Providers need to make sure they're ready to meet the new oncology standards established by the American College of Surgeons. The standards, which go into effect Jan. 1, were issued in 2012 to ensure patient-centered care, and are required for Commission on Cancer accreditation. "Cancer Program Standards 2012: Ensuring Patient-Centered Care" establishes new requirements for patient-centered needs and expands the focus on improving the quality of care and patient outcomes.
Putting the patient at the core of the care model means understanding that the cancer experience is hugely personal. To effectively execute the CoC standards, providers must also ensure that they are addressing the personalized communication necessary for patient-centered cancer care.
The Patient Navigation Process
In 2015, the CoC standards will require all cancer programs to demonstrate that they have the resources to assist cancer patients, families and caregivers in navigating through their cancer journey. The goal of these new standards is to address an unmet need for cancer patients and caregivers.
With a similar objective in mind, The Cancer Experience: A National Study of Patients and Caregivers (released in June 2014) was conducted to obtain a comprehensive analysis of how cancer patients and caregivers evaluate their experiences, providing insights into specific areas in which health care providers are meeting expectations and needs, or are falling short.
Commissioned by the Cancer Treatment Centers of America, the survey of 1,058 cancer patients and 1,058 caregivers who sought treatment at hospitals across the United States found that communication was the most important criterion in selecting a treatment facility. However, there was a gap between the three things patients identified as most important when choosing a cancer treatment facility and what they experienced. The survey showed:
- 91 percent of patients want timely information, but only 79 percent said they received it;
- 90 percent want a care team willing to answer questions, but only 74 percent reported having had a team willing to do this;
- 87 percent want to be fully involved in treatment decisions, but only 70 percent said they felt fully involved.
From these results, it's clear that patients want more help coordinating their cancer care. One effective model is for the full care team — medical oncologist, clinic nurse, registered dietitian, naturopathic oncology provider and nurse care manager — to be present during each appointment, so patients get answers to their questions and enjoy greater comfort, convenience and privacy. While this model may not work for every cancer center, it is important that every institution provide a central point of contact that can help patients to navigate appointments quickly and efficiently, get answers to their questions, and be fully involved in decisions about their care.
Survivorship Care Plans
Another requirement for 2015 will be providing a summary of treatment as well as a follow-up plan for all patients completing cancer treatments. Ten years ago, cancer survivorship programs were rare, but now these programs are common at large hospital systems as well as community hospitals. These programs address short- and long-term side effects as well as quality-of-life issues that may occur after a patient is cancer-free, with services including physical therapy, pain management and psychological counseling as well as care for premature aging and sexual health.
The Cancer Experience Survey results note that patients and caregivers want survivorship programs, but are often unclear on what exactly those programs entail and what that term really means. More than one-third of patients and caregivers said that they had never heard of survivorship programs, or they had no idea what they were, while more than half of survey respondents say the availability of survivorship programs is an important factor when deciding where to seek treatment. This suggests there is some misunderstanding among patients and caregivers about what these programs really mean to them.
Survivorship programs offer an opportunity to meet the demand of patients and caregivers; but, it is essential to communicate the benefits of the programs and how they address physical, emotional and social issues to help improve patients' quality of life. There need to be channels in place to stress the importance of survivorship programs to new patients, as they may not be educated on the options before seeking care.
Psychosocial Distress Screening
The third standard that must be phased in for accreditation in 2015 is that cancer programs will need to demonstrate that they screen patients diagnosed with cancer and identify any issues that can negatively impact treatment and outcome.
In pinpointing these issues, providers can help patients and caregivers respond to a cancer diagnosis and treatment in empowering and stress-minimizing ways to improve health, relationships and overall well-being. It's important to consider that every patient is different, so initiatives need to be personalized to meet the needs of individual patients.
For example, the Cancer Experience Surveyresults identified differences between what motivates men and women from different ethnicities and what they consider important to care:
- Women are significantly more motivated by family goals and support to get well (56 percent of women versus 46 percent of men), while men are more motivated by health goals and resuming daily activities (43 percent of men versus 36 percent of women).
- Compared with women, men rate fewer components of care — such as nutritional and psychological counseling — as important.
- African-American patients are likely to be driven by their faith and spirituality (79 percent).
- Hispanic patients are more likely to be driven by family responsibilities and support (84 percent).
Knowing what motivates a patient can help to tailor how providers discuss their care approach. It's more important than ever to be trained to communicate with patients from different backgrounds and for cancer centers to offer a range of integrative care services and counseling that individual patients can choose from, with services ranging from pet therapy to group counseling to wellness practices for stress management.
These new standards showcase the need for cancer centers to go beyond the standard of clinical excellence and put patients truly at the center of care. The common thread in each of the CoC standards is ensuring open and direct communication with patients and caregivers, as well as the understanding that care is personal. Providers need to make sure the patient is at the core of everything they do, not only to meet these new standards, but to ensure that all patients and caregivers have the best experience possible.
Maurie Markman, M.D., is the president of science and medicine at Cancer Treatment Centers of America in Philadelphia.