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Cancer Care Outcomes Report 2015
Cancer Care Outcomes Report 2015
1 Shady Grove Adventist Aquilino Cancer Center, Cancer Committee Chairman Letter
2 Adventist HealthCare Washington Adventist Hospital, Cancer Committee Chairman Letter
3 2015 Cancer Committees
5 Community Cancer Outreach—Adventist HealthCare
6 Cancer Care Program at Adventist HealthCare Shady Grove Medical Center
7 Cancer Cases by Site for 2014 Patients: Adventist HealthCare Shady Grove Medical Center
8 Integrative Medicine Program Treats Whole Person
9 Clinical Trials Pave Way for New Cancer Treatment Options
10 Interventional Radiology Offers Patients Non-Surgical Treatment Option
11 Focus on Digestive Health
11 Digestive Health Launch Event a Success
Table of Contents
12 2015 Quality Improvement Implementation: Adventist HealthCare Shady Grove Medical Center
• Imaging Services See Increased Growth, Turn-Around Time
• Cancer Rehab Services Offer Patients Early Evaluation Option
• Timely Treatment of Prostate Patients
16 Welcome Neurosurgeon Dr. Amin Amini
17 Cancer Care Program at Adventist HealthCare Washington Adventist Hospital
18 Cancer Cases by Site for 2014 Patients: Adventist HealthCare Washington Adventist Hospital
19 New Guidelines for Breast Cancer Screening
20 2015 Quality Improvement Implementation: Adventist HealthCare Washington Adventist Hospital
• Focus on Breast Cancer Care
• Breast Cancer Survivors Honored at Annual Celebration
• Nutrition Services Integral to Patient Care
24 Renewed Accreditation for Cancer Care: Adventist HealthCare Washington Adventist Hospital
ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
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Dear Colleague,2015 was an exciting year for the Shady Grove Adventist Aquilino Cancer Center. Our second year of operations saw an expansion of services for cancer patients in Montgomery County.
Through Adventist HealthCare’s acquisition of Shady Grove Radiology, the cancer center is now more comprehensive than ever. The addition of imaging equipment and technology critical in diagnosis and treatment has expanded our ability to serve and community and broadened access to quality service in our continuum of care.
We also launched our Digestive Health Program, which provides personalized services to treat a range of digestive issues, from chronic gastrointestinal (GI) and acid-related diseases to GI infectious diseases and cancers. Our digestive health patients now benefit from advanced diagnostic procedures, high-quality treatment, nutrition counseling and guidance from our experienced team of doctors and navigators.
We’ve also undergone a series of quality improvement processes designed to improve access to care and improve the speed of communication, without sacrificing the personal approach that our patients have come to expect from Shady Grove.
The Aquilino Cancer Center was created to offer patients a comprehensive, yet convenient location to receive outpatient cancer care. We remain committed to this concept, offering the full spectrum of the latest treatment options from our expert team of caregivers under one roof.
From oncologists, surgeons and technicians to cancer care navigators, nutritionists, social workers, and an abundant offering of wellness classes, the team at the Aquilino Cancer Center continues to deliver compassionate care to our community.
Joseph Haggerty, MD Cancer Committee Chairman Adventist HealthCare Shady Grove Medical Center
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015 ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
Dear Colleague,2015 was a time of change for Adventist HealthCare Washington Adventist Hospital, and of promise for expanding access to cancer services in our community.
The end of 2015 marked a huge milestone for Adventist HealthCare when The Maryland Health Care Commission granted formal approval for Washington Adventist Hospital to develop a replacement hospital in the White Oak section of Montgomery County. The project is part of our longstanding plan to expand access to care in the region and includes keeping healthcare services on our current Takoma Park campus.
The new, 170-bed acute-care hospital and medical campus is on 48 acres at Plum Orchard Drive and Cherry Hill Road, along the border of Montgomery County and Prince George’s County. It is near the U.S. Food and Drug Administration (FDA) headquarters, which partners with the hospital on medical and scientific issues. Construction on the $331 million project began earlier this year with an opening scheduled for early 2019.
Project highlights and construction progress can be found by visiting www.ourcommunitytransformed.org.
This year, Washington Adventist Hospital was also granted a three-year accreditation with commendation in four areas by the American College of Surgeons (ACoS) Commission on Cancer (CoC). This prestigious designation exemplifies the continued high-quality care provided through the Washington Adventist Hospital cancer program.
Although times are changing, our focus will always be to deliver personalized care for our patients. The Cancer Team at Washington Adventist Hospital has been and will continue to be committed to providing the best, most advanced clinical care possible for our patients.
Kashif Firozvi, MD Cancer Committee Chairman, Medical Oncology Adventist HealthCare Washington Adventist Hospital
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
Shelvan ArunanPastoral Care
Wendy AldermanQuality Improvement
Donald Bridges, MDRadiation OncologyCancer Liaison Physician
Lindsey Wise, MSW, LCSW-COncology Social WorkPsychosocial Services Coordinator
Patricia Guay-Berry, RD, LDN, CSONutrition Services
Gregory Dick, MDPlastic & Reconstructive Surgery
Caryn Liebowitz, RN, BSNOncology Nursing
Joseph Haggerty, MDMedical OncologyChairman
Robert Isaacs, MDRadiology
Amir Kende, MDPathology
Mikhail KalnitskiyClinical Research RepresentativeClinical Research Coordinator
Linda Love, CTRCancer RegistryCancer Registry Quality Coordinator
Rachel SerioAmerican Cancer Society
Christopher BiancaDirector, Cancer Care Services
Chitra Rajagopal, MDMedical Oncology
Cristy RuizCancer Outreach Coordinator
Vijay Varma, MDNuclear Medicine
Ellen Young, CTRCancer RegistryCancer Conference Coordinator
Stephanie Smith, RN, BSNNurse Navigator
Emily Quaglieri, BSN, RN, OCNNurse Navigator
Janet Connors, MSW, LCSW-CIntegrative Medicine Coordinator
Laurie Herscher, MDIntegrative Oncologist
Mary GreenbergExecutive Director, Service Lines
Jennifer Nulton, OTR/L, CHT, CLTRehab Manager
Louis Dainty, MDOB-GYN Surgeon
Liz Kotroba, PT, DPT, MBADirector of Outpatient Therapy
2015 Cancer Committee—Adventist HealthCare Shady Grove Medical Center
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015 ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
Kashif Firozvi, MDCancer Committee Chairman
Alan Schulsinger, MDCancer Liaison PhysicianRadiation Oncology
Lorena MontecinoRadiology Manager
Mary GreenbergExecutive Director, Service Lines
Robert JepsonVice President of Business
Development
Cynthia Plate, MDSurgery Physician
Sherif Selim, MDGeneral Surgeon
Po Zhao, MDPathology Physician
Senda Beltaifa, MDPathology Physician
Asante Dickson, MDRadiology Physician
Jonathan Marx, MDInterventional Radiologist
Taira Norals, MDHospice / Palliative Care Specialist
Brenda Millet, MSN, RN-BCOncology NurseOncology Nurse Manager
Jaime Alvey, RNManager, Quality Services
Felicia Benjamin, RNDirector, Quality Services
Alta Berhaneselassie, MBACancer Conference CoordinatorAdministrative Coordinator
Hongmei Liu, MBA, MS, CCRPClinical Research CoordinatorClinical Trials
Zara NecessarioAlternate, Clinical Trials Coordinator
Melody Bankert, LGSWCancer Services Social Worker
Michell Manu, RN, BSN, OCN, MBABreast NavigatorAdventist HealthCare White Oak
Breast Center
Cristy RuizCancer Outreach Coordinator
Katie Ronca, CTRCancer Program Manager
Patty Guay-Berry, RD, LDN, CSOOncology Nutrition CoordinatorOncology Dietician
2015 Cancer Committee—Adventist HealthCare Washington Adventist Hospital
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
Breast Cancer Screenings Serve Montgomery County’s Underserved Women
Since 1993, the Breast Cancer Screening Program at Adventist HealthCare Shady Grove Medical Center and Adventist HealthCare Washington Adventist Hospital has been helping low income, uninsured women 40 years and older in the Maryland area fight the battle against breast cancer. The purpose of the program is provide free screening services to underserved women who may otherwise do without these services due to income and insurance limitations. The aim is to make screening, diagnostic and treatment services accessible to all women to reduce the number of deaths related to breast cancer.
The Breast Cancer Screening program was selected to be highlighted as a success story in the Maryland Comprehensive Cancer Control Program 2015 Progress Report
The Breast Cancer Screening Program is funded by:
l Avon Foundation
l Montgomery County Health Department’s Women’s Cancer Control Program
l Primary Care Coalition
l The State of Maryland’s Breast and Cervical Cancer Diagnosis and Treatment Program.
As of December 2015, 1,503 patients have benefited from the program through breast health education, clinical breast exams, mammograms and treatment, including:
l 983 Screening Mammograms
l 375 Diagnostic Mammograms
l 196 Breast Sonograms
Community Cancer Outreach— Adventist HealthCare
2015 Adventist HealthCare Prevention Activities and Education
l 2015 Annual Cancer Screening Day: 49 participants received 94 cancer screenings for breast, thyroid, colorectal, oral, prostate and skin cancers.
l Susan G. Komen Global Race for the Cure: Handed out several educational materials at the Washington Monument to over 1,500 people.
l Telemundo Washington’s Fiesta De las Madres event: Over 1,500 educational materials handed out with 270 one-on-one encounters.
l Guru Gobind Singh Foundation: Provided free clinical breast exams and educational material on breast health, and information regarding Montgomery County’ Safety-Net Clinics.
l Colorectal Cancer Education and Referrals: Education is provided to women who attend the Breast Screening Program on Colon Cancer. We work with Montgomery County Cancer Crusade, who provide free colonoscopies to eligible Montgomery County residents. Over 25 referrals have been sent to Montgomery County Cancer Crusade.
l Look Good…Feel Better: 38 individuals participated in the program led by specially trained cosmetologists and beauticians designed to help women undergoing cancer treatments look and feel their best.
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015 ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
Since opening our doors in 2014, the Shady Grove Adventist Aquilino Cancer Center has expanded services and treatment options for cancer patients throughout our community. Our multidisciplinary Cancer Team provides coordinated, top-quality care you’d find at an academic medical center—delivered with a personal touch in a soothing setting, close to home.
Together, our team is able to provide services throughout the continuum of care; from screening to diagnostics to treatment and through survivorship.
The Aquilino Cancer Center has a wide variety of support services available to patients, including:
l Assistance with insurance, transportation and financial issues
l Counseling
l Nutrition
Cancer Care Program at Adventist HealthCare Shady Grove Medical Center
l Fitness Classes
l Cooking Classes
l Support Groups
l Rehabilitation Services
l Survivorship Programs
l Integrative Medicine Program
These support services, along with our state-of-the-art equipment and treatment options, are offered under one roof, making it easy for patients to visit multiple doctors and appointments in one convenient location. This means more time for patients to spend on their family, work, hobbies and rest.
We know that a cancer diagnosis can be overwhelming and we will continue to strive to provide the best possible care and healing environment for patients and their families.
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
In 2014, Adventist HealthCare Shady Grove Medical Center saw 848 analytic cancer cases, including those diagnosed at Shady Grove Medical Center and those who received all or part of their initial course of treatment here.
Cancer Cases by Site for 2014 Patients: Adventist HealthCare Shady Grove Medical Center
For the second year in a row, breast continues to be the number one site of new cancer cases, accounting for nearly a quarter of new cases, followed by digestive system (including colorectal), male genital system and endocrine.
Adventist HealthCare Shady Grove Medical Center 2014 Cancer Cases (n=848)
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015 ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
A key Adventist HealthCare mission is to treat the whole person, not just their illness. One aspect of this whole person treatment is through the use of integrative medicine. The Shady Grove Adventist Aquilino Cancer Center gives people access to the region’s only Integrative Medicine Program. Our program is patient-centered, integrating conventional cancer care with evidence—informed complementary therapies addressing the whole person—body, mind and spirit.
The scientific basis for integrative medicine in cancer care is as follows: It was once believed that tumor growth, progression, and metastasis were intrinsically driven by the tumor. Instead, recent research has demonstrated that a solid tumor is surrounded by a complex matrix of cells, particularly fibroblasts, which support and even promote tumor progression. This matrix of stromal cells, also known as the tumor microenvironment (TME), plays a critical role in cancer. There is mounting data that the internal metabolic milieu significantly influences the tumor microenvironment and that life style habits and exposures determine to a large extent the internal metabolic milieu. When we refer to treating the whole person, therefore, we are addressing the internal metabolic milieu.
There is much scientific evidence that supports an “integrative” approach to healthcare. Andrew Weil, M.D., Founder and Director of the Center for
Integrative Medicine Program Treats the Whole Person
Integrative Medicine, defines Integrative Medicine as “an intelligent combination of conventional medicine and evidence-informed complementary
therapies. It looks at all aspects of lifestyle, whole person, body-mind-spirit, places emphasis on the practitioner/patient relationship and makes use of all available therapies—biological, psychological, social and spiritual well-being—in the treatment of disease.” The National Institute for Health’s National Center for Complementary and Integrative Health
supports an “integrative” approach to help manage some of the symptoms and side effects of cancer. With this is mind, the Integrative Medicine Program at the Aquilino Cancer Center addresses and educates people about lifestyle factors that can impact their health—i.e., stress management, nutrition, physical activity, sleep, toxin exposure and spiritual well-being—to improve their quality of life. Our Integrative Medicine approach optimizes lifestyle factors and not only improves a person’s quality of life but also can improve outcomes during and after cancer treatment. This approach also helps them to regain a sense of control over their health.
In addition to the Integrative Medicine Program, the Aquilino Cancer Center also offers Wellness Programs to further support people in their healing process, such as activity-based classes (fitness and yoga), nutrition/cooking classes, and mindfulness meditation/yoga nidra classes.
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
The cancer team at Adventist HealthCare recognizes the important role that clinical trials play in treating cancer. The expert, on-site research teams include physicians and clinical research nurses as well as research associates and assistants. At the Shady Grove Adventist Aquilino Cancer Center and at Adventist HealthCare Washington Adventist Hospital, patients and staff are involved with more than 65 studies each year. In 2015, the cancer team enrolled participants in clinical research trials for 12 types of cancer.
Clinical Trials Pave Way for New Cancer Treatment Options
By participating in Adventist HealthCare’s state-of-the-art clinical trials, patients receive access to promising new treatment options that would otherwise not be available. Adventist HealthCare is committed to bringing patients the latest in cancer research through groundbreaking clinical trials. In addition, our team recognizes and appreciates the invaluable contribution of clinical trial participants in cancer research and treatment efforts.
Cancer Trials Underway
Adventist HealthCare’s cancer team currently offers access to clinical research for the following types of cancer:
l Breast
l Colorectal
l Lung
l Lymphoma
l Multiple myeloma
l Melanoma
l Ovarian
l Pancreas
l Prostate
l Renal
l Solid tumor
l Advanced transitional cell carcinoma
Learn more by visiting www.adventistsgmc.com/ clinicaltrials.
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015 ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
Adventist HealthCare now offers cancer patients a treatment option designed to provide an alternative to surgery or other invasive treatment techniques.
Ablation offers a non-surgical localized method for shrinking and killing tumor cells with extreme heat, cold, radio waves or microwaves while sparing healthy tissue. It is applied directly to tumors by an interventional radiologist without adversely affecting the patient’s overall health.
Consequently, patients often more easily tolerate this outpatient treatment compared to other systemic therapies used to fight cancer. Most patients experience short recovery times and can resume their usual activities in a few days after completing treatment.
Available since the late 1990s, ablation has been shown to be a relatively safe procedure. Because it is a local treatment that does not harm healthy tissue, ablation may be repeated as often as it is needed.
Decreasing a small number of lesions (ideally no larger than three to five centimeters in size) or treating new tumors as they arise can help alleviate the pain and other debilitating symptoms caused by tumors.
Interventional Radiology Offers Patients Non-Surgical Treatment Option
While tumors themselves often are not painful, they may press against nerves or interfere with vital organs, which in turn, can cause pain. Ablation typically treats patients with tumors of the liver, kidney, adrenal, lung and bones.
Adventist HealthCare Shady Grove Medical Center introduced interventional radiology and ablation treatment options in 2014 and has treated several patients with this technique.
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
Approximately 70 million Americans suffer from digestive disorders, ranging from heartburn to colon cancer. Whether common or complex, many diseases of the digestive tract can be effectively treated or prevented. Earlier this year, Adventist HealthCare Shady Grove Medical Center launched the comprehensive Digestive Health Program to help members of our community identify, treat and manage digestive conditions.
Adventist HealthCare’s program takes a team approach with personalized services to treat a range of digestive issues, from chronic gastrointestinal (GI) and acid-related diseases to GI infection diseases and cancers. The road begins with an Adventist HealthCare nurse navigator.
Navigators are available to patients immediately following their diagnosis, serving as the patient’s personal guide throughout their treatment. With one call, the navigator can connect primary care doctors with digestive health experts to coordinate state-of-the-art medical care of GI issues.
Focus on Digestive Health
Digestive health physicians in Shady Grove Medical Center’s Digestive Health program are board-certified in their specialties. They use the latest techniques and technologies to diagnose and manage everything from common digestive ailments to complex conditions, including:
l Biliary tract disease
l Celiac disease
l Cirrhosis of the liver
l Colorectal cancer
l Functional disorders (constipation, diarrhea, gas)
l Heartburn/GERD
l Hemorrhoids
l Hepatitis
l Inflammatory bowel disease
l Irritable bowel syndrome
l Pancreatitis
l Peptic ulcer disease
Adventist HealthCare Shady Grove Medical Center spotlighted the doctors and services in its new Digestive Health program at a launch event for referring physicians in April 2015 at the Shady Grove Adventist Aquilino Cancer Center. The event provided the medical community with a chance to speak one-on-one with Shady Grove specialists, including:
l Gastroenterologists
l Medical Oncologists
l Radiation Oncologists
Digestive Health Launch Event a Success
l Integrative Oncologists
l Nurse Navigator
l Nutritionist
l Surgeons
l Interventional Radiologists
l Social Worker
The event helped to showcase the uniqueness of Shady Grove Medical Center’s Digestive Program which integrates our navigators, GI physicians, surgeons and other specialists to provide a personal touch.
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015 ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
Imaging Services See Increased Growth, Turn-Around Time
Adventist HealthCare Shady Grove Medical Center opened new imaging services within the Shady Grove Adventist Aquilino Cancer Center in April 2014. The new services included positron emission tomography (PET) scans and computed tomography (CT) scans.
PET CT studies show pictures of the body that help detect cancer. They help find the location, size and stage of cancer. A PET scan is an imaging test that helps doctors assess if organs and tissues are working correctly. Examples include blood flow, oxygen use and glucose metabolism. The scan can also help assess how well a patient’s treatment plan is going and whether it needs to be changed. The Aquilino Cancer Center’s PET scanner provides crisp images, features an open design and has fast scan times. It also limits the patient’s exposure to radiation.
2015 Quality Improvement Implementation: Adventist HealthCare Shady Grove Medical Center
A CT scan is a computerized x-ray that creates 3-D images of the body. A patient may ingest contrast before the scan. The scan then takes pictures of “slices” of the body to show if a tumor is present. If there is one present, it shows how deep the tumor is in the body.
These services join an array of other clinical and support services already in the cancer center. With the PET and CT services, patients are now able to get diagnostic imaging in the center. In addition, having this equipment and a radiologist on site allows the oncology physician specialists to immediately work together on their patient’s care plans.
In 2015, the PET/CT programs initiative was to improve the turnaround time (TAT) it takes from a patient receiving their PET/CT to the time it was read by the radiologist. This is a very important metric because it ensures that the referring physicians and their patients receive the report in a timely fashion. In January of 2015, 73.10% of PET/CT’s were being read within 24 hours. By October of 2015, 100% of scans were read within 24 hrs. This was a direct result of an Imaging Services Coordinator who was hired to assist referring physicians and staff with scheduling and obtaining prior authorizations.
As we look to the future, we will continuously strive to do right by our patients and physicians, building on a foundation of trust and quality.
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
Growth: PET—% of Final Reports Within 24 Hours
In 2015 Adventist Healthcare Shady Grove Medical Center’s Radiation Oncology service line went through the reaccreditation process with the American College of Radiology (ACR). This is the “gold standard” of accreditation for radiation centers. It requires facilitates to maintain top quality care along with meeting strict evidenced based guidelines. Adventist Healthcare’s Radiation Oncology was reaccredited for three years with zero deficiencies and the surveyors had many positive comments about the quality of care provided.
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015 ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
Cancer Rehab Services Offer Patients Early Evaluation OptionAdventist HealthCare Physical Health and Rehabilitation came to the Shady Grove Adventist Aquilino Cancer Center in March 2014 to provide outpatient lymphedema therapy services for patients receiving cancer care services. Our occupational therapists are certified in completed decongestive therapy by the Klose Training Program. In addition to providing complete decongestive therapy for patients with lymphedema, our occupational therapists also provide education on risk reduction for at risk patients.
Soon after joining the cancer care team at the Aquilino Cancer Center, Adventist HealthCare Physical Health and Rehabilitation realized there was a need for general rehabilitation services within
Cancer Rehab Call to Eval Quarterly 2015
the cancer care population. Therefore, in addition to lymphedema services, our occupational therapists now provide services for patients with a wide range of functional deficits including decreased range of motion, decreased strength and pain.
Along with offering an increased range of rehabilitation services came an increased wait time for patients to be scheduled for an initial evaluation. Lymphedema treatment requires intensive daily treatment. In the past, patients were not evaluated by a therapist until a daily treatment time was available. Treatment was often delayed due to the time required to obtain required paperwork and insurance authorization. In 2015, Adventist HealthCare Physical Health and Rehabilitation began offering an early evaluation option. By
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
offering early evaluation, patients are often seen for evaluation within one business day. To streamline processes, all required paperwork is now received prior to the patient’s appointment and insurance authorization procedures are initiated while the patient prepares to begin treatment. The clinic director is also meeting with the scheduling department regularly to ensure that the scheduling process is efficient.
In the coming year, we plan to monitor staffing needs and track the time it takes for a patient to begin treatment once they have had an initial evaluation.
Timely Treatment of Prostate Patients
Adventist HealthCare and the American Brachytherapy Society, American College of Radiology and American Society of Radiation Oncology recommend Post Radioactive Seed Implant for patients receiving prostate brachytherapy.
The recommendation from these organizations is to insure the proper dosing of the implant and allow for re-implantation if the doses do not reach a minimum value.
However, completion of the dosimetry can be problematic for various reasons including scheduling issues, patient non-compliance, and prioritization of work within the hospital.
To resolve these issues, the Shady Grove Adventist Aquilino Cancer Study underwent a Quality Improvement Project to track the timeliness of implant dosimetry for patients undergoing prostate brachytherapy in 2015.
The goal of the project was to review the current guidelines and best practices for completion of post implant dosimetry, establish guidelines and determine compliance with these guidelines, and put in place the procedures needed to achieve these goals.
In 2015, 53 patients were implanted who met the criteria for entry in the focused review.
Current goals are to complete the planning CT scan by approximately 30 days post-implant and have the physician review completed by 60 days post implant.
The average time for review by a physician was 44 days and 49 days until approval in EHR. The future goal is to have the scan within 30 days post implant.
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015 ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
The Adventist HealthCare cancer services team was pleased to welcome Dr. Amin Amini as Medical Director of Neurosurgery for Adventist HealthCare Shady Grove Medical Center and Adventist HealthCare Washington Adventist Hospital in
July 2014. He was chosen to lead the development of a neurosurgery program to better serve the needs of the community.
Since 2008, Dr. Amini has been treating patients in the Maryland area for a variety of neurological conditions. Dr. Amini is board certified and completed his residency and chief residency in neurosurgery at the University of Utah Medical Center. His significant research in malignant
Welcome Neurosurgeon Dr. Amin Amini!
tumors of the brain and spine, traumatic cervical spine injuries, and endoscopic spine surgeries has contributed to the neurosurgical literature. He has published more than 40 scientific papers, abstracts, and chapters in prestigious neurosurgical journals and text books. Dr. Amini is currently a principal investigator for research into brain tumors for the National Cancer Institute.
Dr. Amini received his medical degree from Medical College of Virginia. He received his bachelor’s degree and master’s degree from the University of Maryland College Park in Neurobiology and Cell Biology. Dr. Amini is board certified by the American Board of Neurological Surgery. He is a member of the American Association of Neurological Surgeons, the Congress of Neurological Surgeons, the Washington Academy of Neurosurgery, and the Maryland Neurological Society.
He has been named a Washingtonian Magazine Top Doctor every year since 2012.
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
Adventist HealthCare cancer care locations include:
l Adventist HealthCare Washington Adventist Hospital in Takoma Park, MD
l Adventist HealthCare Shady Grove Medical Center in Rockville, MD
l Shady Grove Adventist Aquilino Cancer Center in Rockville, MD
l Adventist HealthCare Radiation Oncology Center in Germantown, MD
l Adventist HealthCare White Oak Breast Center in Silver Spring, MD
Adventist HealthCare Washington Adventist Hospital offers patients the latest treatment options and cutting-edge approaches for cancer and those services are poised to grow. Skilled physicians and staff deliver compassionate care for cancer patients and their families.
Washington Adventist Hospital has recently been granted a three-year accreditation with commendation in four areas by the American College of Surgeons (ACoS) Commission on Cancer (CoC). This prestigious designation exemplifies the continued high-quality care provided through the Washington Adventist Hospital cancer program.
More recently, The Maryland Health Care Commission has granted formal approval for Adventist HealthCare Washington Adventist Hospital to develop a replacement hospital in the White Oak section of Montgomery County. The project is part of the hospital’s longstanding plan to expand access to care in the region and includes keeping healthcare services on its current Takoma Park campus.
Washington Adventist Hospital is part of the Adventist HealthCare system which offers comprehensive, skilled cancer care services including:
l Inpatient Cancer Treatment
l Outpatient Cancer Treatment
l Cancer Related Surgery
l Radiation Oncology
l Community Cancer Programs
l Skilled Home Care
l Cancer Support Groups
l Clinical Trials
l Multi-Disciplinary Clinics
Cancer Care Program at Adventist HealthCare Washington Adventist Hospital
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015 ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
In 2014, Adventist HealthCare Washington Adventist Hospital saw 324 newly diagnosed cancer cases, including those diagnosed at Washington Adventist Hospital and those who received all or part of their initial course of treatment here.
Cancer Cases by Site for 2014 Patients: Adventist HealthCare Washington Adventist Hospital
Breast continues to be the number one site of new cancer cases, accounting for more than a quarter of new cases, followed by male genital system, digestive system (including colorectal) and endocrine.
Adventist HealthCare Washington Adventist Hospital 2014 Cancer Cases (n=324)
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
In October 2015, the American Cancer Society (ACS) revised their guidelines on breast cancer screening for women. The new ACS guidelines recommend that women with an average risk of breast cancer receive annual mammograms starting at age 45. Additionally, the latest guidelines recommend mammograms every two years for women age 55 and older. While these changes are important, the ACS recommends that women between the ages of 40 and 44 have the opportunity to start annual mammograms. Finally, and similar to past guidelines on this topic, the ACS does not recommend breast self-exams.
Despite the latest changes to breast cancer screening guidelines Adventist HealthCare acknowledges that mammography screening saves lives and early detection is critical for improving breast cancer survival. Several well-respected organizations, including the American College of Radiology, the Society of Breast Imaging and
New Guidelines for Breast Cancer Screening
the American Congress of Obstetricians and Gynecologists, continue to recommend screening mammograms beginning at age 40 and yearly thereafter for most women while they are in good health.
The latest breast cancer screening guidelines may create confusion and concern among women who are unsure about when and how to be screened for breast cancer. We encourage women to discuss breast cancer screening with a physician or other healthcare provider to make an informed decision based on personal and family health history. For women who are considered high-risk based on their personal or family history, additional supplemental screening with tools such as MRI may also be recommended. Mammograms are still considered the best tool for screening, and can detect up to 85 percent of all breast cancers, despite the recognized limitations of false positive exams and patient anxiety.
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015 ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
Number of Patients: 777
l Total Mammograms
l Screening: 431
l Diagnostic: 219
l Sonograms: 163
Abnormal Mammograms
l Code 3 short-term follow up: 79
l Code 4 biopsy needed: 36
l Code 5 highly suspicious: 1
Focus on Breast Cancer Care
Adventist HealthCare’s Breast Cancer Screening Program provides breast health services to low-income, uninsured and ethnically diverse minority women in Montgomery and Prince George’s counties. The program works with community safety net clinics in Montgomery County, the Primary Care Coalition of Montgomery County (PCC), and the Montgomery County Women’s Cancer Control Program (WCCP). Safety net clinics refer women to the program for mammography screening, and PCC and WCCP fund services for eligible women. The program navigates women through the screening process, and links them with diagnosis and treatment when needed.
2015 Quality Improvement Implementation: Adventist HealthCare Washington Adventist Hospital
Through the use of an Avon grant, the program is now able to complete the application for coverage of diagnostic imaging, which has reduced the burden on the patient and decreased the number of days from screening to diagnostic mammogram from about 40 days to as low as 17 days at Adventist HealthCare Washington Adventist Hospital and 19 days at Adventist HealthCare Shady Grove Medical Center. Patient care has also improved by taking the letter generated by the electronic medical record (EMR) system in English and translating it into 16 languages so patients better understand what to expect at appointments and how to read results.
Two program highlights for 2015 were:
l Adventist HealthCare’s Breast Cancer Screening Program was selected to be highlighted as a success story in the Maryland Comprehensive Cancer Control Program 2015 Progress Report.
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
l The Breast Cancer Screening Program also received an award from Primary Care Coalition for Breast Health Quality Consortium data collection and improvement of breast healthcare quality indicators.
Breast Cancer Survivors Honored at Annual Celebration
The Adventist HealthcareAquilino Cancer Center hosted more than 50 local breast cancer survivors and their loved ones during Adventist HealthCare’s 8th Annual Breast Cancer Survivorship Celebration.
The systemwide event featured the inspirational stories of two patients who have battled back against the disease. Dr. Laurie Herscher, Director of the Integrative Medicine Program at the Shady Grove Adventist Aquilino Cancer Center, delivered a thought-provoking presentation on ways that
Adventist HealthCare Washington Adventist Hospital Screening to Diagnostic Mammogram/Breast Screening Program Patients YTD 2015
lifestyle choices such as proper diet and exercise can help prevent cancer. Guests also enjoyed healthy cooking demonstrations, education on make-up and skin care, a raffle and a fun photo booth.
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015 ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
Though the Survivorship Celebration has become a tradition, this year’s event was the first time that Adventist HealthCare Shady Grove Medical Center and the Adventist HealthCare Shady Grove Breast Center joined with Adventist HealthCare Washington Adventist Hospital and the Adventist HealthCare White Oak Breast Center to highlight the success of patients systemwide.
Nutrition Services Integral to Patient CareIn 2015, the Cancer Committee at Adventist HealthCare Washington Adventist Hospital conducted a study which identified Nutrition Services as an underutilized support service in the care of oncology patients.
To increase utilization of this service, a Quality Improvement process was conducted, which was designed to enhance the number of oncology patients that were referred to nutrition services. The process reflected the need for patients to maintain optimal nutrition status throughout their treatment. This implementation was piloted on outpatient Radiation Oncology patients in 2015.
January through June 2015 the Washington Adventist Hospital Cancer Team reviewed existing policies and procedures, which included the current nutrition assessment tool/method, referral patterns, and what diagnoses were most in need of nutritional support. After this assessment, the team redeveloped the screening tool/questionnaire and overhauled the referral process and policy.
Beginning July 2015, Radiation Oncologists began including nutrition services referrals as part of the treatment plan for all new patients, with a nutrition consult scheduled within the first two weeks of treatment.
From this initial consult, a dietitian follow-ups with patients who are considered a high nutritional risk (diagnosis of lung, colorectal, gastric, gynecologic, head & neck, lung and pancreatic cancer) every two weeks to monitor and reevaluate nutritional needs and/or provide further nutrition counseling regarding symptom management.
This Quality Improvement Process has also resulted in the hiring of a 0.5 FTE dietitian for Washington Adventist Hospital, as well as outpatient centers like the Infusion Centers and Adventist HealthCare White Oak Breast Center. Cooking classes are now offered monthly to anyone in the community that has an interest in learning more about healthy, nutritious recipes and cooking techniques. And, the Cancer Teams are currently developing a Head & Neck Pathway at the Shady Grove Adventist Aquilino Cancer Center for patients at high risk for nutrition decline and nutrition impact symptoms while going through treatment.
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
Adventist HealthCare Washington Adventist Hospital Oncology Nutrition 2015/2016
Nutrition Referrals 2015
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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2015
Adventist HealthCare Washington Adventist Hospital has been granted a three-year accreditation with commendation in four areas by the American College of Surgeons (ACoS) Commission on Cancer (CoC). This prestigious designation exemplifies the continued high-quality care provided through the
Renewed Accreditation for Cancer Care: Washington Adventist Hospital
Washington Adventist Hospital cancer program. More than 70 percent of all newly diagnosed cancer patients are treated in the more than 1,500 CoC-accredited cancer programs nationwide. Washington Adventist Hospital has been approved as a Community Cancer Program for the past six years.
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