QUALITY OF CARE AND SURVIVORSHIP ISSUES
Two of the most pressing cancer-related issues to be addressed through the NCCCP are the quality of cancer care and addressing the needs of cancer survivors.
Quality of Care Resources
For Professionals
Physician Data Query
NCI developed the Physician Data Query (PDQ) to make the most current, credible, and accurate cancer information available to health professionals and the public. PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care.
http://www.cancer.gov/pdq
Public/Private Partnership Efforts
NCI has been working in partnership with initiatives sponsored by the American College of Surgeons (ACoS) and participating in American Society of Clinical Oncology (ASCO) to enhance quality of cancer care at both the hospital-based and oncology practice levels. NCI is considering building on these collaborations with both ACoS and ASCO to assess quality-of-care through review of pilot site enhanced infrastructure for quality improvement, the increased utilization of evidence-based guidelines, and review of selected quality indicators as reported to the American College of Surgeons' Commission on Cancer (CoC), the capability and results of multidisciplinary coordination of care, patient satisfaction results compared over the pilot, and consideration of an optional study involving pilot site physician participation in the ASCO Quality Oncology Practice Initiative (QOPI).
American Society of Clinical Oncology (ASCO)
The American Society of Clinical Oncology's Quality Oncology Practice Initiative (QOPI) is an oncologist-led, practice-based quality improvement initiative. Its goal is to promote excellence in cancer care by helping practices create a culture of self-examination and improvement. QOPI includes a set of quality measures, a specified chart selection strategy, a secure system for data entry, automated data analysis and reporting, and a network of resources for improvement. Currently, more than 250 oncology practices are registered for QOPI.
www.asco.org/qopi
American College of Surgeons (ACoS)
Electronic Quality Improvement Packets (e-QuIP) for Breast and Colorectal Cancer:
The Cancer Program Practice Profile Reports (CP3R) Stage III colon cancer project has demonstrated that improvements in data quality and patient care are possible when the entire multidisciplinary cancer committee supports system level enhancements to ensure complete and precise documentation. To continue on this success, the Commission on Cancer (CoC) is moving forward with providing additional levels of data feedback to our programs to:
- Improve the quality of data across several disease sites
- Foster preemptive awareness to the importance of charting and coding accuracy
- Improve clinical management and coordination of patient care in the multidisciplinary setting.
The Commission on Cancer (CoC) has released an electronic Quality Improvement Packet (e-QuIP) for breast and colorectal cancer to each approved program. These Web-based applications provide individual-level case summary reports for breast and colorectal cancers diagnosed in 2003 and 2004, as transmitted to the NCDB by each CoC-Approved program cancer registry. These packets are designed to allow facilities to review and address data completeness in preparation for the release of future CP3R initiatives that measure concordance with standard of care guidelines.
In addition, this and future e-QuIPs, are designed to specifically promote quality improvement activities that can assist facilities in the fulfillment of the CoC Approvals Standards requirements:
- 2.11, analysis of diagnostic and treatment modalities
- 8.1, complete and document studies that measure quality and outcomes
- 8.2, documented implementation of two improvements that directly affect cancer patient care.
e-QuIP Measures
The e-QuIPs are directed toward assessing data completeness for breast and colorectal cancer patients recorded in each cancer program's registry. The e-QuIP provides a case-by-case review of cases reported to the NCDB and identifies cases that lend themselves to the future evaluation of concordance for various breast and colorectal cancer measures.
The standard of care measures for breast and colon disease are now posted on the ACoS Web site at: http://www.facs.org/cancer/qualitymeasures.html.
The measures are also on the Web sites of the American Society of Clinical Oncology (ASCO) (http://www.asco.org/qualitymeasures) and National Comprehensive Cancer Network (NCCN) (http://www.nccn.org/).
Survivorship Resources
NCI's Office of Cancer Survivorship (OCS) seeks to enhance the quality and length of survival of all persons diagnosed with cancer and to minimize or stabilize adverse effects experienced during cancer survivorship. The Office maintains a comprehensive Web site of resources and funding opportunities. OCS promotes the dissemination of information to professionals who treat cancer patients, and the public concerning the problems and needs of cancer survivors and their families. The OCS Web site can be found at http://survivorship.cancer.gov.
For Professionals
From Cancer Patient to Cancer Survivor: Lost in Transition
This important Institute of Medicine report details what we know about the challenges faced by survivors as they finish active treatment and live long-term following a cancer history, the nature of the care they receive and the directions we need to take to improve both the quality of life and length of survival of this growing population.
http://www.iom.edu/?ID=30869
Journal of Clinical Oncology (Special Issue on Survivorship)
This special issue of the Journal of Clinical Oncology on Cancer Survivorship (volume 24, number 32, pages 5101-5169, November 10, 2006) contains 12 articles that review the challenges faced in providing optimal care for cancer survivors who are post-treatment for cancer.
Living Beyond Cancer: Finding a New Balance
This President's Cancer Panel's 2003/2004 annual report provides a national perspective on survivorship issues experienced across different age groups and from patients' as well as their caregivers' and healthcare providers' testimony.
http://deainfo.nci.nih.gov/ADVISORY/pcp/pcp03-04rpt/Survivorship.pdf
Information on Follow-up Care After Cancer Treatment
This Web-based Q & A fact sheet for patients/providers is available at http://www.cancer.gov/cancertopics/factsheet/Therapy/followup.
PDQ Cancer Information Summaries
PDQ Cancer information summaries on palliative care issues patients may face during and after their cancer treatment may be found at http://www.cancer.gov/cancertopics/pdq/supportivecare.
Education in Palliative and End-of-life Care for Oncology (EPEC™-O)
This CD-ROM contains a comprehensive curriculum in palliative and end-of-life care developed specifically for clinicians caring for persons with cancer.
http://www.cancer.gov/aboutnci/epeco
For Patients
NCI has developed a variety of educational materials for cancer survivors, their families, and caregivers. Some materials of particular note are described below. All materials can be accessed directly through the NCI Web site, http://www.cancer.gov, or ordered through NCI's Cancer Information Service at
Moving Beyond Breast Cancer DVD and VHS (with closed captioning)
Facing Forward: Life After Cancer Treatment (English and Spanish)
Ways You Can Make a Difference in Cancer
