In addition to providing excellent cancer care at its home facility, Fox Chase partners with community hospitals in Pennsylvania and New Jersey to develop their cancer programs into cancer centers of excellence. These Fox Chase-affiliated hospitals, which are part of the Fox Chase Cancer Center Partners program, have access to Fox Chase resources while focusing on expanding access to outstanding cancer care within their own communities.
To help you develop a cancer center of excellence, Peg O’Grady, RN, MSN, OCN, senior director for Fox Chase Cancer Center Partners, shares the following eight best practices.
1. Analyze your local market and develop accordingly. An institution looking to develop a cancer center of excellence should first take steps to understand its community’s needs, says Ms. O’Grady.
“There is really no cookie-cutter approach for a cancer center of excellence,” says Ms. O’Grady. “You need to examine your community needs to determine which programs will allow you to treat the highest number of patients within your community with the best care.”
Ms. O’Grady recommends that a hospital pull data on patients affected by cancer in their area, using cancer-tracking and other databases, to determine which cancers are affecting the most patients in the areas it serves and create programs that target these cancers. Most of Fox Chase partner hospitals target breast, lung, colon and prostate cancer care, but this may vary by community, says Ms. O’Grady.
2. Analyze your cancer program’s existing assets. After determining which programs are most needed in your community, an institution needs to determine the assets and resources already available to its cancer program, such as technology, facilities, research or educational programs and well-recognized physicians or staff. After determining the program’s assets, the institution can compare itself to its competitors and begin to create a unique plan for developing its current program into a center of excellence.
“You have to know where you’re starting from to know where you want to go,” says Ms. O’Grady. “One of our partner hospitals had an excellent breast cancer program already, but the program leaders didn’t know what volume of patients were staying with the hospital for cancer care versus going elsewhere. Once they determined that, and why, they could begin to develop initiatives that would build their program and be tailored to the experts in their community.”
3. Solicit feedback from patients and employees. Institutions developing cancer centers of excellence should solicit input from former and current patients as well as employees when developing their centers of excellence.
“Bring the patients into what you want to build and develop early and often,” says Ms. O’Grady “We have wonderful survivors that want to give back to their cancer centers. Ask them what they want out of a program. One of the hospitals we work with gave its patients disposable cameras and had them take pictures of the ugliest part of the facility, so they knew what to change first. Give them a draft of your plan and ask them to rip it apart. “
Ms. Grady also suggests that cancer center leaders solicit the buy-in of employees, including clinical staff and physicians, when determining plans for the center of excellence. “Focus groups become critical. Both patients and clinicians are customers, and your plans will be very shortsighted if you don’t get the buy in of all your customers and users,” she says.
In addition to soliciting patient feedback during the initial planning session, cancer program leaders should continue to use patients to determine if recently unveiled facilities or care programs can be further improved.
“Walk as many patients through your system as early as possible. As you do this both the patients and your staff will notice all kinds of things that can be improved,” says Ms. O’Grady. “Pay attention to things such as each patient being asked for the same intake data and the comfortability of your staff in following policies and knowing who to go to for what.”
4. Partner with IT early in the development process. Information technology services should be contacted as early as possible in the development process of your center of excellence and should be viewed as a partner throughout.
“IT really can be a saving grace,” says Ms. O’Grady. “They are so integral, and we don’t credit them as much clinicians. Good IT infrastructure that allows you to get data with ease is truly valuable.”
IT departments and advisors can assist in market share metrics, help to streamline data flow, update software for disease management programs and save an enormous amount of clinician data-mining time. Additionally, real-time data give centers the information they need to identify processes that may need adjusted and allows centers to change these processes in a much timelier manner, according to Ms. O’Grady.
5. Emphasize integrated care and case management. Cancer care services, including surgery, radiology and imaging, should be fully integrated in your center of excellence, and patients should be seamlessly guided from one service to another. Integrated services allow programs to provide better care and more quickly determine any problems that might come up for patients during their course of care.
At Fox Chase Cancer Center Partners, integrated care and case management is referred to as patient navigation. “We firmly believe that navigation is highly important to providing outstanding care and increasing patient satisfaction,” says Ms. O’Grady.
Patients at all Fox Chase-affiliated facilities are given a case manager to oversee their entire course of treatment, and the facilities have set coordinators within each of the multidisciplinary clinics who help to support each patient through initial diagnosis and treatment to survivorship.
“We think of it in terms of passing the baton. Each coordinator passes the baton to another coordinator, and if the baton can’t be passed, due to scheduling issues or other reasons, our staff works together to find a solution for the patient,” says Ms. O’Grady. “We track and log metrics for each patient into our computer so we can find out gaps in our care. If the OR wait is too long or radiation oncology is backlogged for several weeks, we can identify those problems and fix them so we don’t lose patients.”
6. Focus on both patient and staff education. While most cancer programs are concerned with patient education, the most recognized cancer programs are equally concerned with the education of their staff.
“The continuous education of your staff is extremely important. You must provide training to ensure compliance to policy and outstanding care,” says Ms. O’Grady “Your staff is ever-changing, as are your policies and innovation in cancer care.”
Ms. O’Grady recommends quarterly training featuring in-house or outside experts for employees within all areas of the cancer center, including non-clinical staff.
In order to best educate patients about their treatment options, Fox Chase partner centers provide complete National Comprehensive Cancer Network Clinical Practice Guidelines to their patients so that “they understand why we give the care we give” says Ms. O’Grady. Staff members are closely trained on these guidelines and use them to guide patient care.
7. Support a strong research program. Cancer centers of excellence stand out from other cancer programs because of the access to new treatment options they provide to patients. Fox Chase physicians and researchers are involved in approximately 170 different clinical trials at any point in time.
Hospitals that want to develop a cancer center of excellence should encourage and support physicians to participate in clinical trials and other research and proactively educate patients about their clinical trial options. “Provide information about clinical trials to patients as early as possible,” says Ms. O’Grady. “Every patient should be offered a clinical trial.”
8. Encourage innovation. All centers of excellence need to be willing to implement innovative programs, technologies and treatments.
“Innovation can refer to technological innovations or the clinical innovation of a truly exemplary and forward-thinking physician,” says Ms. O’Grady. “Centers of excellence that accept these innovations early can set themselves apart from other providers.”
Fox Chase Cancer Center Partners recently began an innovative program to provide services within their cancer centers to family members of their cancer patients. These facilities now have dedicated clinics for these family members and provide opportunities for genetic testing. Members that test positive for a genetic mutation can undergo genetic counseling and work with Fox Chase experts, in tandem with their primary care providers, to formulate prescriptive health plans that may include more frequent screenings or testing. Even family members who do not test positive for mutations are offered programs such as preventative education classes and nutritional counseling.
“By being innovative and developing these family programs, we have opened up a whole new patient segment for our partners,” says Ms. O’Grady. “These types of preventative services and coordinated efforts with primary care providers are very appropriate for community hospitals.”
Learn more about Fox Chase Cancer Center Partners at www.fccc.edu/partners.
Contact Lindsey Dunn at lindsey@beckersasc.com.
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