Cancer Community Needs Assessment · 7 • Cancer Genetics and Risk Assessment(s) are provided by our advanced practice nurse practitioner. A total of 336 people were seen with 243

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Cancer Community Needs Assessment

2016

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Gwinnett Medical CenterCancer Community Needs Assessment | 2016

Purpose

The purpose of this assessment is to identify the cancer-related needs of our population, cancer health disparities and gaps in cancer-related resources within Gwinnett County.

Goal

The goal of this assessment is to improve and save lives as related to cancer navigation, screening, prevention and education services within underserved populations. We anticipate accomplishment of this by:

a. Implementation of community outreach programs that will help eliminate cancer-health disparities in the population

b. Creation of cancer-related resources so that underserved populations may have better access to quality care

Methods

Secondary data was obtained through Healthy Communities Institute (HCI) indicators that include data from the U.S. Census Bureau, American Community Survey and County Health Rankings. Statistics and maps have also been included from the Georgia Department of Public Health’s Online Analytical Statistical Information System (OASIS) standardized health data repository. Additionally, we chose to utilize data from the Hospital Comparison Benchmarks Reports available from the National Cancer Database depicting the time from diagnosis to treatment as an indicator of timeliness of care. Finally, the cancer care program has chosen to use primary data through the use of focus groups.

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Introduction

Gwinnett Medical Center

Gwinnett Hospital System is the leading health care provider in Gwinnett County. Gwinnett Medical Center (GMC) is a licensed 553-bed healthcare system with two acute care hospitals: Gwinnett Medical Center-Lawrenceville and Gwinnett Medical Center-Duluth. These two facilities are 10 miles apart.

GMC-Lawrenceville is centrally located in the county and has 304 acute care licensed beds (excluding the Gwinnett Women’s Pavilion)—this was an increase of 129 beds for the campus. About 80 percent of GMC-Lawrenceville’s patients are from the Gwinnett County area. GMC-Lawrenceville provides award-winning care in an extensive array of specialities.

GMC-Duluth combines a quiet, healing environment with the latest in medical technology. Featuring private, spacious patient rooms and comfortable family suites, the hospital promotes patient healing while offering the very latest medical care for efficient treatment and quick recovery times. Approximately 78 percent of GMC-Duluth's patients originate in Gwinnett County; however, it is easily accessible for all metro Atlanta residents, particularly those in Duluth, Johns Creek, Norcross and Suwanee. GMC-Duluth offers nationally-recognized and renowned services at several facilities on campus.

GMC maintains accreditation with the American College of Surgeons’ Commission on Cancer (ACoS CoC) and the National Accreditation Program for Breast Centers (NAPBC). Both accreditations are for three years and require ongoing documentation to support meeting the standards around navigation, screening, prevention and education. Both accreditations require regular meetings of the Cancer Committee and Breast Program Leadership which engage a wide spectrum of physician specialists, nurses, technologists, therapists and other allied health professionals throughout the system.

Through our weekly breast cancer and tumor conferences, GMC provides safe cancer care. These conferences allow discussion and coordination of care across disciplines, providing high quality cancer care. Additionally, these conferences are required by both accrediting bodies.

As of December 3, 2012, GMC has established a formal relationship with Suburban Hematology-Oncology, a private physician practice, whereby their infusion centers in Lawrenceville, Duluth and Snellville are now known as the Center for Cancer Care, a service of Gwinnett Medical Center. We believe this relationship represents a major breakthrough in the way residents of Gwinnett and the surrounding communities receive cancer treatment. The idea is to provide cancer patients with a continuum of care so that they can receive a growing range of oncology and hematology-related services through GMC. In short, we want to make it as convenient as possible for patients to get the high quality care they need.

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Cancer navigation, community outreach, screening, prevention and education services are priorities of Gwinnett Medical Center. There has been a seven percent increase in new cancer cases seen at GMC in the last four years (2011-2014) from 1,430 to 1,542. In addition to offering high quality treatment options in the region, there are a significant amount of outreach, navigation, screening and prevention offerings accessible locally. These services include the following:

Navigation Services

• Breast Health Navigator assists patients in securing services throughout the system. The Breast Health Navigator (in place since 2005) made 3,905 patient contacts in 2015.

• American Cancer Society Patient Resource Navigator is offered through Oncology Services. Since 2008 the population our American Cancer Society Patient Navigation program serves is 28 percent uninsured/underinsured and more than 38 percent are black or Hispanic. The American Cancer Society Navigator made 278 patient contacts in 2015.

• Patient Financial/Benefits Counseling services are offered in each of the three Center for Cancer Care locations.

Screening Services

• Health screenings such as blood pressure screening, cholesterol, cancer, etc. are provided to persons in the faith community and during special events, called health fairs, offered through Faith Community Nursing and the Marketing and Communications department.

• Care-a-Van mobile mammography unit makes breast cancer screening more accessible throughout the region. In 2015, 1,623 mammograms, at 158 sites, were provided through the mobile mammography unit.

• Low dose CT lung cancer screening is offered to those patients in the community that meet certain criteria to help with early detection of lung cancer. There were 228 screenings done in 2015.

Prevention Services

• More Fruit and Veggies Matter campaign is promoted by Health Education & Wellness Services.

• Healthy Living program includes education and support programs which teach healthy eating, nutrition and exercise such as Believercise and First Place Health offered through Faith Community Nursing.

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Education Services

• Cancer Awareness educational programs and exhibits are designed to alert persons to the warning signs of cancer, such as skin cancer and colorectal, and are offered through Faith Community Nursing and the Marketing and Communications department. A total of 13,045 contacts/offering were provided by our organization in fiscal year 2015 on topics related to cancer prevention and support. GMC provides publications to the community both online and in print, such as Vim & Vigor, covering topics related to the latest on health living, overcoming health issues, life-saving treatments. GMC frequently sponsors campaigns and screenings to promote health observance months such as colorectal and head and neck cancer screening events.

• The Cancer Institute, through the Cancer Support Center, provides educational materials to support men and women diagnosed with cancer.

• Freshstart is an outpatient smoking cessation program created by the American Cancer Society. The program consists of four classes taught by trained facilitators. The goal of the program is to help participants stop smoking by giving them the information and strategies needed to create a personal plan for quitting while in a supportive group environment. We had classes in March, June, September and December of 2015. We had 11 people come to at least one session, but less than half completed all four sessions.

• Smoking Cessation information and counseling is offered to hospitalized patients and patients in our outpatient infusion centers who have expressed a desire to quit smoking. Post discharge follow-up calls are also offered for continuous support

and counseling.

• Nutrition and Cancer is a free class for patients receiving cancer treatment by offering general nutrition information about what to eat while undergoing treatment.

• Cancer Transitions is a free class offered to those patients who have completed their treatment. It is a 6-week class designed to help cancer survivors make the transition from active treatment to post-treatment care. There were 23 people that attend the class in 2015.

Supportive Services

• Nutritional support is provided by a registered dietician though oncology services. In 2015, 190 people were seen.

• Social services are provided by a social worker through oncology services. In 2015, 166 people were seen and 506 distress screenings were done on newly diagnosed cancer patients and were follow-ups were completed by the social worker.

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• Cancer Genetics and Risk Assessment(s) are provided by our advanced practice nurse practitioner. A total of 336 people were seen with 243 being referrals, 91 for genetic counseling and two being high risk.

• Outpatient Palliative Care is offered to patients to manage discomfort, symptoms and stress of a serious illness.

• Grief and Bereavement Support Groups are for people suffering grief from bereavement or other losses offered through Faith Community Nursing.

• Women’s Cancer Support Group is offered monthly through oncology services. In 2015, 200 people attended the Women’s Cancer Support Group.

• Caregiver’s Support Group is offered through oncology services and had 14 people attend during 2015.

• Men to Men Support Group is offered through oncology services and had 5 men attend during 2015.

• Hispanic Women’s Support Group is offered through oncology services and had 117 attend during 2015.

• Look Good... Feel Better® programs are held in cooperation with the American Cancer Society, these sessions help women undergoing cancer treatment cope with the appearance related side effects of cancer. There were 43 attendees at the Look Good... Feel Better® classes in 2015.

• Appearance Specialist further helps female cancer patients with their appearance issues, we have a licensed cosmetologist on staff. She provides patients with private consultations designed to help them look and feel their best during treatment. Free wigs through the American Cancer Society Wig Bank are available. There were 123 patients given appearence services and 64 wigs provided in 2015.

• Chaplaincy Services is staffed 24 hours a day, seven days a week with four staff chaplains and five Clinical Pastoral Education Residents (with a one year commitment). Residents have begun rounds in our Center for Cancer Care at GMC-Lawrenceville this year.

• Atlanta Legal Aid provides free legal services to low income persons living with cancer who have civil legal problems who meet guidelines and priorities.

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Rehabilitative Services

• Lymphedema therapy is offered by appointment for excessive edema as a result of cancer treatment through Gwinnett SportsRehab.

• Speech language pathology services are offered by appointment for voice and swallowing deficits as a result of head and neck cancer.

• Physical therapy and occupational therapy services are available to assist patients with cancer regain function.

• GMC at the Y is a program available to cancer survivors. It includes the Coach Approach, a free support program at 18 local YMCAs where wellness coaches work with cancer survivors to address their individual needs concerning nutrition and

physical activity.

Secondary Data Analysis

Health Statistics for Gwinnett County

Overview

With a total population of 877,922, Gwinnett is the 64th most populated county in the nation (U.S. Census Bureau, 2016). The adult population (20 years old and over) makes up 70 percent of the total population with 22 percent in the 30-44 age range (OASIS, 2016). Gwinnett’s diverse population includes 52.5 percent non-Hispanic white, 24.2 percent non-Hispanic black, 20.2 percent Hispanic/Latino, 10.8 percent non-Hispanic Asian and 2.2 percent other races (American Community Survey, 2009-2013). In 2014, it was reported that 75.1 percent of adults (ages 18-64) had health insurance (2016 Census). According to the National Cancer Institute (NCI), the average incidence rate of cancer between 2008 and 2012 within the county was 439.6 per 100,000 total population. Prostate, breast, lung and colon cancers are the most common within our county. The average death rate for the same time period was 148.7 deaths per 100,000 total population. Lung, prostate, breast and colon cancers are the most common cause of cancer deaths for residents of our county. Tables 1 and 2 on the next page, summarize the incidence and mortality rates of cancer for Gwinnett County compared to U.S. counties as a whole, as well as the racial and ethnic rates for the same time period.

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Table 1. 2008-2012 Average Cancer Incidence Rates by Disease Site

Cancer SiteGwinnett County

National Counties (n=2,919)

White Black HispanicAsian/Pacific

IslanderProstate 145.2 123.8 140.4 248.7 135.4 66.5

Breast 129.4 116.8 135.8 133.2 104.9 72.1

Lung 54.1 70.3 59.8 43.0 30.9 25.5

Colon 37.6 44.0 38.0 38.9 34.6 29.8

Cervical 6.6 7.9 7.0 8.2 11.4 n/a

All 439.6 452.4 466.9 439.1 337.5 250.3Source: National Cancer Institute, Healthy Communities Institute 06/2016; Note: Prostate cancer incidence rate per

100,000 males; Breast cancer incidence rate per 100,000 females; Cervical cancer incident rate per 100,000 females.

Lung, colon and all rates are 100,000 population. n/a = not available

Table 2. 2008-2012 Average Cancer Mortality Rates by Disease Site

Cancer SiteGwinnett County

National Counties (n=3,081)

White Black HispanicAsian/Pacific

IslanderLung 39.2 53.6 42.7 35.9 12.5 18.4

Prostate 21.3 22.1 20.6 33.2 n/a n/a

Breast 21.8 22.3 22.1 26.1 n/a 12.1

Colon 13.7 16.6 13.4 17.9 12.2 10.5

All 148.7 180.4 154.5 163.3 75.3 87.8Source: National Cancer Institute, Healthy Communities Institute 06/2016; Note: Prostate cancer age-adjusted death

rate per 100,000 males; Breast cancer age-adjusted death rate per 100,000 females; lung, colon and all rates are

100,000 population. n/a = not available

Incidence and mortality rates of cancer overall remain the highest among the black population. The rates for breast cancer are also highest, but there is not as much disparity between blacks and whites with breast cancer rates. Whites have the highest incidence and death rates for lung cancer. There is also a higher incidence rate and death rate among men when it comes to lung cancer.

Gwinnett County data shows that we are below the Healthy People 2020 target rates for cancer mortality in colon cancer (13.7/14.5), lung cancer (39.2/45.5) and prostate cancer (21.3/21.8). We are above the Healthy People 2020 target rate for cancer mortality in breast cancer (21.8/20.7).

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Table 3. Healthy People 2020 Tracker Cancer Objective Comparisons Gwinnett County, 2008-2012

Source: National Cancer Institute, Healthy People 2020, Healthy Communities Institute 06/2016

The following OASIS tables and maps display cancer mortality data through age-adjusted rates and premature death rates using charts and maps. Premature deaths are particularly important because they demonstrate the years of life lost through death that occurs before age 75. As you will see, the areas of the county that have the highest percentage of deaths are different between the two measures. Of note, there are specific areas to the north of the county that we see are associated with death from age-adjusted and premature death rates for lung cancer. The premature death rate for colorectal cancer is trending up when compared with the previous five year aggregate period. Premature death rates and mortality rates for prostate and breast cancer are unchanged from previous years, but they are higher than the Healthy People 2020 targets.

Cancer

Age-Adjusted Death Rate due to Breast Cancer

Age-Adjusted Death Rate due to Colorectal Cancer

Age-Adjusted Death Rate due to Cancer

Age-Adjusted Death Rate due to Lung Cancer

Age-Adjusted Death Rate due to Prostate Cancer

Cervical Cancer Incidence Rate

Current: 21.8Target: 20.7 deaths/100,000 females

Current: 148.7Target: 161.4 deaths/100,000 population



Current: 21.3Target: 21.8 deaths/100,000 males

Current: 6.6 Target: 7.1 cases/100,000 females

Colorectal Cancer Incidence Rate Current: 37.6Target: 39.9 cases/100,000 population

Current Target

21.8 20.7

148.7 161.4

21.3 21.8

39.2 45.5

13.7 14.5

6.6 7.1

37.6 39.9

TARGET NOT MET

TARGET MET

TARGET MET

TARGET MET

TARGET MET

TARGET MET

TARGET MET

Current Target

Current Target

Current Target

Current Target

Current Target

Current Target

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Lung Cancer Age-Adjusted Death Rate

As stated, the current rate is 36.8. The rate for the previous five year aggregate (2005 - 2009) was 42.4. Thisdifference is statistically significant. Below is both the number and rate in the county over the 10-year period.

Georgia Department of Public Health - Office of Health Indicators for Planning (OHIP) Contact UsApplication Version: 1.1.0, Content Version: 1.5Date Accessed: 6/27/2016 11:22:41 AMOASIS Community Health Needs Assessment Dashboard - http://oasis.state.ga.us/

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As stated, the current rate is 186.9. The rate for the previous five year aggregate (2005 - 2009) was 207.6. This difference is statistically significant. Below is both the number and rate in the county over the 10-year period.

Lung Cancer Premature Death Rate


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Colon Cancer Age-Adjusted Death Rate


As stated, the current rate is 13.6. The rate for the previous five year aggregate (2005 - 2009) was 14.4. Thisdifference is not statistically significant. Below is both the number and rate in the county over the 10-year period.

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Colon Cancer Premature Death Rate



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Breast Cancer Age-Adjusted Death Rate


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Breast Cancer Premature Death Rate

As stated, the current rate is 115.4. The rate for the previous five year aggregate (2005 - 2009) was 119.1. This difference is not statistically significant. Below is both the number and rate in the county over the 10-year period.

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Smoking Rate in Gwinnett County

According to the County Health Ranking (2016), in 2014 13.7 percent of Gwinnett adults over the age of 18 reported smoking cigarettes. This is above the Healthy 2020 target of 12.0 percent; however, Gwinnett is below the national counties 50th percentile of 17.8 percent. Gwinnett County has banned smoking in restaurants and most public places. Gwinnett Medical Center is a tobacco-free campus and does not hire people who use tobacco products.

Obesity Rate in Gwinnett County

According to the Centers for Disease Control and Prevention (CDC) (2016), in 2013 the percentage of obesity in Gwinnett County was 29.5 for adults aged 20 and older using Body Mass Index (BMI). This was less than the national counties 50th percentile of 31.2 percent and less than the Health People 2020 target of 30.6 percent. Obesity in Gwinnett has gone up since the 2012 percentage of 27.4. While the community has an overabundance of fast food restaurants that often offer less healthy food options, famers markets are located in many Gwinnett communities and community gardens are becoming more common as well. Gwinnett Medical Center cafeterias list nutritional information for their entrees and also offer “Healthy Choices” on their daily menu. The hospital offers several exercise and weight loss programs for associates and community members.

Sedentary Lifestyle

According to the CDC (2016), in 2013 the percentage of Gwinnett County adults aged 20 and older who were sedentary was 19.9 which is below the Healthy People 2020 target of 32.6 percent and below national counties 50th percentile of 25.8 percent. The percentage has decreased from the 2011 level of 20.2 percent. As noted earlier, the adult population of Gwinnett County is young with the highest percentage being the 30-44 age range. Gwinnett County also has an award-winning recreation program which is well utilized by its residents.

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Secondary Data Analysis

Timeliness of Care National Benchmarks

The Hospital Comparison Benchmark reports provide hospitals with a measure of elapsed time, in days, between a patient’s diagnosis and the date on which first treatment was reported to have started. Disease-site distributions of the elapsed time between diagnosis and treatment were evaluated to establish decile ranges. A cut point, using an aggregate analysis of data from the National Cancer Data Base, was identified to group patients in the last, or most time-delayed deciles. The elapsed time cut point used in this data element separates patients into two groups: The time within which 90 percent of patients across all Commission on Cancer Accredited programs started therapy and the time after which the last 10 percent of patients initiated therapy. We can see from our data that GMC outperformed for all sites falling into >90% for all disease sites. It is also interesting that GMC takes the lead for people being diagnosed younger with cancer across the disease continuum when compared to the national data.

Lung Cancer

Gwinnett Hospital System, Lawrenceville, GA 30046Days to 1st Rx - 90th percentile of Lung Cancer Diagnosed in 2013

Dx and all/part 1st crx. Rx at reporting facility

Days to 1st Rx - 90th Percentile N %

1. 0 - 75 48 92.31%

2. >= 76 4 7.69%

Total 52 100%

©2016 National Cancer Data Base (NCDB) / Commission on Cancer (CoC) / Thursday, July 14, 2016

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Gwinnett Hospital System, Lawrenceville, GA 30046Days to 1st Rx - 90th percentile of Colon Cancer Diagnosed in 2013



1. 0 - 43 58 95.08%

2. >= 44 3 4.92%

Total 61 100%

Colon Cancer

Breast Cancer


Gwinnett Hospital System, Lawrenceville, GA 30046Days to 1st Rx - 90th percentile of Breast Cancer Diagnosed in 2013



1. 0 - 63 226 96.17%

2. >= 64 9 3.83%

Total 235 100%

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Prostate Cancer

Thyroid Cancer

Gwinnett Hospital System, Lawrenceville, GA 30046Days to 1st Rx - 90th percentile of Prostate Cancer Diagnosed in 2013



1. 0 - 133 65 94.2%

2. >= 134 4 5.8%

Total 69 100%

Gwinnett Hospital System, Lawrenceville, GA 30046Days to 1st Rx - 90th percentile of Thyroid Cancer Diagnosed in 2013



1. 0 - 62 40 97.56%

2. >= 63 1 2.44%

Total 41 100%

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Primary Data Analysis

Patient Focus Group

To obtain primary data and further assess our programmatic strengths and potential gaps, GMC conducted a focus group in the summer of 2016 with cancer patients. The following is a summary of the focus group findings.

Demographics

Our groups had seven female and two male participants. All the participants had graduated from high school and eight of them had education ranging from some college all the way to a graduate degree. The household annual income ranged from $15,000-25,000 to over $100,000. All the participants had some form of insurance, ranging from Medicare to private to government insurance plans. All but one participant had Gwinnett County zip codes. Six were married. Two were divorced and one was single. Employment status ranged from working full time to unemployed. We did not achieve a representative cross section of the uninsured. The participants had lung, breast, throat, colon and lymphoma cancers.

Common themes

As the focus group progressed, several themes emerged. Overwhelmingly, the participants said their treatment was a positive experience. The second theme was the importance of convenience in receiving treatment close to home. The third theme was the positive impact made by participating in support groups. These themes will be further discussed in another section.

Perceptions of treatment options and available resources

Two of our participants considered another health care facility for treatment. All of our participants stated that the advice of their physicians was instrumental in how they selected their treatment. One of our participants made her decision based on the availability of Spanish-speaking interpreters and having a Spanish-speaking physician. . One patient chose GMC because they were able to begin treatment quickly. One participant wished she had been more informed about other reconstruction options that were not recommended while she was receiving treatment.

What Gwinnett Medical Center does well

The participants of the focus group were very engaged in sharing their perceptions and experiences. The participants stated they were very pleased to receive their treatments close to home. They felt confident in their treatment plan and trusted their physicians. They felt that most of the nurses involved in their care were great and would go out of their way to be helpful. The participants shared throughout the focus group, the importance of their support groups both through the hospital and in the community.

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What Gwinnett Medical Center could improve

The participants felt that communication with physicians (radiologist and oncologist), particularly at the beginning of their cancer journey, was not provided or incomplete. Language barriers could have played a part in this problem for one of our participants. One participant became her own advocate by researching her cancer and treatments through the internet. Some of the support treatments for her chemotherapy were not offered by the oncology treatment staff. Another patient requested ice chips but the unit did not have a patient ice machine available at the beginning of her chemo treatments. The patient was encouraged to bring ice from home which she felt was inappropriate. GMC now has ice machines in the patient areas. The timing for infusions became an issue for one participant. This participant needed her chemo infusions to last longer than the designated hour and a half-length. After comments from a nurse, the patient felt that the nursing staff was being inconvenienced by the late afternoon completion of infusion. Future infusions were scheduled in the morning which was inconvenient for the patient. Some participants felt that sometimes physicians and PA’s should listen to patient’s concerns instead of dismissing them. The cancer transition program was not available at convenient times.

Use of Cancer Support Services

Since our Cancer Needs Assessment in 2013, we have developed the Cancer Institute. This institute includes the services of dietician, social workers, navigators, palliative care, genetic counseling and support groups. The following are our participants comments associated with each service.

a. Dietician - Six of the participants knew of the dietician through participation in their support groups. They felt the information shared with them was interesting and supportive. None of the participants had received individual counseling. A comment was made that it would have been useful to have more information about diet before treatment.

b. Social work - Two participants used the services of the social worker to involve the financial assistance services advisor. This was very important to this patient because she expressed great concerns about paying for her medical treatment.

c. Navigators - Five of the participants spoke highly of their relationships with their navigators. One of the participants mentioned that transportation was an issue and the navigator helped solve her transportation barrier. Some participants did not feel they needed a navigator and were confident with their physician’s treatment plan.

d. Palliative care - None of the participants have received palliative care consults because none of them felt they needed that service.

e. Genetic counseling - One participant sought out genetic testing and another received genetic testing as part of her treatment plan.

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f. Clinical trials - None of our participants were involved in clinical trials. Through conversations with their physicians, none of them qualified for any clinical trial

associated with their disease. One participant commented that her physician didn’t feel clinical trials were appropriate in her situation. Some participants would have been interested in clinical trials if they had been available.

g. Support groups - As mentioned earlier, all participants felt support groups were very important to their treatment. Having a Spanish-speakers support group was very helpful for our Spanish-speaking participant. She commented that a

Spanish-speaking support group for caregivers would be helpful.

Press Ganey Results

Back in 2014, we added four specific questions to represent the services offered by the Cancer Support Center on the Press Ganey survey. This survey is sent out to the patients to receive feedback on the care they received. In July of 2015, the surveys started to be emailed to patients and the number of responders significantly increased.

The first question was about the dietician and nutritional education. Over the past two years we have increased our performance by 2%.

Mean Trends Outpatient Oncology Gwinnett Medical Center

Displayed by Received Date and Total Sample

Question - Dietitian & nutritional educ srvc


Mean Trends

Outpatient Oncology Gwinnett Medical Center

Question - Dietician & Nutritional Education Services

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The second question was about the patient navigators answering questions. Over the past two years we have increased our performance by 8%.

The third question was about social work services. Over the past two years we have increased our performance by 1%. We had a change in personnel in November of 2015.



Question - Social Work services


Mean Trends


Question - Social Work Services



Question - Pat Nav answers questions



Question - Patient Navigators Answering Questions Mean Trends

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The fourth question was about community resources information. Over the past 2 years our performance had decreased, but is now back up to the level we started at.

Conclusions

While much exists in the way of cancer navigation, screening, prevention, support and education services at GMC, there are some areas that require strengthening and there is an overall need to increase awareness of these services within the community. Through our focus groups we found that patients were very pleased to receive their treatments close to home. They felt confident in their treatment plan and trusted their physicians. They felt that most of the nurses and other caregivers were great and would go out of their way to be helpful.

We also found areas that need improvement as participants expressed opportunities to improve provider communication before, during and after treatment. Communication of treatment schedule changes could be improved to promote patient understanding. We need to ensure patients feel their concerns are being heard, addressed and that we provide services and support at times that are convenient to our patients. Also improving timeliness of when services are offered to be of maximum value to the patient and provide culturally specific support groups to maximize the support for the patient and caregiver. And finally, increase education and offerings for clinical trials.



Question - Community resources info


Mean Trends


Question - Community Resources Information

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GMC’s Cancer Committee is committed to developing annual plans to continually ensure that our services meet the needs of the community. There are a number of areas in our secondary data analysis that point to some health disparities or specific populations that might be targeted programmatically in some way. Our community is above the Health People 2020 target for cancer mortality in breast cancer. Colon cancer and prostate incidence is also a concern. Although the death rate is at the Healthy People 2020 target, we are trending up in premature death rates with younger people dying of colon and lung cancer. We also know that we are performing well in comparison to the nation and the state of Georgia with regards to timeliness of care from diagnosis to treatment. According to the data, we see a higher percentage of younger patients being diagnosed with breast, lung, prostate, thyroid and colon cancer in comparison to the national data.

Potential plans in the upcoming years (2017-2019) may include elements outlined in this report, either expanding services or better promoting the existing services:

a. Promote our oncology social work services across the three Centers for Cancer Care (CCC) offices.

b. Additional disease specific site navigation, possibly colorectal. Secondary data analysis findings in this assessment should be considered in selecting site on which to focus.

c. Promote our oncology registered dietician services across the three CCC offices.d. Promote Cancer Transitions cancer survivorship program and determine

feasibility of additional session times.e. Include navigation between care settings starting with inpatient as a focus of our

patient navigation services.f. Ensure optimal promotion of GMC cancer navigation, screening, prevention,

support, research and education services in web and written formats.g. Expand support groups for patients and families in Spanish and Korean.h. Raise awareness and collaborate on early screening options for colon and

prostate cancer in an effort to better educate the community.i. Promote palliative care across the three CCC offices.j. Promote cancer genetic and risk assessment across the three CCC offices.

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Documents

Cancer Community Needs Assessment · 7 • Cancer Genetics and Risk Assessment(s) are provided by our advanced practice nurse practitioner. A total of 336 people were seen with 243