Cancer Care Outcomes Report 2016 - Adventist HealthCare...ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2016 1 ... l Crossroads Farmers Market: Provided breast cancer and digestive

Cancer Care Outcomes Report 2016

Shady Grove Adventist Aquilino Cancer Center, Cancer Committee Chairman Letter ........................................................... 1

Adventist HealthCare Washington Adventist Hospital, Cancer Committee Chairman Letter .............................................. 2

2016 Cancer Committees ................................................................................................................................................................................ 3

Community Cancer Outreach—Adventist HealthCare ....................................................................................................................... 5

Cancer Care Program at Adventist HealthCare Shady Grove Medical Center ............................................................................ 7

Cancer Cases by Site for 2015 Patients: Adventist HealthCare Shady Grove Medical Center ............................................... 8

Clinical Trials Provide Hope for New Cancer Treatment Options .................................................................................................... 9

l Focus On: Neuroscience

2016 Quality Improvement Implementation: Adventist HealthCare Shady Grove Medical Center................................ 11

l Focus On: Enhanced Recovery After Surgery

Cancer Care Program at Adventist HealthCare Washington Adventist Hospital .................................................................... 12

Cancer Cases by Site for 2015 Patients: Adventist HealthCare Washington Adventist Hospital ....................................... 13

Welcome Dr. Ackerman! ............................................................................................................................................................................... 14

2016 Quality Improvement Implementation: Adventist HealthCare Washington Adventist Hospital .......................... 15

l Focus On: Palliative Care

Breast Cancer Survivors Celebrated at Systemwide Event .............................................................................................................. 16

Breast Center Receives Full Accreditation ............................................................................................................................................. 17

Table of Contents

ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2016

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Dear Colleague,The Shady Grove Adventist Aquilino Cancer Center spent 2016 deepening its impact as our community’s first and only comprehensive cancer treatment center in Montgomery County. We’ve added new physicians and equipment to the service line, allowing us to treat cancer in new, innovative ways. Our integrative medicine program continues to grow and thrive with new programs that aim to treat the whole patient—mind, body and spirit.

Our team is on the cutting edge of research, offering access to clinical trials for the following types of cancer:

We’ve added Neurosurgery to our already long list of services and are now able to care for patients that are living with cancer of the brain, neck and spine.

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.

When we first conceived the Aquilino Cancer Center, we envisioned an innovative, comprehensive facility that made it convenient for patients to meet with physicians and receive the latest treatments under one roof—eliminating the stress of running to and from appointments for their cancer care. Two years later, it’s clear this vision has been realized.

Our team of specialized staff, including oncologists, surgeons, nurses, technicians, navigators, social workers and integrative medicine experts, allow us to continue to develop and deliver compassionate cancer care for our community.

Joseph Haggerty, MD Cancer Committee Chairman Adventist HealthCare Shady Grove Medical Center

l Advanced Cancer

l Breast Cancer

l Colon Cancer

l Lung Cancer

l Myeloma

l Ovarian Cancer

l Prostate Cancer

l Solid Tumors

l Urothelial Cancer

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ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2016 ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2016

Dear Colleague,Throughout 2016, Adventist HealthCare Washington Adventist Hospital served the growing and unique population found within our community with the compassionate cancer care that patients have come to expect from us. Our dedicated team of physicians, surgeons, nurses and specialists continued to provide high-quality treatments, clinical outcomes and support services in many disciplines within cancer care, including social work, infusion, imaging services, radiation oncology, research and nutrition.

We’ve remained dedicated to safety and quality with the completion of several quality improvement projects, which have led to streamlined processes and even better patient outcomes.

The work has begun on our new, 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. Construction began with a groundbreaking in March and we are well underway with the project, pouring the foundation in the later part of 2016. We anticipate opening our doors to the community in early 2019.

Project highlights and construction progress can be found by visiting www.ourcommunitytransformed.org.

As the needs in our community continue to change and evolve, the Cancer Team at Washington Adventist Hospital 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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Donald Bridges, MDRadiation OncologyCancer Liaison Physician

Ana Munoz-CruzCommunity and Wellness

Sheryl Daugherty, CTRProgram Manager, Cancer Registry

Gregory Dick, MDPlastic & Reconstructive Surgery

Mary GreenbergVice President, Service Lines

Joseph Haggerty, MDMedical OncologyChairman

Dominique HaynesCancer Program Administrator

Robert Isaacs, MDDiagnostics Radiology

Amir Kende, MDPathology

Caryn Liebowitz, RN, BSNOncology Nursing

Lindsey WiseOncology Social WorkPsychosocial Services Coordinator

Natalie Kontakos, MDMedical Director Palliative Care

Lesa Poinsett, NPGenetics

Viviane YusaitisQuality Improvement

2016 Cancer Committee—Adventist HealthCare Shady Grove Medical Center

Linda Iovanni, MBA, BSN, RN, CCRP

Director, Clinical Research

Patricia Guay-Berry, RD, LDN, CSO

Nutrition Services

Jennifer Nulton, OTR/L, CHT, CLTRehabilitation Manager

Chitra Rajagopal, MDMedical Oncology

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Melody Bankert, LGSWCancer Services Social Worker

Felicia Benjamin, RNDirector, Quality Services

Alta Berhaneselassie, MBACancer Conference CoordinatorAdministrative Coordinator

Paul DavisManager, Rehab

Kashif Firozvi, MDCancer Committee Chairman

Mary GreenbergVice President, Service Lines

Elizabeth KotrobaAssociate Vice President of

Operations

Robert JepsonVice President of Business

Development

Jonathan Marx, MDInterventional Radiologist

Brenda Millet, MSN, RN-BCOncology NurseOncology Nurse Manager

Hong Mei Liu, MBA, MS, CCRPClinical Research CoordinatorClinical Trials

Dorcas LwangaOncology Dietician

Taira Norals, MDHospice / Palliative Care Specialist

Cynthia Plate, MDSurgery Physician

Katie Ronca, CTRCancer Program Manager

Alan Schulsinger, MDCancer Liaison PhysicianRadiation Oncology

Rachel SerioAmerican Cancer Society

Chor-Kiat Sim Pastoral Care

Barbara SweeneyPastoral Care

Po Zhao, MDPathology Physician

2016 Cancer Committee—Adventist HealthCare Washington Adventist Hospital

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Breast Screening Program Provides Valuable Service for Community Women

For more than two decades, Adventist HealthCare’s Breast Screening program has been serving low income, uninsured women that are 40 years and older in our community to help detect and fight breast cancer. The purpose of the program is to 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 and reduce the number of deaths related to breast cancer.

Community Cancer Outreach— Adventist HealthCare

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 October 2016, 1,160 patients have benefited from the program through breast health education, clinical breast exams, mammograms and treatment, including:

l 853 Screening Mammograms

l 280 Diagnostic Mammograms

l 158 Breast Sonograms

Adventist HealthCare Paints the RIO Pink!On Oct. 6, many Adventist HealthCare employees came out to the RIO Washingtonian Center in Gaithersburg, Maryland to help kick off breast cancer awareness month! Participating stores and restaurants proudly displayed our “Paint the RIO Pink” logos and our many volunteers helped fill gift bags filled with prizes such as water bottles, sweet treats and coupons. The focus of the event was to help women take our free, online breast cancer risk assessment to determine their 5-year risk and lifetime risk for breast cancer. By raising awareness, women are empowered to know their options and plan for their health and well-being. And by connecting with our community in these types of events, we can introduce Adventist HealthCare’s expert breast program and imaging services as a trusted provider of mammograms and breast care.

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2016 Adventist HealthCare Prevention Activities and Education

l Breast and Colon Cancer Education Presentation: Provided education to seniors at the Victory Tower Senior Apartments in Takoma Park, Maryland.

l 2016 Avon Walk to End Breast Cancer: The Cancer Outreach staff volunteered with participant registration at the event held in Washington, D.C.

l Crossroads Farmers Market: Provided breast cancer and digestive health education to several community members in Takoma Park.

l Fifth Annual Latino Health Fair: The cancer outreach team provided lung cancer education to more than 50 community members. The group also worked with the Tobacco Cessation team to provide carbon monoxide screening and tobacco cessation counseling.

l Susie’s Cause Free Outreach Health Festival: The Cancer Outreach team provided colorectal cancer education and digestive health information to more than 40 community members in the Adventist HealthCare Washington Adventist Hospital secondary service area.

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 35 referrals have been sent to Montgomery County Cancer Crusade.

l Look Good…Feel Better: More than 35 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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The Shady Grove Adventist Aquilino Cancer Center has been operating for nearly two years in Montgomery County and has provided cancer patients in our community with new and innovative options for treatment and care.

As the only comprehensive cancer center in Montgomery County, our multidisciplinary 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 Nurse Navigators

l Social Workers

l Registered Dieticians

l Rehabilitation/ PT/OT/Speech therapy

l PET/CT

l Cancer screenings and education

l Sophisticated diagnostic tools

Cancer Care Program at Adventist HealthCare Shady Grove Medical Center

l Patient navigation services, which guide you through diagnosis, treatment and recovery

l Chemotherapy and other infusion therapies

l Radiation therapy, including methods that spare healthy tissue

l Palliative care, which eases patients’ symptoms

l A retail shop that provides items to make your daily life easier

l Support and wellness, including one of the region’s only integrative medicine program

Adventist HealthCare’s comprehensive imaging services are offered at convenient locations throughout Montgomery County. Our locations hold accreditations representing the highest quality recognition from the American College of Radiology. We offer mammography, CT, MRI, nuclear medicine and ultrasounds, which play critical roles in a cancer patient’s diagnosis and treatment.

In 2017 and beyond, we will continue to establish ourselves as a world-class center for comprehensive cancer care.

Jeanne Lieder of Derwood, Md., is a fitness professional who radiates positivity. She eats well and regularly exercises, so she was surprised, then, to discover a hard mass in her right breast in March 2015.

The Shady Grove team wasted no time in administering chemotherapy, aiming to shrink the tumors before the cancer became more aggressive. In January 2016, she had a bilateral mastectomy followed by additional radiation and chemotherapy to prevent the tumors from returning. Now, more than a year after her diagnosis, Lieder has finished treatment and is hopeful about the future.

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In 2015, Adventist HealthCare Shady Grove Medical Center saw 967 newly diagnosed cancer cases, including those diagnosed at Shady Grove and those who received all or part of their initial course of treatment here.

Cancer Cases by Site for 2015 Patients: Adventist HealthCare Shady Grove Medical Center

For the third year in a row, breast continues to be the number one site of new cancer cases, accounting for more than a quarter of new cases, followed by digestive system (including colorectal), male urology and endocrine.

Adventist HealthCare Shady Grove Medical Center 2015 Cancer Cases (n=967)

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Adventist HealthCare’s clinical trials offer our patients local access to the latest research surrounding innovative treatments or strategies that may lead to prevention, earlier detection, better treatments or cures for numerous health conditions, including cancer. Patients who participate in our state-of-the-art clinical trials receive access to promising new treatment options that would otherwise not be available.

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 currently involved in more than 20 studies. In 2015, the cancer team enrolled participants in clinical research trials for 12 types of cancer, including lung, breast and prostate.

In addition, our team recognizes and appreciates the invaluable contribution of clinical trial participants in cancer research and treatment efforts.

Clinical Trials Provide Hope for New Cancer Treatment Options

Cancer Trials Underway

Adventist HealthCare’s cancer team currently offers access to clinical research for the following types of cancer:

l Advanced Cancer

l Breast Cancer

l Colon Cancer

l Lung Cancer

l Myeloma

l Ovarian Cancer

l Prostate Cancer

l Solid Tumors

l Urothelial Cancer

Learn more about the clinical trials offered by Adventist HealthCare by visiting www.adventistsgmc.com/clinicaltrials.

Focus On: Neuroscience

Adventist HealthCare’s brain and spine experts offer our patients state-of-the-art, advanced neurological and neurosurgical care.

Whether patients need advanced diagnostic care, specialized therapy or advanced surgery, they now can receive these critical services without traveling outside of their communities at Adventist HealthCare Shady Grove Medical Center, Adventist HealthCare Washington Adventist Hospital and other Adventist HealthCare locations throughout the region.

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The Adventist HealthCare Neurological and Neurosurgical team specializes in managing:

l Brain and spinal tumors

l Back pain

l Neck pain

l Stroke

l Spinal fractures

Adventist HealthCare’s neurosurgery experts perform a wide range of advanced diagnostic and therapeutic brain and spine procedures at both Washington Adventist Hospital and Shady Grove Medical Center, including:

Brain Procedures

l Brain biopsy

l Chiari decompression

l Craniectomy for stroke or intracranial hemorrhage

l Craniotomy and image-guided, microscopic, endoscopic surgical resection of brain tumors

l Shunt placement

l Transsphenoidal surgery for pituitary tumors

l Vagal nerve simulator placement

Peripheral Nerve Procedures

l Carpal tunnel decompression

l Ulnar nerve decompression

l Peripheral nerve tumor resection (Neurofibromas and Schwannomas)

Spinal Procedures

l Minimally invasive lumbar laminectomy, microdiscectomy and spine surgery

l Anterior cervical discectomy and fusion

l Cervical arthroplasty (artificial disc)

l Cervical laminectomy and fusion

l Foraminotomy

l Kyphoplasty

l Open laminoplasty/laminectomy

l Lumbar fusion

l Occipital cervical fusion

l Odontoid screw placement

l Spinal laminectomy for spinal tumors

l Surgical treatment for spinal deformities

Specially trained nurses care for neurosurgery patients on our surgical units and in our comprehensive Intensive Care units at each hospital. With our team approach to patient care, we develop individualized treatment plans with input from the patient, primary care physicians and multidisciplinary specialists.

Elizabeth Campbell had been free of breast cancer for nearly 12 years. After breaking her leg in fall 2015, she was shocked to learn that cancer had returned. She turned to Adventist HealthCare’s integrated health system for cancer care, which included surgery with our neuroscience team to correct a spinal compression fracture and tumor. She credits God and the great care she received with Adventist HealthCare for getting her through the last year.

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Focus On: Enhanced Recovery After Surgery

In 2016, the team at the Shady Grove Adventist Aquilino Cancer Center, led by colorectal surgeon Dr. Vivek Patil, and the Adventist HealthCare Shady Grove Medical Center Department of Anesthesia, set out to create a multimodal evidence-based perioperative pathway to improve recovery and reduce complications after major surgery.

The study or pathway looked at post-op recovery for patients undergoing elective laparoscopic or robotic colon resections in patients age 75 or younger.

Traditional postoperative colorectal surgery care, included:

l Complete bowel preparation

l NPO until bowel function

l Nasogastric tube

l IV fluids until starting regular diet

l High-dose narcotics for pain management

l Bed rest

l Foley catheter until postoperative day 3 or 4

2016 Quality Improvement Implementation: Adventist HealthCare Shady Grove Medical Center

The team at Shady Grove wanted to better standardize the protocol for pre-and post-surgery for these patients. The protocol they developed included:

l Encouraging pre-hospital optimization of nutrition and hydration

l Maximizing pre-and postoperative non-narcotic pain medicine

l Limiting intraoperative IV fluids (7mg/kg/hr)

l Stopping IV fluids and remove urinary catheter day after surgery

l Starting clear liquid diet immediately and advance to regular diet by postoperative day two

l Encouraging early and frequent ambulation

The study’s first 40 patients included 80 percent who had laparoscopic surgery and 20 percent that had robotic. Of those, 21 had benign diagnoses and 19 had malignant.

After examining the initial results, the team adjusted the protocol to include the addition of TAP (transversus abdominis plane) blocks and a nutrition protocol, which included a pre-op assessment and the utilization of nutritional supplements before and during their hospital stay.

These changes led to an enhanced recovery for the next 30 patients seen in the study, with ERAS decreasing from 3.78 in the first 40 patients to 3.12.

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 Washington Adventist Hospital offers patients the latest treatment options and cutting-edge approaches for cancer and those services are only poised to grow in 2017. Skilled physicians and staff deliver compassionate care for cancer patients and their families.

Our accredited cancer program offers patients the full spectrum of preventive tools, including screenings, diagnostics and excellent treatment options for a variety of cancers. We also offer a personalized approach with coordinated care from a multidisciplinary team throughout a patient’s cancer journey.

Cancer Care Program at Adventist HealthCare Washington Adventist Hospital

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

l Nutrition Services

l Social Worker

l Palliative Care

Adventist HealthCare cancer care locations in Maryland include:

l Adventist HealthCare Washington Adventist Hospital in Takoma ParkAdventist HealthCare Shady Grove Medical Center in Rockville

l Adventist HealthCare Radiation Oncology Center in Germantown

l Adventist HealthCare White Oak Breast Center in Silver Spring

l Shady Grove Adventist Aquilino Cancer Center in Rockville

Angela Reid looks at the glass half full, which isn’t what you’d expect from a woman who just finished six months of chemotherapy. Keeping her glass—and her pantry—full these days are weekly deliveries of fruit and vegetables, courtesy of a program at Adventist HealthCare Washington Adventist Hospital that helps recently discharged patients eat healthier.

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In 2015, Adventist HealthCare Washington Adventist Hospital saw 307 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 2015 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 urology, digestive system, including colorectal, and endocrine.

Adventist HealthCare Washington Adventist Hospital 2015 Cancer Cases (n=307)

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Courtney Ackerman, MD, will begin as the next Cancer Liaison Physician of the Adventist HealthCare Washington Adventist Hospital Commission on Cancer accredited cancer committee. Her term will begin on Jan. 1, 2017 and end Dec. 31, 2020.

In addition to helping steer the direction of Washington Adventist’s cancer program for the next three years, as the Cancer Liaison Physician (CLP), Dr. Ackerman will be responsible for evaluating, interpreting, and reporting our cancer program’s performance using the National Cancer Database (NCDB) data. This analysis is used to improve

Welcome Dr. Ackerman!

quality of patient care and to compare Washington Adventist’s performance with other Commission on Cancer’s-accredited programs in the nation.

Dr. Ackerman earned her medical degree from St. George’s University School of Medicine. She completed her internal medicine residency at Christiana Hospital in Delaware. She then went on to pursue her Hematology and Oncology fellowship training at Drexel University in Philadelphia. During her training she was appointed Chief Fellow. Dr. Ackerman is Board Certified in Internal Medicine and Oncology.

She is a member of the American College of Physicians, American Society of Hematology, and the American Society of Clinical Oncology. Dr. Ackerman is originally from Maryland and looks forward to providing outstanding and compassionate care to patients with any oncologic or hematologic needs.

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Focus On: Palliative Care

Adventist HealthCare Washington Adventist Hospital introduced palliative care as a new service in 2016. With the launch, the cancer team wanted to better understand the need for palliative care in the oncology population for Stage IV cancer inpatients at the hospital.

To do this, the team tracked how many patients received a pathological Stage IV diagnosis, including the number of inpatients, outpatients, consult orders, consults given and if goals of care were discussed. Through October 2016, 45 patients received a pathological diagnosis of Stage IV Cancer in an inpatient setting, and 27 percent of these patients received a palliative care consult prior to discharge.

Conducting this quality study led to several findings, including:

l The need for continued education for medical staff and nursing/allied health on the purpose of palliative care

l The need for a dedicated, full-time palliative care specialist at Washington Adventist Hospital

l The need for identifying patients appropriate for palliative care referral

l The need for a formal policy and/or process for referrals and ordering consults between providers

l The need to expand palliative care services into an outpatient setting

2016 Quality Improvement Implementation: Adventist HealthCare Washington Adventist Hospital

The quality improvement study’s results led to the following approved implementations for 2017 at Washington Adventist:

1. A dedicated, full-time palliative care physician at Washington Adventist

2. The addition of a palliative care education module presented by Dr. Taira Norals as part of the monthly nursing orientation sessions

3. The development of a palliative care service line for outpatients in the home health setting

The development of home health palliative care allows for an opportunity for Washington Adventist’s cancer program to address an identified need for our patients across the system.

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The Shady Grove Adventist Aquilino Cancer Center hosted nearly 60 local breast cancer survivors and their loved ones during Adventist HealthCare’s ninth Annual Breast Cancer Survivorship Celebration. The event on Oct. 25, 2016, highlighted the positive outcomes of our breast cancer patients across the system.

The event featured the inspirational stories of two patients, one from Adventist HealthCare Shady Grove Medical Center and one from Adventist HealthCare Washington Adventist Hospital, who have battled back against the disease. The event also featured a devotional from Ann Roda, Vice President of Mission Integration and Spiritual Care, a presentation from Mary Greenberg, Executive Director of Service Lines, and an informative speech from guest speaker, Anu Kaur, a registered dietician and yoga teacher.

Our survivors were also treated to live music and presentations on nutrition, fitness, self-care and integrative medicine. Thanks in part to the generosity of our donors, attendees were able to participate in a raffle for great prizes including gym memberships, Fitbits, Wegmans gift cards, a Ninja blender and more.

Breast Cancer Survivors Celebrated at Systemwide Event

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The Breast Center at Adventist HealthCare Shady Grove Medical Center was recently granted a three-year, full accreditation designation by the National Accreditation Program for Breast Centers (NAPBC), a program administered by the American College of Surgeons. Accreditation by the NAPBC is only given to those centers that have voluntarily committed to provide the highest level of quality breast care and that undergo a rigorous evaluation process and review of their performance. “Receiving our second accreditation from NAPBC is such an honor, and speaks to the quality of care and dedication of our Breast Team,” said Lori Hartinger, Breast Cancer Navigator for the Shady Grove Adventist Aquilino Cancer Center. “This reaccreditation confirms that the behind-the-

Breast Center Receives Full Accreditation

scenes work by Adventist HealthCare and our medical providers to maintain this accreditation and achieve the highest standards of breast care for our patients is everyone’s goal.” A breast center that achieves NAPBC accreditation has demonstrated a firm commitment to offer its patients every significant advantage in their battle against breast disease. Congratulations to the dedicated team at the Shady Grove Breast Center for this impressive accomplishment!

820 WEST DIAMOND AVE. • GAITHERSBURG, MD 20878 • ADVENTISTHEALTHCARE.COM

Documents

Cancer Care Outcomes Report 2016 - Adventist HealthCare...ADVENTIST HEALTHCARE CANCER CARE OUTCOMES REPORT 2016 1 ... l Crossroads Farmers Market: Provided breast cancer and digestive