Comprehensive Thoracic Oncology Program: COG Update

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Comprehensive Thoracic Oncology Program: COG Update. CTOP Research Retreat David Nalepinski Director, Oncology Service Line & Business Operations May 23, 2014. Conflict of Interest. - PowerPoint PPT Presentation

Text of Comprehensive Thoracic Oncology Program: COG Update

Research Program

Comprehensive Thoracic Oncology Program:

COG UpdateCTOP Research RetreatDavid NalepinskiDirector, Oncology Service Line & Business OperationsMay 23, 20141Conflict of InterestI, David Nalepinski, have no conflict of interests related to the material presented within this presentation.Objectives:The Cancer Oncology GroupDefining the Grey ZoneAligning PrioritiesCTOP MetricsNext StepsThe Patient at the CenterA couple of definitions.Clinical Microsystem: a small group of people who work together in a defined setting on a regular basis to provide care and the individuals who receive that careSurgery, HemOnc, RadOnc. Organized by subspecialties, sections and cost centers

Clinical Mesosystem: Connect microsystems, Surround microsystems..Can HELP or can HINDER microsystemsThe Cancer Oncology Group (COG) is a mesosystem made up of microsystemsSource: Value by Design: Developing Clinical Microsystems to Achieve Organizational ExcellenceThe Patient at the Center

ScreeningReferralOncology F/UDiagnosisTreatmentSupportSurvivorshipTreatment Modality ChemotherapyTreatment Modality SurgeryTreatment Modality RadiationRadiologyPathologyDOS MICROSYSTEMSECTION RESOURCESHEMONC MICROSYSTEMSECTION RESOURCESRADONC MICROSYSTEMSECTION RESOURCESANCILLARY SERVICESVARIOUS SECTIONS /DEPTSReferring Providers/Primary CareTumor BoardTHINK PROGRESSION/HORIZONTAL/LONGITUDINAL Referring Providers/Primary CareNutrition/Rehab/PalliativeResearch/Clinical TrialsNavigation/Care-ManagementSupportive ServicesPrevention/Education/Pop HealthCTOP MESO-SYSTEMCTOP MESO-SYSTEMCTOP MESOSYSTEMSurg MicrosystemHem MicrosystemRadOnc MicrosystemIncentives: Episodes, FFS, wRVUs, Cost/UnitOrganization Vision Market/Geopolitical SystemIncentives: ACO, Quality/Cost, CapitationResolving accountability and incentives for the mesosystem to facilitate horizontal longitudinal patient careColors- green is defined, overriding grey undefinedAt some point we must recognize that there is a mesosystem existing in the background, behind the microsystems, and we must bring it to the forefront and be accountable to it- for the patient. We must think about how we align our resources.7COG (Mesosystem) Successes!!Tumor boardsClinical trialsInterdisciplinary clinicsSome pathway developmentPatient focused providers and staffClear financial impact pictureStrong Q/S programConcepts on the Cancer Center strategic planCTOP COG Metrics.

Lung Financial Trends.

Lung Financial Trends.

Lung Financial Trends.Esophagus Financial Trends.

Esophagus Financial Trends.

Esophagus Financial Trends.

New Lung Cancer Patients

New Lung Cancer Patients

New Lung Cancer Patients

New Esophagus Cancer Patients

New Esophagus Cancer Patients

New Esophagus Cancer Patients

Lung Cancer Referrals (w/ Upper Valley)

Lung Cancer Referrals (w/o Upper Valley)

Esophagus Cancer Referrals (w/ Upper Valley)

Esophagus Cancer Referrals (w/o Upper Valley)

Next Steps

Disease basedMultidisciplinary membershipMedical Director who is willing and able to establish the mission, goals, processes and procedures necessary to optimize the group/program in the areas of patient care, research, and education Accountability to the Meso-System the COG

Oncology Service Line DevelopmentCenter Director: Norris Cotton Cancer Center Clinical Organization StructureSurgery ChairMedicine ChairChief(s) Hematology OncologyVice PresidentCenter Deputy DirectorChief Radiation OncologyNursing DirectorNCCC Steering CommitteeNCI-CCSG Admin DirectorChair PathologyChair RadiologyNCICancer Center Support GrantClinical ResearchTranslational ResearchClinical Cancer CommitteeSurgeryRadiationHematologyPathologyRadiologyNursingCare CoordinationPharmacyCare ManagementCancer Oncology Group DirectorsPatient Conferences(Tumor Boards)Head & NeckBMTSpineThoracicEsophagus/LungPediatricNeuroMelanomaLymphomaCutaneous LymphomaGYNGUKidney/ProstateBladder/TestisGIColon/Liver/PancreasEndocrineThyroid/PituitaryBreastComprehensiveInterdisciplinary ClinicsClinical Care TeamPalliationCare Pathways30Care PathwaysClinical ResearchPatient & Family Centered Care: Elements of Integrated & Coordinated CareCancer Oncology Group(s)Patient Conference(Tumor Board)Interdisciplinary ClinicCare PathwayDecisionsPatient NavigationClinical DiagnosisTreatment Schedule CoordinationMini Patient Care Conference(s)Treatment ModalitiesMeasurement: Quality and SafetyCare Management/Supportive Services/Palliation & EOLSurvivorshipReferral

Patient IntakeSuspected DiagnosisMeasurement: Financial & Volume(s)EducationShared DecisionElectronic Medical Record (eDH)31