stronach regional cancer centre at southlake centre rÉgional de cancÉrologie stronach À southlake...

STRONACH REGIONALCANCER CENTRE AT SOUTHLAKE

CENTRE RÉGIONAL DE CANCÉROLOGIE STRONACH À SOUTHLAKE

Stronach Regional Cancer Centre at Southlake

ESAS and MOREApril 27, 2011

www.southlakeregional.org/cancer

Objectives

Refresher on Edmonton Symptom Assessment System

Symptom Management Guides

Measure of success

www.southlakeregional.org/cancer

CCO Identified Issue…Cancer Patient Symptoms Not Optimally ManagedInconsistency in cancer symptom management practices across

province

Clinicians can fail to recognize 50-80% of patient concerns during consultation (Ruland et al, J Am Med Inform Assoc, 2010)

Adequate symptom management is not consistently achieved for cancer patients (Patrick et al, J Natl Cancer Inst, 2003)

Poor system outcomes

~ 40% visit ED last 2 weeks; dyspnea and pain among most common chief complaints

~ acute care LOS last 6 months (14 days)

(CSQI, 2010; Barbera et al, J Can Med Assoc, 2010)

www.southlakeregional.org/cancer

OCSMC Targets Improvement in Cancer Patient’s Physical and Emotional Symptoms

Purpose

To improve the quality and consistency of patient’s physical and emotional symptom management across the patient journey

• Earlier identification and communication of symptoms

• Improved symptom management

• Improved collaborative care planning

Approach Implement and assist in adoption of common tools: ESAS, PPS, ECOG, symptom management guides, collaborative care plans

www.southlakeregional.org/cancer

OCSMC Targets Improvement in Cancer Patient’s Physical and Emotional Symptoms

Host and support ISAAC - electronic tool for ESAS

Establish and monitor improvement aims and regional targets

• 90% lung cancer patients screened with ESAS

• 65% all other cancer patients screened with ESAS (2010/11)

Approach

Purpose

www.southlakeregional.org/cancer

Ontario Cancer Plan 2011-2015

Strategic priority #4

“Continue to assess and improve the patient experience”

By 2015 every cancer patient in Ontario will receive care in a timely manner for physical and emotional symptom scores flagged through symptom screening.

www.southlakeregional.org/cancer

Edmonton Symptom Assessment Scale

www.southlakeregional.org/cancer

Patients Value Computerized Approach to Symptom Assessment…

www.southlakeregional.org/cancer

Information Captured in ISAAC Has Uses Ranging from Individual Patient Care to System Planning and Performance…

www.southlakeregional.org/cancer

Monthly Reports Monthly reports show percentage of patients experiencing

specific symptom

Identification of resources required to meet patients’ symptoms

Important for new Cancer Centre developing Palliative and Supportive Care Program

Future steps– Monitor effectiveness of symptom management

www.southlakeregional.org/cancer

Q3 2010- 11 SRCC Reports

www.southlakeregional.org/cancer

Q3 SRCC 2010-11 Report

No targets set for PPS as yet

www.southlakeregional.org/cancer

ESAS and PPS Reports

www.southlakeregional.org/cancer

Need to Manage Symptoms

Have consistent approach to Symptoms

Provide Tools to use as Guide

Provide easy access to tools

Knowledge Transfer

www.southlakeregional.org/cancer

Guide Development Symptom Management Working Groups

Literature search

~ conducted by Rebalance Focus Action Group of Canadian Cancer Control Strategy

~ Additional search within Ontario programs

~ Evidence-based, cancer-specific, clinical practice focus

Guidelines reviewed using AGREE tool

ADAPTE process used to endorse or modify elements of the chosen guideline

www.southlakeregional.org/cancer

The Tools

www.southlakeregional.org/cancer

www.southlakeregional.org/cancer

Making Knowledge Available at Point of CareiPhone App Near Completion and Will be Available on iTunes

www.southlakeregional.org/cancer

How to Use the Guides

Save the link to your workstation PC or portable device

www.cancercare.on.ca/toolbox/symptools/

Select the symptom you are managing

Decide if you need a quick reference or need to study the topic more fully

Select the full guide, pocket version or algorithm

www.southlakeregional.org/cancer

What’s Next?

How do we know it is working?

– Chart Audit

– Every month 25 charts

– One symptom

– Look for interventions~ Referrals

~ Further assessments

~ Decrease in symptom scores over time

www.southlakeregional.org/cancer

Summary of Symptom Management Guides Variety of tools to help standardize assessment, documentation

and management of the most common cancer related symptoms

Pain, Dyspnea, Nausea Vomiting and Delirium

More to come - Anxiety, Depression

Easily accessible

Perform Chart Audit to determine effectiveness of Guides and Care Plans