La Porte Hospital Commission on Cancer Report for 2018 4.1 Cancer Prevention Program 4.5 Quality Improvement Measure 4.8 Quality Improvements 11/1/2018 1
4.1 HPV Education and Awareness Cancer Prevention Program The CDC reports, HPV cases are not formally reported in the U.S., but available data shows at least 75 percent of the reproductive age population have been exposed to HPV. 81% of new HPV associated cancer cases diagnosed each year could be prevented by HPV vaccination (CDC). Nationwide only 6 out of 10 parents are choosing HPV vaccines for their children. Per the CDC as of 8/25/17, National coverage of adolescent boys and girls who have received one or more HPV vaccines is only 60% Per the CDC as of 8/25/17, Indiana coverage of adolescent boys and girls who have received one or more HPV vaccines is 49% or less. The CDC reports that 7 states have HPV coverage of 49% or less; 16 states have HPV coverage of 50% to 59%; 21 states have HPV coverage of 60% to 69%; and 7 states have HPV coverage of 70% or greater. Most cervical cancer is caused by HPV. The virus has also been linked to cancers of the vulva, vagina, penis, anus, and throat. 2
National Cancer Institute, Center for Disease Control and Prevention, along with the American Cancer Society updated its human papillomavirus (HPV) vaccination guideline, supporting a two-dose schedule for boys and girls who initiate the vaccine at ages 9 to 14. CDC updated guideline, same as Advisory Committee on Immunization Practices (ACIP) recommendation: 2 doses of HPV vaccine for children starting series before their 15th birthday Giving the second dose 6 to 12 months after the first dose 3 doses for those starting the series from ages 15 to 26 Starting at age 11 or 12 for best results and convenience 3
Steps Taken To Raise HPV Education And Awareness 3-4-18 First International HPV Awareness Day 3-5-18 La Porte Hospital collaborated with the American Cancer Society, Indiana Immunization Coalition, and Purdue NorthWest Campus in Westville for a public viewing of the award-winning documentary Someone You Love: The HPV Epidemic Participants: Local School Nurses, Physicians, Nurses, Nursing Students, and Community Residents Advertised through LP Hospital Facebook, Marque at PNW, LP Community School Corporation community event page, and ACS web page 34 in attendance (32 females and 2 males) Pre and Post surveys given Packets given to each participant contained: HPV Cancer & Prevention Profile, HPV VACS Just the Facts, Take a Shot at Cancer, and Cervical Cancer Fact Sheet. 3-16-18 Dr. Ashley Kirkwood was interviewed by a reporter from the NWI Times regarding HPV vaccinations. An article entitled Northwest Indiana Hospitals, clinics aim to increase HPV vaccination rates was published in the NWI Times. 4
5/22/18 and 5/23/18 Biology teacher at La Porte High School showed the award-winning documentary Someone You Love: The HPV Epidemic (70 students viewed the film). 8/15/18 Slicer Health Clinic opened at La Porte High School via a grant through Healthcare Foundation of La Porte and collaboration with La Porte Hospital FNP, Elisa Bergquist. This clinic will allow students to be seen before, during, or after school for sickness, physicals, and immunizations. 9/12/18 Collaboration with Patient Navigators from La Porte Physician Network in regards to HPV vaccination rates. 10/31/18 Collaborated with Carolyn Snyder, Executive Director of Indiana Association of School Nurses to promote HPV education and awareness. Guidelines used for HPV Prevention: American Cancer Society (ACS), Center for Disease Control (CDC), American College of Pediatrics, and Advisory Committee on Immunization Practices (ACIP) 5
La Porte Hospital Cancer Program went through a rigorous survey process with the Commission on Cancer (CoC) on June 29, 2018. La Porte Hospital was awarded a three year certificate of accreditation with Silver-Level Commendation by the Commission on Cancer (CoC) on August 3, 2018, affirming that our community has an exceptional cancer program. All cancer programs accredited with the CoC participates in the Cancer Programs Practice Profile Reports (CP³R) provided by the National Cancer Data Base (NCDB). The CP³R offers local providers comparative information to assess consideration and adherence to standards of care for bladder, breast, cervix, colon, endometrium, gastric, kidney, lung, ovary and rectal cancers. 6
Figure 1 encompasses Standard 4.5 and shows performance rates from years 2014 and 2015 comparing La Porte Hospital, Indiana hospitals, and all hospitals approved by the CoC. La Porte Hospital has exceeded the set performance rate of 85% for the quality improvement measure, At least 12 regional lymph nodes are removed and pathologically examined for resected colon cancer. Figure 2 encompasses an accountability measure and shows performance rates from years 2014 and 2015 comparing La Porte Hospital, Indiana hospitals, and all hospitals approved by the CoC. The Commission on Cancer has not set forth a benchmark on this accountability measure. La Porte Hospital s performance rates are 100% for 2014 and 2015 for accountability measure, Adjuvant chemotherapy is recommended, or administered within 4 months (120 days) of diagnosis for patients under the age of 80 with AJCC Stage III (lymph node positive) colon cancer. 7
4.5 Quality Improvement Measures- Colon 2014 and 2015 8
Accountability Measure-Colon 2014 and 2015 9
4.8 Quality Improvements 8/15/18 Slicer Health Clinic opened at La Porte High School via a grant through Healthcare Foundation of La Porte and collaboration with La Porte Hospital FNP, Elisa Bergquist. This clinic allows students to be seen before, during, or after school for sickness, physicals, and immunizations. Radiation Nurse and Oncology Nurse Navigator changed the process of identifying high risk patients before treatment initiates and are working collaboratively to review: disease site, stage, comorbidity score, socioeconomic issues, transportation issues, mood disorders, evaluation of support system, and being proactive in preventing missed radiation therapy treatments. Chester Wilson, MD Cancer Committee Chairperson Radiation Oncologist 10