For decades, the Coleman Foundation has funded cancer programs directed at improving quality of life for cancer patients and survivors in the Chicagoland area. Motivated by the Institute of Medicine (IOM) 2013 Report - Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis, the Coleman Foundation conducted an exploration of supportive oncology with local healthcare providers. Supportive Oncology focuses on improving the quality of life for patients and their families affected by cancer from diagnosis to survivorship and end-of-life. The goal of supportive oncology is to reduce the physical and emotional burdens of illness through pain and symptom management, psychosocial support and integration of complementary therapies.
With assistance by the Center for Business Models in Healthcare, the exploration sought input from leadership and supportive oncology professionals from over 35 organizations: 13 cancer treatment sites, 14 cancer support centers, and 8 hospice organizations*(listed at end). The exploration generated dozens of project ideas. The top four ranked projects were focused on delivery of supportive oncology services. While most Chicago cancer centers have implemented or started implementation of some aspects of supportive oncology, no cancer centers in Chicago have achieved the level of quality and service delivery demanded by the IOM 2013 Report or cancer accreditation bodies. Cancer centers are wrestling with how to implement effective changes in supportive oncology that address recommendations and requirements, while adapting to local/regional requirements, resources and patient needs.
The Coleman Foundation Supportive Oncology Initiative aims to implement improvements in supportive oncology that both meet the intention of the IOM Report and advance Coleman’s goal of the Initiative, which is defined as:
Cancer patients are:
- regularly screened for psychosocial/distress support and palliative care needs; and
- receive all services as identified by psychosocial/distress and palliative care screenings (from diagnosis through survivorship and end-of-life) from a collaboration of multiple, high quality community service providers that have core competencies in delivering cancer care.
The Initiative will be approached through two interconnected components: 1) Process Design Teams and 2) Process Improvement Sites. Both components focus on supportive oncology processes for Distress, Survivorship, Palliative Care and Hospice referral.
1) The Process Design component will be led by:
- Northwestern University to manage design teams for Distress and Survivorship.
- NorthShore University Health Systems to manage design teams for Palliative Care and Hospice referral.
Teams of professionals with experience implementing services in their institution will design processes for improving supportive oncology. Design teams will be responsible for a variety of activities with the goal to determine and document optimal processes, pathways and resources to support the cancer care continuum: at diagnosis, pivotal points of care, progression, remission, etc. Team members will provide coaching and mentoring to six process improvement site teams.
2) The Process Improvements component will utilize the designs developed by the Process Design teams at six Chicago based hospitals. Process Improvements will be implemented at the following sites:
- Rush University Medical Center
- University of Chicago Medical Center
- University of Illinois Hospital
- Mercy Hospital
- Sinai Hospital
- John H. Stroger Hospital of Cook County
These process improvement sites will document and measure the current state of oncology care processes at their institution including services, resources, capabilities, capacity, reimbursement, and patient entry points at their institution. Each site will work with internal team members and their design team coach to understand what is included in optimal processes, provide feedback on feasibility and how the processes may work at their site, and adjust process as necessary. Sites will identify gaps and opportunities for improvement including: additional supportive oncology services, and methods to move supportive oncology services earlier in the cancer care continuum.
The Chicago Metropolitan Breast Cancer Task Force (Task Force) will collect and analyze data for supportive oncology from all process improvement sites, and other cancer treatment sites participating in the Initiative. The data will be used to assess the current state of processes at each institution, and inform process improvements in supportive oncology. The Task Force will conduct an analysis of each institution's submitted data, and compare benchmarks against other regional sites and against national standards. The analysis will serve to inform implementation of process improvements at sites participating in the Initiative.
Throughout the project, Process Design and Process Improvement teams will be guided by the Center for Business Models in Healthcare. All teams will also interact with the Task Force for data collection and participate in exploring payer reimbursement for supportive oncology.
The Coleman Foundation Board of Directors approved program grants totaling $1.8 million for the Supportive Oncology Initiative. This support is intended to improve processes at local hospitals, which includes collaboration with community service providers to deliver supportive oncology in the Chicagoland region.
*American Cancer Society, Adventist Midwest Health, Advocate, Aurora Health, Cadence Health Care System, Cancer Wellness Center, Cancer Support Center, Community Cancer Center, Foundation for Women's Cancer, Gilda's Club of Chicago, Healing Pathways, Home of Hope, UnityPoint Health, Horizon Hospice and Palliative Care, Hult Center for Healthy Living, John H. Stroger Jr. Hospital of Cook County, JourneyCare, Leukemia and Lymphoma Society, LivingWell Cancer Resource Center, Loyola University Medical Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Mercy Hospital and Medical Center, Midwest Palliative & Hospice CareCenter, NorthShore University HealthSystem, Rainbow Hospice, Northwestern Medicine, Rush University Medical Center, Rush-Copley Medical Center, Sinai Health System, Stillwaters Cancer Support Services, Swedish Covenant Hospital, University of Chicago Medicine, University of Illinois Hospital & Health Sciences System, Wellness House, White Crane Wellness Center