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Implementing Improvements Recommended by Patients and Families
February 26, 2016
Robert Colburn, Sue Fuller Blamey,
Tracy Lust, & Kris Gustavson
Provincial Out-Patient Cancer Care Survey
Survey sent to 20,000 BC patients
& families
All BC Cancer Centres and
Health Authorities cancer clinic
patients
Survey was in the field for 6 months
(patient in care from June – Dec
2012)
Patients participated from all over BC
BCCA Centres
Health Authorities
CON clinics
13,000 patients &
families included
Results to be proud of…
97.5 %
of survey respondents rated the “overall quality of the Out patient Cancer Care they received” as:
“Excellent, Very Good or Good”
Original Survey Question: Overall, how would you rate the quality of care at (location) in the past 6 months?
Response Options: Excellent, Very good, good, Fair, Poor
Overall Rating
for all Treatment Groups
PHSA 2005/2006 2012/13
Physical Comfort 77.4% 71.4%
Coordination & Continuity of Care 64.2% 65.4%
Information, Communication & Education
63.7% 60.1%
Respect for Patient Preferences 77.2% 75.7%
Access to Care 71.9% 72.4%
Emotional Support 46.3% 46.8%
Provincial Action Group
To explore the reasons for these lower scored survey responses a provincial committee was created with representatives from the
BC Cancer Agency and all health authorities. 56 leaders from BCCA centres and each Health Authority met for almost 2 years
Chose 2 Survey Questions that Scored Lower Throughout the Province for Focus
1. If you had any worries or concerns during your treatment/visit, did your care provider discuss them with you?
2. Did you know who to go to with questions?
Provincial Patient/Family and Staff focus Groups
Focus groups were held for patients, families and staff at each BCCA centre across the province to explore the reasons for lower scores for the specific survey questions
Focus Groups at BCCA Centres & CON sites
Focus groups
October 2014 –
January 2015
CN & Quesnel
(CON)
VIC, CSI & Comox,
Nanaimo, Kamloops
CON
VC & Powell River
Hospital CON
FVC, AC & Royal
Columbian Hospital
CON
Underlying Themes from the Survey & Focus Groups
1. Access to cancer care
2. Not enough information about specific concern
3. Lack of empathy or poor communication
4. Counseling
5. Coordination of care
What would have made a difference?
Knew that counselling services were available during cancer care, but did not know one could access them post-discharge from the BCCA
Would have liked to speak with someone that was going through the same type of cancer experience
What Patients need…Emotional Support 3.
To have
info about
support groups in
home community
2. To be offered support services throughout
their cancer care
1. To connect with other patients who are experiencing the same type
of cancer
Recommendations – Promote Top 4 Emotional Support Resources
1. CancerChatCanada- Professionally led online support groups for Canadian cancer
patients as well as their family members. 2. CancerConnection – A confidential telephone based peer support program.
Individuals are matched with a trained volunteer who has had a similar cancer experience. Volunteers listen and offer support.
3. Counselling – Services offered at different stages throughout the patient’s
cancer care journey to address both emotional and practical care such as returning to work, finances and aspects of daily living.
4. Support Groups – Information about how to access various support groups throughout British Columbia.
Emily Carr School of Art and Design - Vote 1. Fostering Connections. Building Community
Cancer support from professionals you trust and patients like you
2. Your Care Plan. Your Journey
We have support options for you at every step in your progress
3. Cancer isn’t a choice
Choose the support that’s right for you.
4. Every Experience is unique.
Cancer support for however you’re feeling
5. Living with Cancer, Together
Let’s explore your options for health.
Evaluation
Indicators of Success:
# of cancer patients who joined the cancerchat on-line discussions
# of people who accessed cancerconnections
# of patients/families that participated in support groups
# of counselling sessions conducted at the BCCA
Patient/Family Surveys prior to and after implementation
Staff Surveys pre & post education and implementation
Cancerconnection – 2014 and 2015
0
50
100
150
200
250
300
Clients Matches
Cancerconnection - Clients & Matches
2014
2015
Referrals to Professional Counselling
0
100
200
300
400
500
600
700
# of Referrals to Patient/Family Counselling Services BCCA
Support Group Participation
0
100
200
300
400
500
600
Jan-15 Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan-16
# of Patients/Families Attending Support Groups
Staff: Cancerchat and Cancerconnections
Yes24%
No76%
Pre: Staff Aware of Cancerchat
Yes52%
No48%
Post: Staff Aware of CancerChat
Yes37%
No63%
Pre: Staff Aware ofCancerconnections
Yes52%
No48%
Post:Staff Aware of Cancerconnections
Counselling, Support Groups and Action
Pre: 63% of staff were aware that they could share the info but only 24% knew where to find it
Post: 50% have shared info, 52% feel equipped to share and 44% knew where to find all of the info
0%
20%
40%
60%
80%
100%
Counsel Support
Staff Aware of Counselling and Support Groups
Pre
Post
Patient/Family Pre-post Survey Results
0%
10%
20%
30%
40%
50%
Cancerchat Cancerconnections
Patient Aware of Cancerchat & Cancerconnection
Pre
Post
0%
20%
40%
60%
80%
Counsel Support
Patient Aware of Counselling & Support Groups
Pre
Post
Campaign, Comfort Asking Questions 1. Have you seen the Emotional Support advertising?
Are you comfortable asking your care team about these resources?
Are you comfortable getting information from the BCCA website?
Campaign Ask questions Website
64%
97%
73%
Patient Aware of Initiative
Original Provincial Survey Questions
1. If you had any worries/concerns during your treatment/visit, did you care provider discuss them with you?
2. Did you know who to go to with questions?
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Worries Questions
Rating of Original Two Questions
Pre
Post
Next Steps
Emotional Support Resources advertising
campaign will be:
Shared with all Community Oncology clinics and physician offices throughout British Columbia.
Continued evaluation for effectiveness next in April and June 2016.
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