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1

Geiser, Clare. "Oncology at Center Stage." Oncology Issues 14, no. 4 (July 1999): 40. http://dx.doi.org/10.1080/10463356.1999.11904859.

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2

Cherney, Alison. "Marketing Your Radiation Oncology Center." Oncology Issues 20, no. 2 (March 2005): 30–31. http://dx.doi.org/10.1080/10463356.2005.11883246.

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3

Bosch, Xavier. "Spanish oncology center under threat." Nature Medicine 6, no. 8 (August 2000): 847. http://dx.doi.org/10.1038/78590.

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4

Cira, M., R. Abudu, D. Pyle, S. Akhavan, and K. Duncan. "A Snapshot of Global Oncology Programming at US Cancer Centers: Results of the 2018 US NCI/ASCO NCI-Designated Cancer Center Global Oncology Survey." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 220s. http://dx.doi.org/10.1200/jgo.18.89200.

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Background: The US National Cancer Institute (NCI) Center for Global Health (CGH) serves as a clearinghouse of information on global oncology activities within the NCI and across the 70 NCI-designated Cancer Centers. Global oncology, as defined by the American Society of Clinical Oncology (ASCO), “addresses disparities and differences in cancer prevention, care, research, education and the disease's social and human impact around the world”. While CGH routinely reports on NCI-funded global oncology projects conducted at the cancer centers, there is limited reporting of non-NCI funded global oncology activities of the cancer centers. To address this gap, CGH has surveyed the cancer centers about their global oncology programs and projects informally in 2012 and 2014. The 2018 survey, in partnership with ASCO, represents the first systematically conducted survey, with new questions about cancer center global oncology programs, faculty, and trainees. Aim: The aim of the 2018 survey is to develop a summary report of cancer center global oncology programs for use by cancer centers as a knowledge sharing and collaborative tool; by the NCI to inform program development; and, by ASCO to better understand the current state of global oncology training at US institutions. Methods: CGH developed a 2-part online survey with questions about global oncology projects led by cancer centers, and the level of support for global oncology training and faculty engagement at cancer centers. CGH piloted the survey to 7 of the 70 cancer centers (10%) from January to March 2018. Revisions based on the pilot were made, and CGH fielded the survey to the rest of the 63 cancer centers (90%) from March to July 2018. CGH supplemented the survey data with an Internet search of cancer centers' Web sites. The submitted data will be compiled, analyzed, and organized into a summary report for distribution to NCI, ASCO, and the cancer centers. Results: Data from the 7 pilot institutions show that while all 7 institutions (100%) have a global oncology program, there is great variance in the percentage of global oncology faculty who receive external or administrative research grant support for their work. Three institutions (43%) report that 50% or fewer global oncology faculty receive external research grant support, and 6 institutions (86%) report that 50% or fewer global oncology faculty receive cancer center administrative fund support for their work. Additional results and analysis will be available and presented as part of this presentation. Conclusion: In addition to serving as a knowledge sharing and collaboration tool for cancer centers, the global oncology survey allows NCI, ASCO, and global oncology partners to understand the current landscape of and sources of support for global oncology training, research, and programming at the cancer centers. This information will inform future discussions on how to strengthen global oncology programming and partnerships.
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Albritton, Karen H., Charles H. Wiggins, Harold E. Nelson, and Jane C. Weeks. "Site of Oncologic Specialty Care for Older Adolescents in Utah." Journal of Clinical Oncology 25, no. 29 (October 10, 2007): 4616–21. http://dx.doi.org/10.1200/jco.2006.08.4103.

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Purpose Adolescents with cancer may access oncologic care from pediatric or adult medical centers, given overlapping age eligibility. However, some recent data suggest a benefit to adolescents with certain cancers when treated at pediatric centers or on pediatric protocols. We used a population-based registry to determine the site of care of children, adolescents, and young adults (age 0 to 24 years) with newly diagnosed cancer. Patients and Methods From the Utah Cancer Registry 1994 to 2000, new malignant cases in patients aged 0 to 24 years were chosen; data including diagnosis, home ZIP code and sites of oncologic care were abstracted. Distance between home ZIP code and Primary Children's Medical Center (PCMC; Salt Lake City, Utah), the state's sole site of pediatric oncology care, was determined. Results Sixty-six percent of Utah 15- to 19-year-olds with cancer were never seen by a PCMC oncologist. Even among this narrow age range, utilization of the pediatric center dropped with each additional year of age. Not unexpectedly, few of those with epithelial malignancies in this age group were seen at PCMC. But surprisingly, 47% of the older adolescents with leukemia, 66% with brain tumors, and 71% with lymphoma never saw a pediatric oncologist. After consideration of age and diagnosis, distance the patient lived from PCMC had a negligible effect on the likelihood of an adolescent being seen there. Conclusion The referral of adolescents with cancer to a pediatric oncology center diminishes greatly with age, and is moderately influenced by diagnosis and minimally by distance from center. Further study should investigate reasons for referral patterns, and impact on outcomes.
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Steen, M. Willemijn, Claire van Vliet, Sebastiaan Festen, Marc G. Besselink, Michael F. Gerhards, and Olivier R. Busch. "Regional oncology network between pancreatic centers safeguards waiting times for pancreatoduodenectomy." Updates in Surgery 71, no. 4 (September 10, 2019): 645–51. http://dx.doi.org/10.1007/s13304-019-00677-6.

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Abstract Pancreatoduodenectomy (PD) is increasingly performed in high-volume centers, which may compromise waiting times. The aim of this study was to evaluate patient flow and outcome of PD within a regional oncology network of two high-volume centers. A post hoc analysis of a partially retrospective and prospective database was performed of all patients who underwent PD for pancreatic or periampullary neoplasms in both centers of the Gastrointestinal Oncology Center Amsterdam, a collaboration between an academic center and affiliated general teaching hospital, from 2010 to 2014. Outcomes included waiting time to surgery and postoperative morbidity and mortality. A total of 525 PDs were performed, 329 in the academic center (annual volume 66) and 196 in the teaching hospital (annual volume 39). Neoadjuvant treatment was more often used in the academic center, other baseline characteristics were similar. Overall time to surgery was 26 days, which was significantly less in the teaching hospital. The major postoperative morbidity rate was 38.3% (n = 201), and the 30- and 90-day mortality was 2.3% and 3.6%. A regional oncology network between an academic center and a general teaching hospital for PD can be an attractive option to safeguard waiting times in selected patients, without compromising outcome.
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7

Rieger, Paula Trahan. "Bringing oncology nursing front and center." Nursing Outlook 48, no. 5 (September 2000): 241. http://dx.doi.org/10.1016/s0029-6554(00)70024-8.

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8

Adderson, Elisabeth E. "Histoplasmosis in a pediatric oncology center." Journal of Pediatrics 144, no. 1 (January 2004): 100–106. http://dx.doi.org/10.1016/j.jpeds.2003.10.035.

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9

Fink, Jennifer L. W. "FDA launches Oncology Center of Excellence." Cancer 122, no. 22 (November 7, 2016): 3421–22. http://dx.doi.org/10.1002/cncr.30407.

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10

Prigoff, Jake, Grace Hillyer, Fletcher Bell, and Melissa Kate Accordino. "Effects of COVID-19 on an academic breast oncology center in New York City." Journal of Clinical Oncology 38, no. 29_suppl (October 10, 2020): 51. http://dx.doi.org/10.1200/jco.2020.38.29_suppl.51.

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51 Background: The influx of patients to the healthcare system due to COVID-19 impacted healthcare practices including the care of breast cancer patients. Our aim is to describe the impact this pandemic had on breast cancer care delivery at an academic center in NYC to inform policy and procedure for future crises that limit patient access to on-site facilities. Methods: A survey was sent to physicians involved in the care of patients with breast cancer at Columbia University Irving Medical Center in May 2020. Participants were asked about practice structure and changes to breast cancer care. The primary outcome was the degree that providers believed breast oncology patients’ clinical outcomes were significantly impacted by COVID-19. Secondary outcomes included changes in diagnostic and management approaches and advice for future providers faced with a similar pandemic. Results: The response rate was 65.4% (17/26). This included physicians from medical oncology (n = 7), radiology (n = 4), breast surgery (n = 3), radiation oncology (n = 2), and plastic surgery (n = 1). Seventy-six percent of physicians somewhat agreed, agreed, or strongly agreed that oncologic outcomes may be significantly impacted by the COVID-19 pandemic. Nearly half (47%) of respondents reported delays in the workup of patients due to COVID-19 with 50.0% for mammograms, 47.5% for bone scans, 46.0% for ultrasounds, 43.8% for PET scans, and 43.3% for biopsies. Eighty-two percent reported delays in overall oncologic management. Delays to systemic therapy were: intravenous/targeted therapy (37.9%), intramuscular/subcutaneous endocrine therapy (28.3%), oral chemotherapy/targeted therapy (22.9%), and oral endocrine therapy (12.8%). Delays to local therapy were: surgery (64.4%) and radiation therapy (44.6%). Almost two-thirds (64.7%) reported it necessary to use alternative oncologic management strategies. The most common piece of advice our providers offered was to increase testing capacity to all patients, especially when coming to a healthcare facility. Conclusions: The COVID-19 pandemic has caused major disruption to breast cancer practices. Breast oncology physicians reported delays in management in over 80% of patients, and the need to use alternative management strategies in over 60% of patients. Effects of these disruptions on oncologic outcomes are unknown, but over 75% of our physicians believe this will significantly impact breast oncology patients’ outcomes. There's a need for policies and procedures to structure patient care should there be a future crisis that limits patient access to oncologic care.
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11

Melas, Marilena, Shanmuga Subbiah, Siamak Saadat, Swapnil Rajurkar, and Kevin J. McDonnell. "The Community Oncology and Academic Medical Center Alliance in the Age of Precision Medicine: Cancer Genetics and Genomics Considerations." Journal of Clinical Medicine 9, no. 7 (July 6, 2020): 2125. http://dx.doi.org/10.3390/jcm9072125.

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Recent public policy, governmental regulatory and economic trends have motivated the establishment and deepening of community health and academic medical center alliances. Accordingly, community oncology practices now deliver a significant portion of their oncology care in association with academic cancer centers. In the age of precision medicine, this alliance has acquired critical importance; novel advances in nucleic acid sequencing, the generation and analysis of immense data sets, the changing clinical landscape of hereditary cancer predisposition and ongoing discovery of novel, targeted therapies challenge community-based oncologists to deliver molecularly-informed health care. The active engagement of community oncology practices with academic partners helps with meeting these challenges; community/academic alliances result in improved cancer patient care and provider efficacy. Here, we review the community oncology and academic medical center alliance. We examine how practitioners may leverage academic center precision medicine-based cancer genetics and genomics programs to advance their patients’ needs. We highlight a number of project initiatives at the City of Hope Comprehensive Cancer Center that seek to optimize community oncology and academic cancer center precision medicine interactions.
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12

Held, Gerhard, and Michael Pfreundschuh. "Germinal center or nongerminal center DLBCL?" Nature Reviews Clinical Oncology 6, no. 4 (April 2009): 188–90. http://dx.doi.org/10.1038/nrclinonc.2009.22.

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13

Rotstein, Coleman, K. Michael Cummings, Andreas L. Nicolaou, Joyce Lucey, and John Fitzpatrick. "Nosocomial Infection Rates at an Oncology Center." Infection Control and Hospital Epidemiology 9, no. 1 (January 1988): 13–19. http://dx.doi.org/10.2307/30144129.

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14

Bernardo, Teresa, Edite Ferreira, Joaquim Castro Silva, and Eurico Monteiro. "Sinonasal Adenocarcinoma—Experience of an Oncology Center." International Journal of Otolaryngology and Head & Neck Surgery 02, no. 01 (2013): 13–16. http://dx.doi.org/10.4236/ijohns.2013.21005.

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15

Wilson, Sarah, and Barbara LiPira. "Multidisciplinary Oncology Clinics at Presbyterian Cancer Center." Oncology Issues 19, no. 4 (July 2004): 28–29. http://dx.doi.org/10.1080/10463356.2004.11883206.

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16

Watts, Lori, Nicolas Camilo, Nicole Thurston, Michele Betts, and Dan Sayam Zuckerman. "Distress management in a community oncology center." Journal of Clinical Oncology 30, no. 34_suppl (December 1, 2012): 107. http://dx.doi.org/10.1200/jco.2012.30.34_suppl.107.

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107 Background: NCCN and the Institute of Medicine recommend distress screening for all cancer patients. Surveys have found that 20% to 47% of newly diagnosed and recurrent cancer patients experience significant levels of distress. Less than half of distressed patients with cancer are actually identified and referred for psychosocial help. The development of screening tools, processes, appropriate timing, and systems for follow up on concerns is an ongoing challenge for many cancer programs. Mountain States Tumor Institute p,iloted a distress screen process as part of our work with NCCCP. Methods: From October 24, 2011, to April 30, 2012, 133 patients completed distress screens. Most frequently reported concerns included fatigue (50%), sleep changes (32%), and anxiety/worry (31%). 51% of patients reported three or more concerns. 90% of all patients reporting anxiety also reported fatigue or sleep problems. All patients who reported concerns were offered social work and other supports. Screens were reviewed by social workers and discussed at weekly multidisciplinary psychosocial care rounds by social workers, psychiatrist, nurse practitioners, and chaplains. A variety of interventions were used to respond to distress including symptom management, education and referrals to on-site social workers, chaplains, supportive care clinic, integrative medicine and psychiatry. Results: A task was created in Mosaiq Electronic Medical Record to cue Health Information Specialists to schedule patients for distress screening as close as possible to 45 days from first chemotherapy treatment. Patients completed screens before seeing their medical provider. The majority of patients screened received one or more interventions in follow-up. Conclusions: EMRs can be effective tools to cue scheduled screening of patient distress. The use of multidisciplinary psychosocial care rounds can effectively help clinics plan interventions to alleviate patient distress. The use of rounds can ensure staff from different disciplines are not duplicating efforts and can help determine appropriate timing of various psychosocial interventions. Project funded with Federal funds from the NCI, Contract No HHSN261200800001E.
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Soffietti, Riccardo, Roberta Rudà, Federica Franchino, Alessia Pellerino, and Rosa Palmiero. "Center for Neuro-Oncology in Turin (Italy)." Clinical and Translational Neuroscience 2, no. 2 (July 2018): 2514183X1878660. http://dx.doi.org/10.1177/2514183x18786600.

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18

Rotstein, Coleman, K. Michael Cummings, Andreas L. Nicolaou, Joyce Lucey, and John Fitzpatrick. "Nosocomial Infection Rates at an Oncology Center." Infection Control & Hospital Epidemiology 9, no. 1 (January 1988): 13–19. http://dx.doi.org/10.1086/645727.

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AbstractNosocomial infection rates were computed for 5,031 patients at an oncology center during a 20-month period. Twelve percent of the patients developed nosocomial infections, accounting for a total of 802 infections. The overall incidence of nosocomial infections during this study period was 6.27 infections per 1,000 patient days. The highest incidence of nosocomial infections was found in patients having acute myelogenous leukemia (30.49 infections per 1,000 patient days); bone and joint cancer (27.27 infections per 1,000 patient days); and liver cancer (26.58 infections per 1,000 patient days). The respiratory tract was the most common site of infection, followed by blood-stream, surgical wound, and urinary tract infections. Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, and coagulase-negative staphylococci were most frequently implicated as pathogens. The distribution of specific types of infection according to underlying malignancy was also tabulated. These data provide nosocomial infection rates, common pathogens, and sites of infection for cancer patients, thus assisting in directing appropriate therapy for these patients.
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Arnold, Anita M., and Cathleen Biga. "Implementing a Cardio-oncology Center of Excellence." Cardiology Clinics 37, no. 4 (November 2019): 545–57. http://dx.doi.org/10.1016/j.ccl.2019.07.016.

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20

Barkley, Ronald. "Where Does Oncology Fit in the Scheme of Accountable Care?" Journal of Oncology Practice 8, no. 2 (March 2012): 71–74. http://dx.doi.org/10.1200/jop.2012.000550.

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The Cancer Center Business Summit focused its 2011 annual survey on the topic of oncology's fit within the context of accountable care planning, and discovered that oncology is not considered an attractive candidate for “early win” cost savings in an ACO initiative.
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Pawloski, Jacob, Lisa Scarpace, Nestelynn Gay, Hassan Fadel, Rachel Hunt, Sameah Haider, Adam Robin, et al. "INNV-14. UTILIZATION OF A PATIENT FAMILY ADVISORY COUNCIL TO ADVANCE PATIENT-CENTERED CARE OF BRAIN TUMOR PATIENTS." Neuro-Oncology 22, Supplement_2 (November 2020): ii119. http://dx.doi.org/10.1093/neuonc/noaa215.497.

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Abstract INTRODUCTION Developing and advancing patient-centered care within neuro-oncology is an essential element of any tertiary brain tumor center. Patient-centered care of neuro-oncology patients requires a holistic approach that integrates oncologic treatment with social and psychological support. OBJECTIVE The aim of this study is to evaluate how a Patient Family Advisory Council can be created within an existing brain tumor center and utilized to improve patient-centered care. METHODS Current patients and caregivers were recruited by brain tumor staff to participate in monthly meetings. All participants underwent screening and training by our Patient Education Research Center team. Discussions focused on current and future brain tumor center initiatives, and participants were encouraged to give feedback from the patient perspective. New ideas to improve the patient experience were solicited. RESULTS A total of 15 participants (female = 57%) were recruited, including 10 with grade 3 or higher brain tumors. Monthly meetings, in-person or virtual, were held for two years. Utilizing participant feedback, the group updated our 80-page patient handbook that contained a variety of patient-caregiver focused resources. Participants also provided feedback on other brain tumor center initiatives such as development of a magnet featuring key phone numbers, an easily accessible website URL for emergencies, and numerous updates to the external website. Additional discussions involved development of neuro-oncology care pathways as we move to a stand-alone cancer center facility and initiation of OncoSTAT and palliative services in this population. CONCLUSION Brain tumor patients require a comprehensive oncologic treatment team as well as a wide variety of support services. A Patient Family Advisory Council is an effective method of advancing patient-centered care and a step toward improving the neuro-oncology patient experience.
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Portman, Diane G., and Sarah Thirlwell. "Pathways, partners and payers: The trifecta of palliative care integration." Journal of Clinical Oncology 33, no. 29_suppl (October 10, 2015): 129. http://dx.doi.org/10.1200/jco.2015.33.29_suppl.129.

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129 Background: Moffitt Cancer Center has developed proprietary oncology clinical pathways. Multiple external partnership agreements which require adoption of these pathways have been completed. Our Center has enacted new cancer care delivery and payment arrangements with payers to foster cost and quality balance via use of the pathways and earlier involvement of palliative care (PC). Methods: Executive and PC leadership collaborated with the clinical pathways and strategic alliance teams to identify high priority disease states for integration of PC. Working with oncologist pathway developers, critical junctures in the pathways for inclusion of PC consultation were proposed and refined. EHR mechanisms to promote pathway adherence by clinicians were initiated. The value of pathway utilization and care coordination to involve PC was promoted to prospective oncology partners and payers. Results: PC has been mandated in oncology clinical care pathways, with a focus on thoracic, breast, gastrointestinal, prostate, gynecologic and hematologic malignancies, as directed by specific payer arrangements. Partnerships have expanded, resulting in greater utilization of PC by other centers as well. Increased referral volumes to PC, broader symptom control, and enhanced advance care planning have resulted. Conclusions: Incorporation of PC in oncologic clinical care pathways, with dissemination to internal providers, external partners and as part of novel payment models, optimizes PC integration. [Table: see text]
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Flaherty, Stephen, Constance Barysauskas, and Paul J. Catalano. "The patient experience: Patient characteristic differences in response." Journal of Clinical Oncology 35, no. 8_suppl (March 10, 2017): 144. http://dx.doi.org/10.1200/jco.2017.35.8_suppl.144.

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144 Background: Understanding and addressing patient experience (PX) is an integral part of oncology care. The Press Ganey Outpatient Oncology instrument is used to better understand PX and performance differences at a large ambulatory oncology center. We investigated select patient characteristics of response among all eligible patients, the surveyed sample, and survey respondents. Methods: Over a six month period at a large ambulatory oncology center, 26,660 patients were eligible to report their PX. 11% of patients were identified following the center’s sampling criteria, of which Press Ganey applied their sampling strategy. Thus, 2,857 patients were randomly selected and sent the survey instrument, of which 828 patients responded. Patient characteristics of the three cohorts were compared across the center and by disease center. Results: Surveyed patients were a representative sample of eligible patients, as surveyed patients were of similar age (NS), gender (NS), education level (NS), and primary insurer (NS). In some dimensions, responders were not a representative sample of eligible/surveyed patients. Respondents were slightly older (p < 0.001), more often male (NS), more college educated (NS), and more frequently had a primary insurance of Medicare (p < 0.001). Similar population differences continued among eligible, surveyed and responders, in further comparisons by disease center. Conclusions: Population based sampling allowed the opportunity to investigate accuracy of the sampling strategy and the ability to identify a representative sample of patients across the oncology center. A comparison across the oncology center and disease centers revealed we cannot assume respondents are similar to the eligible and surveyed populations, thus we caution all assumptions made with unadjusted PX comparisons. Further research allows the opportunity to continuously update/improve the sampling strategy and administer electronic surveys to identify a more representative sample better positioned for future quality improvement opportunities. [Table: see text]
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Terry, Karen, Sophia Tsesmelis Piccolino, Alaysia Williams, and Cardinale B. Smith. "Integrating spiritual care into an ambulatory cancer center." Journal of Clinical Oncology 37, no. 27_suppl (September 20, 2019): 205. http://dx.doi.org/10.1200/jco.2019.37.27_suppl.205.

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205 Background: Spiritual care is identified as a core component of quality oncologic care. Unmet spiritual needs can lead to worse quality of life, lower satisfaction with care, and greater psychological distress. Despite increasing evidence that cancer outpatients also have unmet spiritual needs, professional spiritual care is often limited in the ambulatory setting. Many cancer centers provide access to professional chaplains only while patients are hospitalized. Where chaplain services are available to outpatients, access is often limited. At Mount Sinai, we embedded a full-time professional chaplain in our ambulatory cancer center. This presentation will describe our methods, results, and conclusions from a year of data on outpatient spiritual care referrals. Methods: We identified three sources of referrals to spiritual care: direct referrals from patients’ primary oncology teams, direct referrals from Supportive Oncology/Palliative Care, and automatic referrals through a question about meaning and purpose on our distress screen. We also included the opportunity for patients to self-refer to spiritual care through our distress screen. We collected data on the number of patients identified through these referral sources, time to initial contact, and the validity of the referral as assessed by our chaplain. Results: These three sources resulted in 454 referrals to spiritual care. We screened 1,410 patients through our distress screen and 16% (226) triggered a referral to spiritual care. Distress screen referrals comprised nearly 50% of all spiritual care referrals. In addition, 32% (144) of our referrals came from the patients’ clinical teams and 10% (46) from the Supportive Oncology team. Our chaplain assessed that 31% (141) had a spiritual need that required regular follow-up and 12% (56) required monitoring. Conclusions: Using multiple referral methods we were able to identify a significant number of ambulatory cancer patients with an identified spiritual need. Future projects will look at specific metrics for patient experience, improving chaplain ability to connect with patients, validating our screening question for spiritual distress, and determining an appropriate patient load for an outpatient chaplain.
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Tacyildiz, Nurdan, Sonay incesoy Ozdemir, Emel Cabi Unal, Handan Dincaslan, and Gulsan Yavuz. "Barriers and solutions of long-term follow up of childhood cancer survivors in Turkey: A questionaire survey." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e22020-e22020. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e22020.

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e22020 Background: The population of childhood cancer survivors has grown with 80 % cure rates. Our aim was to establish the barriers of longterm followup (LTFU) in Turkey. Methods: An e-mail questionnaire survey has been sent to 33 pediatric oncology centers (POC). Questionnaire compossed of 3 sections: 1- Description of the center; yearly new patients number, follow-up period, etc. 2- Methods for follow-up of late effects Content of provided information to the families related cancer treatment & side effects & healthy life style, missing parts of LTFU 3- Transition problems of survivors to adult survivorship programs. Educational problems of Hematology/Oncology Fellows (HOF) Suggestions for improvement of LTFU. Results: 21 of 33 centers (63%) responded the questionnaire. Experience as POC: 2-50 years (median: 23). New patients / each year: 8 - 300 (median: 68). Most of the centers accepting patients up to 18 years, only 4 center providing lifelong LTFU. No Available Risk Adapted LTFU guideline at 21 center. LTFU provided by pediatric oncologist at the pediatric oncology outpatient clinic with transition problems to adult clinic. All centers were following Cardiotoxicity, Secondary cancer,and Kidney toxicity with no problem Barriers of Turkish POC for LTFU of Pediatric Cancer Survivors were: Lack of enough care providers 66%, lack of time 57%, transportation problems 57 % ,lack of providing knowledge to patients 38 %. Although 80 % of the centers have fellows for HOF, not enough edication on survivorship 66%, due to lack of survivorship clinic ( 80%), busy working schedules. Conclusions: Questionnaire survey was able to reach 2/3 the pediatric oncology centers that were located in 8 cities and following most of the pediatric oncology patients in Turkey Mostly POCs do not provide enough LTFU. All centers agree on national guidelines for LTFU. [Table: see text]
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Hicks, Lisa K., Jordan J. Feld, Joshua Juan, Judy Truong, Urszula Zurawska, Angie Giotis, and Kelvin K. Chan. "An electronic prompt to improve hepatitis B virus screening prior to cancer treatment." Journal of Clinical Oncology 32, no. 30_suppl (October 20, 2014): 169. http://dx.doi.org/10.1200/jco.2014.32.30_suppl.169.

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169 Background: Hepatitis B virus (HBV) reactivation is a potentially fatal complication of cancer therapy that is almost entirely preventable. Despite this, HBV screening rates remain low at many centers. We evaluated the effectiveness of an electronic prompt on HBV screening rates and compared this strategy with education alone. Methods: An education session on HBV reactivation was delivered to all oncology staff at two large, academic oncology centers in the fall of 2010. At one center (study center) an electronic prompt was also introduced. The electronic prompt reminded physicians to screen for HBV when booking a new patient’s first chemotherapy and automatically trigged an electronic order for HBsAg if the physician assented. The prompt was not implemented at the second (control) center. The primary endpoint was the rate of HBV screening. Actual HBV screening rates were determined in both centers for 10 months prior to and for 12 months following the interventions. HBV screening rates were assessed and compared with process control charts (p-charts); 3-sigma limits were employed to define special cause variation. Results: 6,116 new patients received their first chemotherapy during the study period (2,095 study center; 4,021 control center). In the pre-prompt period, the screening rate was stable at 16% at the study center and 25% in the control center. In the prompt period, the screening rate increased to 62% at the study center and was unchanged at 25% in the control center. Special cause variation suggesting a non-random improvement in HBV screening rate was detected at the Study Center two months after the introduction of the electronic prompt. Conclusions: An electronic prompt increased the rate of HBV screening, however screening rates remained relatively low. Education sessions did not appear to improve the HBV screening rate.
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Jensen, Christopher Edward, Amy Iarrobino Laughlin, and Daniel Jeffrey Landsburg. "Communication among oncology teams at an academic center." Journal of Clinical Oncology 36, no. 30_suppl (October 20, 2018): 166. http://dx.doi.org/10.1200/jco.2018.36.30_suppl.166.

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166 Background: Effective communication is essential to ensure optimal care for oncology patients admitted to the hospital and safe transitions between care settings. Methods: A questionnaire adapted from the Collaboration and Satisfaction about Care Decisions survey instrument addressing inpatient/outpatient communication was sent to nurses and physicians who cared for patients admitted to the housestaff oncology services at the University of Pennsylvania from 10/2016-2/2017. Questions addressed care plan formulation, communication, and satisfaction with medical decision making on a seven-point Likert scale. Contextual interviews with stakeholders were also conducted. Iterative adjusted rounding pilots were implemented in PDSA cycles including rounding checklist, multi-disciplinary rounds and a two-step paging process to inform nurses of teams’ rounding times. Results: For 66 respondents, the ranges of mean score for each question by provider type were: oncology nurses (4.07-4.29, n = 28), medicine interns (4.33-5.11, n = 9) and residents (4.00-4.83, n = 12), oncology fellows (5.00-7.00, n = 1), and oncology attendings inpatient (5.56-5.89, n = 9) and outpatient (4.71-5.57, n = 7). Given the lowest scores among nurses, rounding interventions targeting nursing attendance on rounds were trialed. Baseline data demonstrated nursing presence on rounds for 47.0% (95% CI: 37.2-56.8%) of patients. During a pilot of the two-step paging process, the rate increased to 63.1% (55.6-70.6%; p = 0.01 for two-sided Z test). A balancing metric of time per patient did not vary significantly before and during the pilot process. Contextual interviews surrounding interventions suggested several barriers to systematically restructuring provider rounds: time limitations for team rounds, frequent rotation of providers and variations in rounding styles as dictated by attending physicians. Conclusions: Satisfaction regarding the care of acutely ill oncology patients appears to negatively correlate with face-to-face time spent with patients in the inpatient setting. These findings provided the basis for a series of pilots of modified rounding models with a focus on integrating nursing staff into provider rounds, which have been difficult to sustain
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Temkin, Sarah Madhu, Lisa Rubinsak, Michelle F. Benoit, Uma Chandavarkar, Linda Hong, Laurel K. Berry, Christine A. Heisler, BJ Rimel, and William P. McGuire. "Gynecologic oncology, gender and relevant leadership in academic medicine." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e19056-e19056. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e19056.

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e19056 Background: Within academic medicine, there has been increasing attention to diversity and inclusion. We sought to characterize gynecologic oncologist (GO) faculty inclusion, with attention to gender in relevant academic leadership roles. Methods: Using the American Association of Medical Colleges list of accredited schools of medicine academic institutions were identified. Observational data was obtained through institutional websites in 2019. Results: Of 154 accredited medical schools, 144 contain a department of obstetrics and gynecology (OBG) with a chair; 103 a GO division with a director; 98 a clinical cancer center with a director. GO divisions included an average of 3.1 faculty. 55% of GO faculty were women, compared to 66% of OBG faculty (p < 0.01). 38% of the GO division directors were women which was an under-representation (p < 0.01). GOs made up 10% of OBG faculty and 15.4% of OBG chairs (NS). Women GOs made up 7.9% of women OBG faculty and 8 (5.6%) women GOs were OBG chairs (NS). 9.9% of GO faculty (11.6% of women GO faculty) report to women GOs at the chair level. OBG departments with a GO chair were more likely to have a woman GO division director (68.4 vs 31.7%, p < 0.01), and GO fellowship (59.1 vs 32%, p < 0.01). The majority (59%) of cancer centers directors were medical oncologists (see Table). 2 (2%) of cancer center directors were GOs; 1 at an NCI designated cancer center. Neither GO directors were women. Incidence to leadership and mortality to leadership ratios were calculated compared to expected rates by SEER 2019. By these measures GOs were underrepresented in cancer center leadership (p < 0.01, p < 0.01). Conclusions: Despite representative leadership of GO and women GO within in OBG leadership, most GOs report to non-oncologists at the department chair level. Potential benefits of GO leadership within OBG departments were identified. The practice of gynecologic oncology includes complex medical and surgical cancer care making these physicians uniquely qualified for cancer center, but representation of GOs in cancer center leadership is low and women GO were absent from cancer center director positions. Without inclusion of GO in cancer center leadership, existing inequities in clinical care, research and funding for gynecologic malignancies may be amplified. [Table: see text]
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Cubero, Daniel Iracema, Felipe Melo Cruz, Suelen Patricia dos Santos Martins, Joao Glasberg, Thomas Giollo Rivelli, Arinilda Silva Campos, Leandro Luongo Matos, and Auro Del Giglio. "Quality Oncology Practice Initiative (QOPI): Preliminary results from a Brazilian academic public oncology service." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e16568-e16568. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e16568.

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e16568 Background: The Quality Oncology Practice Initiative (QOPI) is a voluntary program developed by ASCO to aid oncology practices in quality self-assessment and continuous improvement of patient records. It consists of a cyclical, semiannual measurement of the adequacy of several care processes pertaining to some important aspects of patient care. Few academic cancer centers have been QOPI participants in the United States and there aren’t reports to our knowledge of any Latin American Cancer Center adopting this strategy. Methods: This study shows the pilot initiative to implement the QOPI at the ABC School of Medicine, Discipline of Oncology, a large public academic cancer center of Santo André, São Paulo, Brazil. Results: From January 2008 to December 2010, we consecutive selected 37 patients with gastric cancer, 40 with breast cancer, 33 with lung cancer and 40 colorectal cancer. The table below shows the first round of the core QOPI. Conclusions: There are several opportunities for improvement such as assessing and recording of pain and analgesic use, documentation patient consent and of the intent of chemotherapy and providing patients with their chemotherapy summaries. Our current electronic record will be modified to reflect the aforementioned needs in order to improve our results in the following rounds of QOPI program. [Table: see text]
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Zinck, Lindsey, Suzanne McGettigan, Jennifer Braun, Abbey Walsh, and Lauren Cullen. "The Oncology Evaluation Center: Implementation of a same-day evaluation and treatment center to avoid unnecessary ED visits." Journal of Clinical Oncology 37, no. 27_suppl (September 20, 2019): 81. http://dx.doi.org/10.1200/jco.2019.37.27_suppl.81.

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81 Background: Oncology patients have high rates of both Emergency Department (ED) visits and readmissions. The Hematology-Oncology Division at this urban, 776-bed academic medical center established the Oncology Evaluation Center (OEC) to provide cancer patients with prompt ambulatory evaluation for new symptoms that may otherwise lead to ED visits and unplanned admissions. With new therapeutic options associated with unique complications, the OEC Advanced Practice Providers are knowledgeable in providing care to this high-risk population. ED providers can lack oncology-specific training, comfort, and confidence when caring for cancer patients, resulting in sub-optimal care. Methods: A retrospective review of the chief complaints (CC) of oncology patients presenting to the ED was conducted. Using Plan Do Study Act methodology, in 2016 the OEC was opened to provide same day evaluations and interventions to patients with symptoms related to their cancer diagnosis, their treatment, or their comorbidities. Inclusion and exclusion criteria were developed to ensure appropriate referrals to the OEC. A hospital awareness campaign launched to promote OEC referrals, including educational sessions at multidisciplinary tumor boards. Additionally, two Lean Six Sigma trained infusion RNs led initiatives to promote OEC utilization. Results: The OEC resulted in quick evaluation and intervention for oncology patients. The most common CC are pain, dehydration, fever, nausea/vomiting, and fatigue. Of the 2721 patients seen to date in the OEC, 72% were discharged to home. According to survey results, 81% of oncology providers agree that if the OEC were not in existence, patients referred to the OEC would be referred to the ED. Oncology readmission rates have decreased from 14% (2016) to 12% (2018). Conclusions: The OEC has proven to be an innovative solution for prompt evaluation and ambulatory treatment of cancer patients with complications. This is a valuable component of comprehensive patient-focused care, resulting in ED visit and readmission avoidance. The OEC is an effective low cost, high reward programmatic strategy to expand access to care while improving patient experience.
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31

Gao, Rebecca W., Anisia Dugala, Janelle Maxwell, Patricia Falconer, Andrew C. Birkeland, Vasu Divi, and Eben L. Rosenthal. "Effect of Medical Scribes on Outpatient Oncology Visits at a Multidisciplinary Cancer Center." JCO Oncology Practice 16, no. 2 (February 2020): e139-e147. http://dx.doi.org/10.1200/jop.19.00307.

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PURPOSE: The use of medical scribes has emerged as a strategy to increase clinic workflow efficiency and reduce physician burnout. While oncology clinics may be ideally suited to scribe integration because of the high burden of documentation, oncology-specific scribe research has been limited. The objective of this study was to determine the effect of scribe integration on clinic workflow efficiency and physician satisfaction and quality of life in outpatient oncology clinics. METHODS: We conducted a retrospective, concurrent qualitative and quantitative analysis of patient visit durations and survey data for 129 attending physicians affiliated with an academic hospital’s cancer center between January 2017 and January 2019. Thirty-three physicians were paired with scribes in each physician’s individual clinic or clinics. RESULTS: In terms of clinic efficiency, physicians with scribes had a 12.1% decrease in their overall average patient visit duration compared with their own time before receiving a scribe ( P < .0001) and spent significantly less time completing charts at the end of the day ( P = .04). Compared with their peers, oncologists with scribes showed a 10%-20% decrease in the duration of all patient visits. Scribes also contributed to patient care, as shown by 90% of physicians surveyed who strongly agreed that they spent less time at the computer and more time with patients; 100% of physicians surveyed strongly agreed that scribes improved their quality of life. CONCLUSION: The integration of medical scribes into oncology clinics across several oncologic disciplines has the potential to reduce burnout through increasing physician satisfaction and quality of life, improving patient care, and streamlining clinic workflow.
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Jehanno, N., M. Wartski, H. Pacquement, J. Michon, M. Luporsi, T. Cassou-Mounat, and D. Orbach. "PET/CT management in a pediatric oncology center." Médecine Nucléaire 40, no. 5 (October 2016): 341–48. http://dx.doi.org/10.1016/j.mednuc.2016.07.003.

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33

Bei, L., A. Silva, A. L. Cunha, C. Franco, J. Oliveira, I. Azevedo, I. Pousa, A. Rodrigues, M. Soares, and D. Pereira. "Pulmonary carcinoid tumors: Experience from an oncology center." Annals of Oncology 28 (April 2017): ii58. http://dx.doi.org/10.1093/annonc/mdx093.009.

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34

Benham-Hutchins, Marge M. "4. Exploring Patient Center Handoffs in Surgical Oncology." Nursing Outlook 63, no. 1 (January 2015): 102. http://dx.doi.org/10.1016/j.outlook.2014.12.006.

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35

Murakami, H. "Oncology Phase I Trials at Shizuoka Cancer Center." Annals of Oncology 23 (October 2012): xi10. http://dx.doi.org/10.1016/s0923-7534(20)31937-2.

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36

Kahler, Bernadette. "Growing Pediatric Oncology in a General Medical Center." Journal of Pediatric Oncology Nursing 17, no. 2 (April 2000): 114–15. http://dx.doi.org/10.1177/104345420001700247.

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37

Abood, S. F., A. Al-Timimi, H. O. M. Al-Dahmoshi, R. M. Alwash, A. Helmi, Y. Q. Alwash, and W. Abdul Ameir. "Malignancy registered in Babylon Oncology Center (1990 - 2015)." Annals of Oncology 27 (October 2016): vi468. http://dx.doi.org/10.1093/annonc/mdw385.23.

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38

Sadaps, Meena, Pauline Funchain, Petros Grivas, Bassam N. Estfan, Jame Abraham, James Stevenson, Nathan A. Pennell, Alok A. Khorana, Brian James Bolwell, and Davendra Sohal. "Precision oncology experience at a tertiary care center." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e18118-e18118. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e18118.

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e18118 Background: Precision oncology – use of tumor genomic profiling to guide therapies – is widely discussed but with limited real-world data. We have previously reported our prospective study on feasibility and clinical utility of routine somatic genomic testing of solid tumors [ J Natl Cancer Inst. 2015; 108(3)], and here we report our longitudinal experience, focusing on therapeutic impact. Methods: Records were reviewed for consecutive adult patients seen at Cleveland Clinic for a solid tumor malignancy without known curative options where tumor genomic profiling was ordered using FoundationOne™ (Cambridge, MA). Results were discussed at the Cleveland Clinic Genomics Tumor Board, and therapeutic recommendations were conveyed to the primary oncologist. Data for this cohort study approved by the Cleveland Clinic IRB included subsequent therapies and clinical outcomes. Results: From 2013 to 2016, 330 patients had tumor genomic testing ordered. Median age was 61 years (range, 24-94); 170 (51.5%) were female; 289 (87.6%) were Caucasian. Colorectal (21.5%), breast (17%), lung (16.1%), and pancreatobiliary (11.5%) cancers were the most common diagnoses. In 300 resulted cases, a median of 4 (0-20) alterations per specimen were noted; the most commonly altered genes were TP53 (n = 174), KRAS (n = 75), APC (n = 65), CDKN2A/B (n = 49), and PIK3CA/ PIK3R (n = 46). A specific therapy targeting an actionable alteration was recommended in 51% (153/300) of patients, and 11.7% (n = 35) received such therapy: 14 on clinical trials, 5 on-label, and 16 off-label. Most common targets for therapy were PIK3CA/PIK3R/PTEN (n = 7), HER2 (6), BRAF (3), EGFR (3), and ALK, FLT3, NTRK1 and RET (2 each). At last follow-up, of 35 patients receiving targeted therapy, best responses were: complete response (n = 1, 2.9%), partial response (n = 5, 14.3%), stable disease (n = 14, 40%), progressive disease (n = 11, 31.4%); data not available for 4 patients. Non-availability of clinical trials was a common reason for non-receipt of targeted therapy. Conclusions: Tumor genomic profiling influenced treatment in 11.7% of patients in this cohort, and 57% of those receiving targeted therapy experienced clinical benefit. These data can help guide real-world discussions of precision oncology.
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39

Costa, D. A., E. J. Gouveia, T. Andre, S. Esteves, I. Sargento, J. Freire, M. Ferreira, and A. Moreira. "Sinonasal Adenocarcinoma (Sna) - Experience of an Oncology Center." Annals of Oncology 25 (September 2014): iv353. http://dx.doi.org/10.1093/annonc/mdu340.43.

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40

Sheridan, Cormac. "IDO inhibitors move center stage in immuno-oncology." Nature Biotechnology 33, no. 4 (April 2015): 321–22. http://dx.doi.org/10.1038/nbt0415-321.

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41

Philip, Thierry. "The Centre Leon Berard Cancer Center." Pediatric Hematology and Oncology 13, no. 6 (January 1996): 477–86. http://dx.doi.org/10.3109/08880019609030863.

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42

Davella, Christopher, Peter Whooley, Emily Milano, Brian L. Egleston, Martin Edelman, James Helstrom, Kenneth Patrick, and Jessica Ruth Bauman. "Impact of oncology urgent care center on healthcare utilization." Journal of Clinical Oncology 38, no. 29_suppl (October 10, 2020): 7. http://dx.doi.org/10.1200/jco.2020.38.29_suppl.7.

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7 Background: Studies suggest that many Emergency Department (ED) visits and hospitalizations for cancer patients may be preventable. CMS has made changes to the hospital outpatient reporting program (OP-35) targeting ED visits and admissions in treatment patients for preventable conditions. Oncologic urgent care centers aim to streamline care for this population. Fox Chase Cancer Center (FCCC) developed an urgent care center called the Direct Referral Unit (DRU) in July 2011. We sought to assess the impact of the DRU on care utilization. Methods: We abstracted visits to our adjacent hospital (Jeanes) ED and the DRU from January 2014-June 2018. Visit rates represent the ratio of visits over the total number of patients with a clinic visit at FCCC per year. ED and DRU visits were associated with both a cancer and visit diagnosis per the International Classification of Disease (ICD). Patient demographics were abstracted. We also analyzed visit charges, inpatient admission and 30-day therapy utilization (chemotherapy, immunotherapy, radiation). Results: A total of 13,210 visits were analyzed including 5,789 ED visits and 7,421 DRU visits. Visits to the Jeanes ED increased over time. The average age of patients at time of first visit was 63 and visits were most common in females and Caucasians. Hispanic and African American (AA) patients were more likely to visit the ED compared to the DRU (OR: 7.54 and 1.30). Patients with GI (27%) and thoracic (15%) malignancies had the most visits. Commercial insurance use was most common (48%) followed by Medicare (34%) and Medicaid (16%). DRU use was most frequent on Mondays (22%), while ED use occurred the most on Sundays (17%). The most common DRU visit diagnoses in order of prevalence were dehydration, nausea/vomiting, abdominal pain, fever, shortness of breath, fatigue, diarrhea, cellulitis/rash, constipation and anemia. Inpatient admission rates were similar between the two settings (p=.8176). Patients on active cancer treatment more frequently presented to the DRU in comparison to the ED (p<.0001). The average charges were $2226.22 for a DRU visit vs. $10,253.44 for an ED visit. Conclusions: The increase in ED visits over time as well the more frequent ED use in Hispanic and AA patients both suggest a need for greater urgent care access. Many of the most common visit diagnoses to the DRU align with CMS’s list of preventable conditions, demonstrating the DRU’s success as a triage center targeting these conditions. DRU visits were associated with considerable cost savings, supporting the use of cancer urgent care centers as a cost-effective method to reduce acute care.
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43

Heifetz, Laurence J., Scott D. Christensen, Ralph W. deVere-White, and Fredrick J. Meyers. "A Model for Rural Oncology." Journal of Oncology Practice 7, no. 3 (May 2011): 168–71. http://dx.doi.org/10.1200/jop.2010.000167.

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44

Song, Jung Min, Joel Daniel Marcus, Carolyn Stanek, Michael J. McNamara, Brian Gastman, Ahmad A. Tarhini, and Pauline Funchain. "Single center experience of dermatologic and oncologic surveillance patterns for late stage melanomas that progressed from early stage melanoma." Journal of Clinical Oncology 36, no. 7_suppl (March 1, 2018): 182. http://dx.doi.org/10.1200/jco.2018.36.7_suppl.182.

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182 Background: Recent data suggests a greater proportion and greater absolute number of thin (T1) melanomas contribute to melanoma death than thicker melanomas (Whiteman et al., J Invest Dermatol 2015). NCCN guidelines for early stage melanoma, defined as stages IA-IIA, suggest at least yearly skin check and H&P, but do not specify if dermatologic and/or oncologic surveillance should be pursued. Methods: We reviewed internal and external records of 16 consecutive patients with new, non-de novo diagnoses of unresectable stage III or IV melanoma undergoing active cancer treatment, i.e. late stage melanoma, from 2016-2017 that had progressed from a preceding primary early stage (IA-IIA) melanoma. Results: Primary early stage melanomas were diagnosed a median of 10.5 years (range, 4 to 29) prior to advanced disease progression. Two of 16 patients (13%) had oncologic follow up. Seven (44%) had continuous dermatology follow-up, of which 6 (38%) were followed only by dermatology. Only one patient had both dermatology and oncology follow-up at the time of progression. Follow up could not be determined for 8 patients due to lack of sufficient records, it is notable however that these 8 (50%) were not following dermatology or oncology at the time of progression. Conclusions: Only a small minority of patients who progressed from early stage melanoma to advanced stage melanoma requiring treatment were followed regularly by medical oncology, despite half having at least regular dermatology follow-up. We conclude that survivorship plans are important for early stage melanomas, and there is a need to effectively educate a larger early stage melanoma population about the infrequent but real oncologic issue of progressing to late stage melanoma.
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45

Lennes, Inga Tolin, Justin Eusebio, Nie Bohlen, Margaret Ruddy, and David P. Ryan. "Characterization of unplanned 30-day medical oncology readmissions after discharge at an academic medical center with a comprehensive cancer center." Journal of Clinical Oncology 34, no. 7_suppl (March 1, 2016): 269. http://dx.doi.org/10.1200/jco.2016.34.7_suppl.269.

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269 Background: Hospital readmission rate is increasingly suggested as a quality care metric. Currently there are no standard criteria for an avoidable readmission in oncology. Although patients with cancer have been identified as being at increased risk of readmission, there has been little to examine the reasons for the oncology patient readmission. The aim was to examine the profiles of patients with an unplanned readmission within 30 days after discharge by an oncology provider and to measure the unplanned 30-day readmission rate. Methods: A retrospective review of oncology provider discharge encounters resulting in a 30-day unplanned readmission during the 2012 calendar year at a tertiary hospital with a comprehensive cancer center was conducted. Planned readmissions for chemotherapy, radiation therapy, hematopoietic stem cell transplantation, dialysis, and surgical procedures, as well as readmissions for rehabilitation, hospice, and psychiatry were excluded. Medical oncologists analyzed medical records for the primary reason of readmission and if the readmission was possibly preventable. Results: Of the 2,944 admissions, a final cohort of 441 unplanned readmissions from 321 unique patients for an unplanned 30-day readmission rate of 14.9% was observed. The average age at admission was 59 (SD 15.9). The cohort was mostly male (56.9%) and White/Caucasian (84.4%). Gastrointestinal (24.0%), lymphoma (18.6%), and leukemia (17.5%) were the most common cancer types. Of those with solid tumors types (n = 225), approximately 70% had metastatic disease. The median time to readmission was 10 days and 10.7% died within 30 days of readmission. Oncology reviewers most commonly assessed that readmission was primarily due to treatment-related effects (46.7%) and the progression of disease (42.2%). Approximately 20% of 30-day readmissions were determined to be possibly preventable, representing 3% of all admissions for the year. Conclusions: Oncology patients readmitted within 30-days frequently present with complicated, advanced disease. A review by medical oncologists suggests there is margin for intervention to reduce 30-day unplanned admissions.
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Fehretdinova, Zemfira. "My work in the oncology center yesterday and today." Medsestra (Nurse), no. 9 (September 9, 2020): 22–28. http://dx.doi.org/10.33920/med-05-2009-03.

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After graduating from the Samara State University, the graduates of the Faculty of the Higher Nursing Education found employment in various fields. I work as a medical statistician at the SHI Regional Clinical Oncology Dispensary in Ulyanovsk. Since the introduction of information technologies, the work of the statistician and of the departments of the institution has changed, which increased the efficiency and the speed of performance. To date, cancer care remains pertinent for the population of the Ulyanovsk region, so the article touches on the structure and features of prevention, examination, and treatment of patients with oncology diseases in the Ulyanovsk region.
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Kline, Ron, Kerin Adelson, Jeffrey J. Kirshner, Larissa M. Strawbridge, Marsha Devita, Naralys Sinanis, Patrick H. Conway, and Ethan Basch. "The Oncology Care Model: Perspectives From the Centers for Medicare & Medicaid Services and Participating Oncology Practices in Academia and the Community." American Society of Clinical Oncology Educational Book, no. 37 (May 2017): 460–66. http://dx.doi.org/10.1200/edbk_174909.

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Cancer care delivery in the United States is often fragmented and inefficient, imposing substantial burdens on patients. Costs of cancer care are rising more rapidly than other specialties, with substantial regional differences in quality and cost. The Centers for Medicare & Medicaid Services (CMS) Innovation Center (CMMIS) recently launched the Oncology Care Model (OCM), which uses payment incentives and practice redesign requirements toward the goal of improving quality while controlling costs. As of March 2017, 190 practices were participating, with approximately 3,200 oncologists providing care for approximately 150,000 unique beneficiaries per year (approximately 20% of the Medicare Fee-for-Service population receiving chemotherapy for cancer). This article provides an overview of the program from the CMS perspective, as well as perspectives from two practices implementing OCM: an academic health system (Yale Cancer Center) and a community practice (Hematology Oncology Associates of Central New York). Requirements of OCM, as well as implementation successes, challenges, financial implications, impact on quality, and future visions, are provided from each perspective.
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48

McFarland, Daniel C., Elizabeth Blackler, Smita Banerjee, and Jimmie Holland. "Communicating About Precision Oncology." JCO Precision Oncology, no. 1 (November 2017): 1–9. http://dx.doi.org/10.1200/po.17.00066.

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Communication in oncology has always been challenging. The new era of precision medicine complicates communication even further as a result of our increasing reliance on genomic data and the varying psychological responses to genomic-based treatments and their expected outcomes. The crux of the matter hinges on understanding communication. The informed consent process may require more attention in the precision medicine era. However, many of the communication issues are actually similar to perennial long-standing communication issues in oncology, which center on providing hope when breaking bad news and ensuring that adequate informed consent to treatments is obtained. This piece presents several common patient reactions to different precision medicine scenarios in oncology practice. We highlight these new communication issues that focus on clinical and ethical questions (ie, informed consent, shared decision making, patient autonomy, and uncertainty in oncologic treatments) and provide guidance on working with each scenario. In this article, we address common reactions of patients to genomic information and provide thoughtful communication suggestions using a Shared Decision Making framework to help patients cope with the inherent distress-provoking uncertainties in oncology practice.
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49

Kim, Yan S., Neha Damle, John D. Greene, Jennifer M. Baker, Esther J. Luo, and Gabriel J. Escobar. "Oncology supportive care clinics as a novel model to integrate oncology and palliative care." Journal of Clinical Oncology 34, no. 26_suppl (October 9, 2016): 154. http://dx.doi.org/10.1200/jco.2016.34.26_suppl.154.

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154 Background: The integration of oncology with palliative care (PC) has been endorsed by the American Society of Clinical Oncology. Starting in 2012, Kaiser Permanente Northern California (KPNC) began introducing Oncology Supportive Care Clinics (OSCCs) to better provide integrated oncology and PC services. We evaluated the impact of OSCCs on outpatient PC referrals among patients diagnosed with advanced cancers. Methods: We included all adult patients diagnosed with incidental stage IV cancer from 2010-2014 from 19 medical centers within KPNC. We excluded 2 medical centers for inconsistent PC referral tracking. Patients were required to have continuous KPNC coverage during the study period and were followed for a minimum of 12 months after diagnosis or until death. Outcomes included the rate of PC referral following diagnosis and time elapsed from diagnosis to referral. Because the introduction of OSCCs was staggered by medical center, we used a difference-in-differences model to compare the outcomes in medical centers with and without OSCC, before and after OSCC establishment. Results: OSCCs are currently operational at 11 medical centers. A total of 1,7640 patients were included. At centers with OSCCs, the referral rate after OSCC increased from 16.5% to 30.9% (p < 0.01); compared to no change at centers without OSCCs (12.5% before vs. 11.7% after, p = 0.35). There was a decrease in the median time from diagnosis to PC referral at all medical centers, from 163 days (IQR 33-541) to 75 (IQR 20-255) days, p < 0.01, regardless of OSCC presence. Conclusions: The KPNC OSCC model has been successful at increasing PC referrals in patients with stage IV cancers, highlighting the important role healthcare delivery systems have in driving practice change. More research is ongoing to examine patient-centered outcomes associated with receiving OSCC services.
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Pavlysh, A. V., and A. S. Kolbin. "Why Abc/Ved Analysis In Oncology? The Experience Of A Major Russian Oncology Center." Clinical Therapeutics 38, no. 10 (October 2016): e18. http://dx.doi.org/10.1016/j.clinthera.2016.07.129.

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