Simmons, MD, FACS Chief, Breast Surgery Director, Breast Health Program Lawrence Solin, MD, FACR, FASTRO Chair, Radiation Oncology Ronit Sugar, MD, FACS Breast Surgeon, Breast Health Program Becky Sullivan, RN Director, Home Health, Hospice and Palliative Care 1

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