Nurse Practitioner's QI Project Standardizes Transplant and Cellular Therapy Nurse Coordinator Visit Scheduling
As an oncology advanced practice provider, I saw a need to enhance the scheduling process for transplant and cellular therapy nurse coordinator visits at my institution. In response, I developed and implemented the following quality improvement project and successfully reduced scheduling error rates by 95%.
COVID-19’s Impact on Nurses Jeopardizes Quality Care
Creating a pathway for policymakers, providers, and the public to understand and recommend a new professional nursing dynamic, the Institute of Medicine’s 2011 Future of Nursing report investigated the current and future state and challenges of the nursing profession.
More Women Have Access to Essential Health Care, HHS Says During Women’s History Month
Healthcare organizations and agencies across the country, including the U.S. Department of Health and Human Services (HHS), prioritized enhancing and expanding services like maternal and postpartum care and sexual and reproductive health during Women’s History Month, HHS announced in March 2022.
Even Insured Patients With Advanced Cancer Experience Financial Toxicity
As many as 71% of patients with advanced cancer—most of whom have healthcare insurance—experience major financial hardship because of their disease, according to study findings published in the Journal of the National Cancer Institute.
Prevent Implicit Bias in Patient Care With These Cultural Conversation Starters
Each clinical encounter with a patient brings together three different cultural perspectives: the patient’s, the nurse’s, and health care’s own culture. Patient-centered care acknowledges and responds to the unique needs and preferences of each patient in the context of their culture. As we approach our patients with respect, humility, and curiosity to learn more, we must ask questions to help prevent assumptions, generalizations, and implicit bias from influencing our interactions.
No Surprises Act Protects Patients From Unexpected Medical Bills
Patients now have protection against unexpected—and often extraordinarily high—medical bills. On January 1, 2022, the Biden-Harris administration’s bipartisan No Surprises Act went into effect to ban surprise billing in private insurance for most emergency care and many instances of nonemergency care, according to the U.S. Department of Health and Human Services (HHS).
Education, Insurance, and Marital Status Linked to Disparities in Survivorship Care Plans
Older cancer survivors who have lower levels of education, are uninsured, or are widowed, divorced, or separated are less likely to receive survivorship care plans (SCPs), researchers found. They reported the results of their study in Supportive Care in Cancer.
CMS Launches Strategy to Drive Health System Transformation
Under a newly refreshed strategy, the Centers for Medicare and Medicaid Services’ (CMS) Innovation Center is expanding models in the healthcare industry that reduce program costs and improving quality and outcomes for Medicare and Medicaid beneficiaries, the agency announced in an October 2021 white paper.
Oncology Nursing Society Issues a Call to Action for Using Appropriate Genomics Terminology for Safety and Quality
The Oncology Nursing Society (ONS) is calling all oncology nurses to become fluent in the ONS Genomics Taxonomy terms and to use them in their practice. Using consistent and correct genomics terminology minimizes confusion and misconceptions and contributes to the high quality and safe delivery of cancer care.
Evidence-Based Practice Gives Oncology Nurses Knowledge and Standards for Clinical Care
We have an approximately 14- to 17-year gap between the inception of research discovery and the implementation of findings into clinical practice. As a profession, nurses have a shared responsibility to address the challenge of identifying and overcoming barriers to evidence-based practice (EBP) implementation to provide the best possible clinical care for patients. My primary area of focus as a researcher is on using EBP to improve patient, staff, and organizational outcomes through the Science and Practice Aligned Within Nursing (SPAWN) model, a framework for applying EBP to clinical nursing care.
Practice Change: Transform Cancer Care Through Quality Improvement and Evidence-Based Practice
Most nurses have not received formal training in quality improvement (QI) methodology, and many workplaces lack the resources to efficiently implement evidence-based practice (EBP), which results in delays in translating science into practice. But ONS members are overcoming those barriers and leading the way in effectively developing, implementing, and sustaining practice changes.
CMS Innovation Center Uses Past Achievements to Build Future Goals
Innovative, affordable, and accountable care are the key to transforming the healthcare system to achieve health equity, according to the Centers for Medicare and Medicaid Services (CMS) Innovation Center’s 10-year plan, which the center announced on August 12, 2021.
Nurses Humanize and Normalize Digital Health as Technology Becomes Part of the Care Team
COVID-19 forced healthcare providers to pivot to digital health, but an estimated 70% of patients still deferred or canceled their care, including routine cancer screening. Technology is an essential tool in cancer care, according to Abigail Baldwin-Medsker, MSN, RN, OCN®, of Memorial Sloan Kettering Cancer Center, who presented a session at the ONS BridgeTM virtual conference on September 16, 2021.
Study Ranks U.S. Healthcare Industry Dead Last Among Other High-Income Countries
The United States is worst among 11 high-income countries in delivery of and access to health care, according to an August 2021 study conducted by the Commonwealth Fund, despite spending the most, by far, of its gross domestic product (GDP) on health care than other countries surveyed. The survey used indicators across domains on access to care, care process, administrative efficiency, equity, and healthcare outcomes to compare healthcare system performance. Overall, the top-performing countries were Norway, the Netherlands, and Australia.
Be Honest: Are You Getting Enough Sleep?
A full night’s sleep is a necessity, not a luxury, yet many people place sleep at the end of their priority list. Rather than seeing it as restorative, they think it takes up precious time to be productive. Many proudly proclaim, “You can sleep when you’re dead,” but ignoring healthy sleep habits can actually bring people closer to that end. Insufficient sleep is so pervasive in the United States that the Centers for Disease Control and Prevention considers it a public health epidemic.
Patient-Centered Care Through the Oncology Care Model
Better care. Smarter spending. Healthier people. Those are the three hallmark goals of the Oncology Care Model, a value-based payment system developed by the Centers for Medicare and Medicaid Service’s Center for Innovation.
Considerations for Care of LGBTQ+ Patients With Cancer
Cancer in the lesbian, gay, bisexual, transgender/transsexual, or queer/questioning (LGBTQ+) population has remained underresearched, and information that is known is less likely to reach oncology professionals who could use it to improve care. In “Care of the LGBTQ+ Patient With Cancer,” Carlton Brown, RN, PhD, AOCN®, NEA-BC, FAAN, president of Zenith Health Care Solutions, Inc., in Portland, OR, and David Rice, PhD, MSN, RN, NP, NEA-BC, director of education, evidence-based practice, and research at the City of Hope National Medical Center in Duarte, CA, examined the delivery of quality cancer care in people identifying as LGBTQ+, along with strategies for addressing their unique needs and minimizing barriers to care. They presented the session on Thursday, April 11, 2019, at the ONS 44th Annual Congress in Anaheim, CA.
How Shared Decision Making Affects Cancer Care
“Two heads are better than one” is an idiom so old and often used that it borders on cliché. But as with most colloquial sayings, a kernel of truth is buried underneath. Combining forces to solve problems, overcome obstacles, and coordinate efforts is the key to nearly every successful endeavor, and it’s especially true for patients and providers navigating the cancer journey.
Joint Commission Focuses on Quality, Safety for 2019
As part of its ongoing work “to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating healthcare organizations and inspiring them to excel in providing safe and effective care of the highest quality and value,” the Joint Commission hosts an annual Health Care Association Forum to educate associations about the commission’s latest initiatives and goals. Here are the outcomes that affect nursing practice in 2019.
2019 Will Be a Strategic Bridge Year as ONS Looks Ahead to a New Decade
Oncology nurses have seen many changes in the past decade with significant improvements in cancer treatment, better symptom management and palliative care, and enhanced care coordination. But much work needs to be done as we look toward the future.
How Do Nurse Practitioners Support Patients With Cancer During Radiation?
Nurse practitioners provide quality and value in radiation oncology clinics. By managing the effects of radiation during and after treatment, as well as following patients into survivorship, nurse practitioners are continually improving the quality of care that patients receive during and following treatment.
Federal Officials Say No to Lifetime Limits on Medicaid; Empowered Patients Are the Future of Health Care; Healthcare Jobs Continue to Grow Faster Than Jobs in the General Economy
On May 7, 2018, the White House told the Department of Health and Human Services to overturn Kansas’s new lifetime limit restrictions on Medicaid. Kansas has been leading the way for states looking to implement restrictions to federal benefits. The state previously implemented work requirements for Medicaid recipients and was trying to impose time limits for how long recipients could receive Medicaid for some time. Had its efforts stood, this would mark a fundamental shift in how the federal program is implemented at the state level.
Use These Methods to Evaluate EBP Outcomes and Disseminate Results
One of the most important but often challenging steps in the evidence-based practice (EBP) process is ensuring that the change we wanted to happen actually occurred. After a practice change has been implemented, it’s important to ask if the expected outcome was achieved. Patient-related outcomes can be psychosocial (change in symptoms such as depression or anxiety), physiologic (reduction in catheter-associated urinary tract infections), or functional (increased exercise or mobility). Outcomes can also be process related, such as reduced readmissions or more efficient discharge planning.
Supportive Care Programs for Patients With Cancer
Focusing on a patient’s quality of life is often a key component to their successful cancer journey. Treating their disease is crucial, but patients have to be recognized as individuals with unique and varying needs. Addressing their emotional, physical, spiritual, and psychosocial stressors can help provide holistic treatment that’s at the heart of successful oncology care.
CMS Releases Report on Oncology Care Model
The cost of cancer care and the quality of patient services has always been a top priority in health care. However, the Centers for Medicare & Medicaid Services (CMS) Innovation Center has been working to strengthen both elements of care. CMS, through its Oncology Care Model (OCM) division, works with cancer care providers to develop payment strategies and performance categories in treatment plans for patients with cancer.
New HHS Secretary Azar Aims to Tackle Drug Prices, Affordable Care
On January 24, 2018, the Senate officially confirmed the nomination of Alex Azar, the newest secretary of the Department of Health and Human Services (HHS). Azar replaces former HHS secretary Tom Price, a physician who stepped down in late 2017. Although confirmed along party lines, Azar’s long governmental experience had plenty of support despite his past connections to the pharmaceutical industry.
APNs Have a Role in Leading Value-Based Care
Recent care delivery models have focused on providing value-based care to patients. The changes provide opportunity for APNs to take a leadership role in implementing models and systems to effectively deliver that care. Here’s what APNs need to know about the new models.
Overcome Barriers to Your Clinical Nurse Specialist Practice
As an oncology clinical nurse specialist (CNS), you may find yourself answering over and over the question of, “What is it you do?” In many instances, it is a broader role then most may realize, and you wear several hats. As you explain to other oncology staff what a CNS does, focus on the three spheres of influence.
Oncology Nurses Need to Advocate for Access to Quality Care
Specialized Knowledge: Quality Care. This is my ONS presidential platform. In several columns, I have discussed how ONS resources can provide you with the specialized knowledge and expertise to provide quality care. This issue, I’d like to focus on quality care.
Personalize Quality-of-Life Measures to Improve Patient Experiences
Quality of life (QOL) is a complicated construct and has been defined many ways. Barbara Anne Biedrzycki, PhD, CRNP, AOCNP®, of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, presented the following view: “Quality of life is achieved when our hopes are matched and fulfilled by our experiences.” She encouraged participants to have a holistic perspective of QOL but to keep in mind that QOL is very individualized—its definition and meaning are different to each individual, and each person finds some factors to be more important than others.
Data Aggregate System Seeks Oncology Nurse Ambassadors
During a session at the 42nd Annual Congress in Denver, CO—on what happened to be National Nurses Day—the American Society of Clinical Oncology (ASCO) asked nurses to consider joining an initiative intended to gather, collate, and disseminate massive amounts of data to enhance evidence-based cancer diagnosis and treatment.
Improve Patient Care by Reaching Benchmark Standards
Nurses and patients know that nursing care makes a difference. During a session at the 42nd Annual Congress in Denver, CO, David Rice, PhD, RN, NP, director of professional practice and education at the City of Hope National Medical Center, encouraged nurses to take strides to prove it by using benchmarks and data.
How ONS and Oncology Nursing Are Helping to Define Big Data and Cancer Care
For oncology nurses, physicians, and care professionals, the importance of implementing tools to collect and analyze big data cannot be understated. Through collaboration and multidisciplinary tactics, data can help drive improvements in the way patients are treated.
ONS and ASCO CancerLinQ Partnership Will Help Institutions Use Practice Data to Drive Greater Cancer Care
Offering personalized treatment plans to patients with cancer is one of the biggest goals for any oncology institution—big or small. ONS leaders and members have united their personal and organizational efforts to move cancer care toward personalization while still aligning the needs of patients with nationally recognized clinical guidelines. Oncology nurses consistently strive to deliver quality cancer care to their patients.
How the Oncology Care Model Is Redefining Quality Care
Oncology institutions across the United States are implementing big change in the way nurses and physicians deliver care to patients with cancer. By highlighting quality care and smart spending, facilities are reimagining the way cancer is treated in America. New procedures, research, and technology have redefined the way cancer is treated, so a new system for delivery and reimbursement is vital to ensure that quality care can be delivered at a reasonable cost.
How Are We Creating a New Payment Model for Oncology Care?
Oncology care is a complex, expensive, and often-fragmented area of medicine. To understand the potential need for a new payment model in oncology care, a thorough evaluation of all the data was important. By reviewing the oncology literature associated with costs and quality, we discovered that there were wide variations in the costs associated with the treatment of advanced cancers, but little variation in the outcomes of patients. We also identified gaps in patient care that we thought could be improved.
My Experience Lobbying for Cancer Care Planning in Washington, DC
National Quality Forum Seeks Comments for Quality Measures
The National Quality Forum (NQF) Cancer Project 2015–2017 seeks to identify and endorse performance measures for accountability reporting and quality improvement that specifically address conditions, treatments, interventions, or procedures relating to cancer. A detailed overview of the goals/objectives of the Cancer Project is provided by NQF.