Continuous improvements in patient care supported by a common scorecard.
- Disease Site (DS) groups: Provide clinical leadership structures across the RCN hospitals and advocate for self-evaluation and benchmarking of performance. A competition led to the selection of new DS leads based on their vision for the group: Dr Agulnik and Dr Spicer (Lung), Dr Davison (Heme), Dr Souhami (Gyne) and Dr Liberman (GI).
- RCN Quality Council (QC): Meeting monthly since August 2016 to ensure coordinated and collaborative monitoring of performance indicators. Mandate to assess gaps in system performance, work towards public reporting of indicators and advise on strategic priorities for quality improvement efforts.
- RCN Public Scorecard: First public release in March 2017 included seven indicators.
- The next release is planned for December 2017, with three new indicators. Annual public releases to follow.
- Improvements in care with expected survival benefits
- All bladder cancer patients now evaluated for chemotherapy before surgery
- Decreased rates of positive surgical margin for pT2 prostate cancer due to awareness
- Adjuvant treatment for stage III colon cancer within the 12-week target has been reached at SMHC and efforts are underway at JGH and MUHC.
- Resident Involvement: More residents are involved in quality improvement projects with the DS groups. Of the 5 residents involved, 2 presented posters at the CPAC Annual Meeting, and publications are in progress.
Improved access and reduced wait times for diagnostic, treatment and supportive services along the cancer care continuum.
- Reduced Diagnostic Delays: Driven by indicators selected by the Hematology and the Lung DS groups, targeted improvements were made:
- Molecular pathology testing delays decreased for FLT3 testing in acute leukemia. Achieved largely through changes in the order form for molecular testing and prioritization of tests with the molecular pathology department.
- Oncologists have molecular test results (EGFR) at the time of initial consult for new lung cancer patients. Achieved through common biomarker testing guidelines and implementation of reflex testing of lung cancer tissue.
- Urgent Care Centre: Following an RCN-funded feasibility study, a project to reduce ED visits at all 3 RCN sites was approved. The team is now focusing on two protocols: one for telephone triage and the other for the treatment of febrile neutropenia.
- Better Fertility Options for Male Patients: Improved access to fertility preservation options by means of patient education resources, information sessions for health care professionals and a more effective referral process.
Earlier access to breakthrough treatments for patients.
- Clinical Trials Webpage: Lists all active clinical trials across the RCN (>100 trials) and receives ~200 unique page views per month.
- McGill-wide Report of Clinical Trial Activities: Our first report, using data from all clinical managers, showing that 6.5% of adult cancer patients at the RCN are enrolled in treatment-based trials.
- Eligibility Pre-screening: New project to pre-screen all breast cancer patients for trial eligibility.
Generating measured improvements in care and scholarly output.
- Empowering front-line oncology professionals to develop new knowledge on cancer care quality and enhance their skills in fields pertinent to cancer care quality.
- Almost 1M$ invested in 2016-17 to support 9 CQI Research projects and 4 Quality Improvement Initiatives (QI2).
- Nursing Skills Enhancement: 40 bursaries were awarded to complete oncology-related professional development courses or CNA (re-)certification through the de Souza Institute.
- CQI Research grants: Over the last three years, we have funded grants with over 20 active projects, involving 125 health professionals across the network, including physicians, nurses, and allied health professionals addressing quality across the continuum of care.
- Kuok Fellowships: The 2nd Kuok Fellowships were awarded this year, supporting a Masters in counselling psychology and PhD trainee in epidemiology.
Outstanding patient support with measured improvement in patient engagement and experiences.
- New RCN Supportive Care Group: Co-led by Manuel Borod and Zeev Rosberger, the group is focusing on implementing patient-reported outcomes and improving end-of-life care.
- Screening for pain, fatigue, anxiety and depression: Completed close to 3000 patient visits in select clinics at the 3 sites as part of a pilot project in partnership with CPAC.