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