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Via Christi Oncology Services
2016 annual report for 2015
Locations and Contents Locations
Via Christi Hospital St Francis 929 N St Francis Wichita KS 67214
Via Christi Cancer Center 817 N Emporia Wichita KS 67214 3162685927 Satellite office of Cancer Center of Kansas outpatient radiation and chemotherapy Via Christi Cancer Resource Center (patient library and classes)
Via Christi Hospital St Joseph 3600 E Harry Wichita KS 67235
Via Christi CyberKnife Center 825 N Emporia Wichita KS 67214 3162683200
Via Christi Hospital St Teresa 14800 W St Teresa Wichita KS 67235
Wichita NCI Community Oncology Research Program (Wichita NCORP) 929 N St Francis Wichita KS 67214 3162685784 or 8003625784 Funded by the National Institute for Health (NIH)National Cancer Institute (NCI) headquartered at Via Christi Hospital St Francis Local partner for national clinical trials and preventive studies
Via Christi Cancer Institute 929 N St Francis seventh floor Wichita KS 67214 Inpatient cancer care on-site Cancer Resource Center home to many clinical trials
Winfield Cancer Center 1305 E 5th Ave Winfield KS 67156 6202212900 Outpatient medical and radiation therapy services provided in partnership with William Newton Memorial Hospital and Cancer Center of Kansas
Contents Oncology Services Overview
Program Goals
Cancer Registry
Tumor Board Conference
Wichita NCORP
Inpatient Oncology
Blood and Marrow Transplant Center
Radiation Oncology
Outreach and Prevention
Outreach and Prevention Activities
Cancer Committee
2
Oncology Services Administration
3
The 2016 Via Christi Oncology Services annual report highlights many of the clinical and technological advancements made during the 2015 year while emphasizing the programmatic growth of oncology services As new goals are established letrsquos celebrate some of the program successes in 2015
The clinical goal for the Cancer Committee was a focus on staff retention by maintaining a turnover rate of less than 13 in the Via Christi Cancer Institute The program goal was the implementation of cancer risk assessment genetic counseling and testing services with the Via Christi Health system The special study was the PCORI study A side study of colorectal screening on area firefighters is planned for 2015
We believe you will enjoy reading the Via Christi Oncology Services annual report The Cancer Committee welcomes any questions or requests regarding the comprehensive services that we provide to our patients providers and community
Sincerely Pavan S Reddy MD and Keisha Humphries MHCL BSN RN OCN
Oncology Services Overview
4
bull American College of Surgeons (ACOS) Commission on Cancer (CoC) Standards reviewed quarterly for 2018 accreditation survey
bull CoC partnership with the American Cancer Society (ACS)
bull Philanthropic donationsfundraising effort providing massage therapy to cancer patients on unit and exercise rehabilitation for Via Christi patients transitioning from inpatient to outpatient
bull Wichita NCI Oncology Research Program (Wichita NCORP) awards NCI accrual Quality-Research Bases Wichita NCORP goal is to have 4 of Via Christi patients enrolled in clinical trials This goal was met in 2015 with 96 enrolled
bull Via Christi Blood and Marrow Transplant Center received a three-year accreditation from the Foundation for the Accreditation of Cellular Therapy (FACT) Goal met in 2015 with 48 patients transplanted
bull Via Christi Radiation Therapy treated on average of 41 patients per day in Wichita and 7 patients per day in Winfield The CyberKnife volume increased 46 from 2014 Department goals reported foam infoam out initiative at 98 compliance daily pain assessment at 99 and fall riskabuse and neglect at 92 each for 2015
bull Cancer Registry abstracted 2004 cases 2015 1st contact cases with 1878 new cases Patient follow-up goal of 80 for long-term cases met at 8557 but short-term cases fell short of the required 90 to 8838
bull Oncology Patient and Family Advisory Board chartered in 2013 remain active in patient advocacy
bull Awarded the Department of Health and Human Services grant for insurance navigation programs in the Wichita community for a second year assisting 1162 individuals on the market place and enrolling 129 individuals for insurance
bull The Cancer Outreach and Risk Assessment Program assisted 42 patients for genetic testing with 16 showing positive 31 showing VUS and 53 showing negative results for genetic abnormalities Nurse navigation completed 60 survivorship care plans and conducted 21 LDCT scans with five positive results for cancer
Oncology Services Overview
5
Program Goals for 2015
6
Clinical goal- Via Christi Cancer Institute to focus on staff retention by maintaining a turnover rate of less than 13 This goal was met in 2015 through attendance in human resource (HRO) training development of CLABSI fall and C diff teams development of oncology specific competency days completion of online chemotherapy certification course for new RNs and the addition of one day-shift chemotherapy certified nurse on the unit
Program goal- Implementation of cancer risk assessment genetic counseling and testing
services within the Via Christi system This goal was met in 2015 with the addition of a nurse navigator to develop and explain survivorship care plans to patients a newly formed lung tumor conference and the development of a cancer outreach and risk assessment to include genetic testing and counseling
Special study- Via Christi Cancer Committee approved moving forward with the Patient-
Centered outcomes Research Institute (PCORI) study which focused on breast colorectal and lung cancer patients The intent is to analysis data from the National Cancer Data Base (NCDB) to assess how patients were being followed with post-treatment surveillance testing to further assess the accuracy of recurrence data Special study standard met as of November 18 2015
Cancer Registry
7
Cancer Registry performs as an information system designed to manage and analyze data on persons with a cancer diagnosis Data for all Via Christi cancer patients is submitted for incidence trend and survival analysis provided to
the Kansas Cancer Registry at the University of Kansas Medical Center and the National Cancer Data Base at the American College of Surgeons
Commission on Cancer- Cancer registrars ensure that complete accurate and timely abstracting is achieved for each patient that is diagnosed andor treated at Via Christi Hospitals
Patient demographics primary site histology stage of disease treatment and outcomes are retrieved The data collected is then analyzed and reported for the purpose of education research and outcome measurements The information collected by cancer registries enables public health professionals to better understand and address the cancer burden Registry data are critical for targeting programs focused on risk-related behaviors such as tobacco use and exposure to the sun or on environmental risk factors like radiation and chemical exposures Such information is also essential for identifying when and where cancer screening efforts should be enhanced and for monitoring the treatment provided to cancer patients In addition reliable registry data are fundamental to a variety of research efforts including those aimed at evaluating the effectiveness of cancer prevention control or treatment programs
The registrars work closely with physicians administrators and researchers to provide support for the cancer program and ensure compliance with the CoC cancer program standards Each patient is provided a lifetime follow-up service that serves as a continuing monitor for diagnostic and treatment results as well as a reminder to physicians and patients that regular post-treatment examinations are needed The follow-up rate is 90 percent for all patients placed in the database since Jan 1 1996 This percentage stayed at or above 90 percent for 2015
Cancer Registry Five-Year Comparisons
8
The number of new cases at Via Christi over the last five years is compared below BronchusLung cancers remain the highest in occurrences with Breast cancers following
There is a steady increase in Hematopoietic amp Reticuloendo System cancer occurrences with a steady decline of Prostate cancer occurrences
The other top cancers remaining at a constant level
0
50
100
150
200
250
300
350
400
2011 2012 2013 2014 2015Colon RectumBronchus amp Lung Hematopoietic amp Reticuloendo SystemBreast Corpus UteriProstate Gland KidneyBladder Lymph Nodes
Cancer Registry County at Diagnosis
9
(no change from 2014) (decrease from 2014) (increase from 2014)
A total of 2004 cancer cases were accessioned in 2015 1878 of them new cases Most were from Kansas with a few from Arkansas Colorado Oklahoma Missouri Nebraska and Texas
Cancer Registry Male vs Female Cancer Occurrence
10
Cancer Registry Most Frequent Sites Comparison
The five most frequent sites seen for cancer occurrence in patients at Via Christi Hospitals in Wichita during 2015 were Bronchus and Lung Prostate Breast Colon and Hematopoietic disorders
Bronchus and Lung made up the greatest percentage of cases
11
Tumor Board Conferences In addition to incidence reporting the Registry plays an active role in coordinating bi-weekly cancer conferences which are
integral to improving the care of cancer patients by providing National Comprehensive Cancer Network guidelines and a multidisciplinary physician team approach to the patient management process and outcomes as well as education to physicians and other staff in attendance
12
During 2015 28 multidisciplinary tumor board conferences were conducted Since 2004 the conferences have been combined presenting cases from Via Christi Hospital St Joseph and Via Christi Hospital St Francis Coordinated by Dr Joel W Alderson the combined conferences are held at St Francis Physicians earn 1 0 AMA PRA Category 1 Credittrade for attending a tumor board conference In the conferences at St Francis 177 cases (10 of Via Christi Cancer Centerrsquos total analytic case load) were presented Primary and multiple sites were reviewed
PHYSICIANSCLINICAL PRACTITIONERS Nicholas M Brewer MD Radiology - Presenter Joel W Alderson DO Pathology Jon C Anders MD Radiation Oncology David Bryant MD Radiation Oncology Chris S Dakhil MD Medical Oncology Earl F George MD General Practice Teh (Ted) I Ho MD Pathology Steve S Hwang MD Pathology Fadi N Joudi MD Urology Chuen-Huey Lai MD Pathology Lidia S Manouilova MD Pathology Cindy Nguyen APRN Radiation Oncology
Additional Cancer Conferences
13
Via Christi Hospital St Francis also hosts a weekly Blood and Marrow Transplant Center of Kansas conference During 2015 40 conferences were conducted The blood and marrow transplant meetings were directed by Bassam Mattar MD Dennis Moore Jr MD Phu Truong MD and Pavan Reddy MD
SITES OF CASES CASES PER SITE PRESENTED CASES
ORAL CAVITYPHARYNX 48 4 DIGESTIVE SYSTEM 378 45
RESPIRATORY SYSTEM 387 39 BONES amp JOINTS 3 0 SOFT TISSUE 21 2
SKIN EXCLUDING BASALSQUAMOUS 53 6
BREAST 307 10 FEMALE GENITAL SYSTEM 99 8
MALE GENITAL SYSTEM 109 19 URINARY SYSTEM 132 24
EYE amp ORBIT 1 1
BRAIN amp OTHER NERVOUS SYSTEM 97 5
ENDOCRINE SYSTEM 61 3 LYMPHOMA 113 5 MYELOMA 48 0 LEUKEMIA 72 1
MESOTHELIOMA 5 0 MISCELLANEOUS 71 5
TOTAL CASES 2005 177
14
Via Christi Cancer Institute is supported by a robust clinical trial program through the Wichita NCI Community Oncology Research Program (Wichita NCORP) Wichita NCORP is one of 34 NCORPs supported by the National Cancer Institute to advance the science of cancer research During the past 34 years the Wichita NCORP has established an excellent track record with clinical research accomplishments recognized by NCI peers and others in the cancer research community
Via Christi Health is the fiscal agent for Wichita NCORP and provides administrative and financial support for this NCI grant-
funded program Clinical trial patients served at Via Christi Cancer Institute receive cutting edge radiation and chemotherapy treatments for a wide variety of malignancies including brain cancer breast cancer and leukemia Wichita NCORP is also proud to partner with Cancer Center of Kansas Lawrence Memorial Hospital and Associates in Womenrsquos Health in order to support cancer research in urban and rural areas across Kansas While approximately 33 percent of Kansasrsquo population lives outside of urban areas the Wichita NCORP is able to boast 18 percent clinical trial accrual due to the amazing support of physician investigators and clinical research staff (Institute for Policy and Social Research 2013
In 2015 the Wichita NCORP placed 96 of patients diagnosed at Via Christi on a clinical trial the target is 4 A total of 73
clinical trials were open to new patient enrollment throughout 2015 with 240 patients enrolled As a means of addressing quality measures for the Commission on Cancer the ldquoReducing Lung Cancer Survivorrsquos Anxietyrdquo (RELAX) clinical trial which involves using FDA approved headphones with device-guided breathing tones for patients who are NSCLC survivors to help with anxiety and hypertension was presented to the Cancer Committee
As cancer research turns to precision medicine that attempts to match treatment to targeted cancer mutations WCCOP is able
to fully support this endeavor with submission of tissue blood urine and stool specimens to biospecimen banks for current and future research initiatives Via Christi Health is a major contributor in this field of research by assisting to prepare and submit specimens for specialized testing on an almost daily basis
15
bull To stimulate quality medical care through participation in treatment protocols for cancer patients in Wichita south central southwest and northeast Kansas a patient population that otherwise would be underserved because its geographical location is remote from comprehensive cancer centers
bull To increase the accrual of patients on adult NCI treatment
cancer prevention and control protocols and cancer care delivery research thus reducing the time necessary to answer critical questions and speeding the transfer of the latest research findings to the community level
bull To continue to ensure quality and timely data collection
while also continually implementing measures to protect clinical trial participant safety
bull To continue to facilitate the involvement of underserved
Kansas minority young adult and rural populations in treatment cancer prevention and control and cancer care delivery research
bull To bring a multidisciplinary approach to the clinical trials
arena and clinical decision-making with an emphasis on collaboration of care
Wichita NCORP GY2 (2015 and 2016)- Accrual to Date
In-Patient Oncology
16
Via Christi Cancer Institute is located in the north towers of Via Christi Hospital St Francis The 40-bed unit consists of private rooms and includes seven beds that accommodate our established FACT-accredited allogeneic and autogenic bone marrow and stem cell transplants The purpose of the Cancer Institute is to develop implement and evaluate a plan of unit operation to facilitate the overall functioning of the patient care unit promote maximum utilization of the nursing staff and deliver a safe effective and appropriate level of patient care We serve patients ranging from young adults to older adults for diagnosis and management of a variety of acute or chronic medical conditions and malignancies Registered nurses with specific skill and knowledge in the care of oncology patients provide comprehensive care in a multidisciplinary team model that ensures that patients and their families are surrounded by highly skilled professionals who work together to craft individualized care for each patient
Complications associated with a malignancy and its treatment may affect a wide variety of systems in which staff work in cooperation with the Blood and Marrow Transplant Center jointly operated by Via Christi Cancer Center of Kansas and the American Red Cross Services are provided through an individualized plan of care utilizing the nursing process
This year there was strong focus on patient safety hand hygiene safety huddles at every shift and patient-centered care Bedside report
has replaced traditional face-to-face report that previously did not involve the patient Communication is improved as the patient is introduced to the staff now assigned to their care Patients are included in report and are encouraged to ask questions and provide feedback as needed Bedside report improves safety as a tubing reconciliation is done between the oncoming and off-going RNs We believe this combination of research education and clinical treatment helps ensure that care provided is on the cutting edge
In-Patient Oncology
The comprehensive care of patients is provided in collaboration with primary care doctors surgical specialists and radiation oncologists A team of highly-trained individuals within the hematology and oncology department work in collaboration to perform the highest level of care Via Christi Cancer Institute nurses are encouraged to obtain their oncology nurse certification which is accredited by the National Commission for Certifying Agencies and the Accreditation Board for Specialty Nursing Certification and equips them with advanced training in the care of patients with cancer The Cancer Institute also works closely with a registered dietitian to maintain proper nutrition before during and after cancer treatment While the medical oncologist hematologist specializes in cancer andor blood related disorders and oversees chemotherapy and other medical treatments as appropriate nurse practitioners and physician assistants work with doctors to diagnose and treat illness offer preventive care prescribe medication and educate patients about their illness and treatment
Amenities include CD players DVD players and a
variety of DVDs to help patient and families pass the time and stay connected Other amenities include Internet access laundry facilities family sleep rooms family area that contains a refrigerator and microwave massage and yoga therapy and a movie theater
17
Blood and Marrow Transplant
18
Performed 43 autologous peripheral blood stem cell transplants and five allogeneic peripheral blood stem cell transplants Survival rate for transplant occurrence is 94 at 100 days from transplant and 92 one year out
Served as an apheresis center for the National Marrow Donor Program Donors are harvested at Via Christi Hospital St Francis and their cells are delivered to the matching recipients throughout the world
Coordinated 56 peripheral blood stem cell harvests that were performed by our transplant program partner the American Red Cross The cells obtained from these harvests are processed by the Via Christi Bone Marrow and Flow Laboratory
Received accreditation from the Foundation for the Accreditation of Cellular Therapy (FACT)
The transplant Quality Management Program continues to evolve and monitors processes and improves functioning in all aspects of the program