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Comprehensive Thoracic Oncology Program: COG Update

Comprehensive Thoracic Oncology Program: COG Update

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Comprehensive Thoracic Oncology Program: COG Update

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  1. Comprehensive Thoracic Oncology Program: COG Update CTOP Research Retreat David Nalepinski Director, Oncology Service Line & Business Operations May 23, 2014

  2. Conflict of Interest I, David Nalepinski, have no conflict of interests related to the material presented within this presentation.

  3. Objectives: • The “Cancer Oncology Group” • Defining the Grey Zone • Aligning Priorities • CTOP Metrics • Next Steps

  4. The Patient at the Center… A 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 care” • Surgery, HemOnc, RadOnc…. Organized by subspecialties, sections and “cost centers” • Clinical Mesosystem: • Connect microsystems, Surround microsystems.. • Can HELP… or can HINDER microsystems • The Cancer Oncology Group (COG) is a mesosystem made up of microsystems Source: Value by Design: Developing Clinical Microsystems to Achieve Organizational Excellence

  5. The Patient at the Center…

  6. Referring Providers/ Primary Care Prevention/Education/Pop Health • Screening • Referral Nutrition/Rehab/Palliative Research/Clinical Trials Radiology Pathology Navigation/Care-Management Supportive Services Treatment Modality Chemotherapy Treatment Modality Surgery Diagnosis Treatment Modality Radiation Treatment Support Survivorship Referring Providers/ Primary Care CTOP MESO-SYSTEM CTOP MESO-SYSTEM Oncology F/U Tumor Board ANCILLARY SERVICES VARIOUS SECTIONS /DEPTS HEMONCMICROSYSTEM SECTION RESOURCES DOS MICROSYSTEM SECTION RESOURCES RADONC MICROSYSTEM SECTION RESOURCES THINK PROGRESSION/HORIZONTAL/LONGITUDINAL

  7. Organization Vision – Market/Geopolitical System Incentives: ACO, Quality/Cost, Capitation Incentives: Episodes, FFS, wRVU’s, Cost/Unit CTOP MESOSYSTEM Surg Microsystem RadOncMicrosystem Hem Microsystem

  8. COG (Mesosystem) Successes!! • Tumor boards • Clinical trials • Interdisciplinary clinics • Some pathway development • Patient focused providers and staff • Clear “financial impact” picture • Strong Q/S program • Concepts on the Cancer Center strategic plan

  9. CTOP COG Metrics….

  10. Lung Financial Trends….

  11. Lung Financial Trends….

  12. Lung Financial Trends….

  13. Esophagus Financial Trends….

  14. Esophagus Financial Trends….

  15. Esophagus Financial Trends….

  16. New Lung Cancer Patients

  17. New Lung Cancer Patients

  18. New Lung Cancer Patients

  19. New Esophagus Cancer Patients

  20. New Esophagus Cancer Patients

  21. New Esophagus Cancer Patients

  22. Lung Cancer Referrals (w/ Upper Valley)

  23. Lung Cancer Referrals (w/o Upper Valley)

  24. Esophagus Cancer Referrals (w/ Upper Valley)

  25. Esophagus Cancer Referrals (w/o Upper Valley)

  26. Next Steps…

  27. Oncology Service Line Development • Disease based • Multidisciplinary membership • Medical 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

  28. : Norris Cotton Cancer Center Clinical Organization Structure Center Director NCCC Steering Committee Chief Radiation Oncology Surgery Chair Chair Pathology Chief(s) Hematology Oncology Medicine Chair Chair Radiology Center Deputy Director Nursing Director Vice President NCI-CCSG Admin Director Clinical Cancer Committee NCI Cancer Center Support Grant Clinical Care Team Breast Comprehensive Surgery Endocrine Thyroid/Pituitary Hematology Patient Conferences (Tumor Boards) GI Colon/Liver/Pancreas Pharmacy GU Kidney/Prostate Bladder/Testis Radiation GYN Clinical Research Translational Research Cancer Oncology Group Directors Head & Neck Care Pathways Radiology Lymphoma Cutaneous Lymphoma Melanoma Interdisciplinary Clinics Pathology Neuro Pediatric Nursing Thoracic Esophagus/Lung BMT Care Management Spine Care Coordination Palliation

  29. Patient & Family Centered Care: Elements of Integrated & Coordinated Care Referral Suspected Diagnosis Patient Navigation Patient Intake Treatment Schedule Coordination Patient Conference (Tumor Board) Cancer Oncology Group(s) Care Pathway Decisions Care Pathways Interdisciplinary Clinic Treatment Modalities Clinical Diagnosis “Mini” Patient Care Conference(s) Shared Decision Care Management/Supportive Services/Palliation & EOL Clinical Research Education Measurement: Quality and Safety Measurement: Financial & Volume(s) Survivorship Electronic Medical Record (eDH)