Workshop Agenda
PATIENT-CENTERED CANCER TREATMENT PLANNING: IMPROVING THE QUALITY OF ONCOLOGY CARE
The Keck Center of the National Academies 500 Fifth Street, N.W. Washington, DC 20001 Room 100
Workshop Description
The National Coalition for Cancer Survivorship and the National Cancer Policy Forum are hosting a public workshop addressing patient-centered cancer treatment planning. Discussions of the cancer care planning process are often broken down into silos that fail to bring to light the holistic approach necessary for coordinated, comprehensive cancer care. While previous Institute of Medicine (IOM) work has focused on the challenges of care planning for individuals who have completed their treatment (sometimes referred to as follow-up or survivorship care planning), this workshop will focus on cancer treatment planning for newly diagnosed cancer patients.
The workshop agenda will reflect the need to integrate the patient perspective in cancer treatment planning and will highlight some best practices in care planning that are currently being utilized by a number of practitioners. The workshop will include an overview of patient-centered care and cancer treatment planning, as well as sessions on shared decision making, communication in the cancer care setting, and patient experiences with cancer treatment. Models of treatment planning and tools to facilitate its use will also be discussed. Workshop presentations and discussions will examine changes in oncology practice that could promote patient-centeredness by having patients better understand the goals of treatment
through a shared decision-making process with their healthcare team from the moment of diagnosis onward.
February 28, 2010
7:30 a.m. | Breakfast and Registration |
8:00 a.m. | Welcome from the IOM National Cancer Policy Forum and National Coalition for Cancer Survivorship Hal Moses, Vanderbilt-Ingram Cancer Center, National Cancer Policy Forum Chair Tom Sellers, National Coalition for Cancer Survivorship |
8:15 a.m. | Session 1: Workshop Overview Betty Ferrell, City of Hope National Medical Center, Workshop Co-chair Ellen Stovall, National Coalition for Cancer Survivorship, Workshop Co-chair |
Patient perspective | |
• Richard Boyajian, Dana-Farber Cancer Institute Defining patient-centered care | |
• Carolyn Clancy, Agency for Healthcare Research and Quality | |
Cancer treatment planning: A means to deliver quality, patient-centered care | |
• Patricia Ganz, University of California, Los Angeles | |
10:00 a.m. | Break |
10:15 a.m. | Session 2: Theory, Research, and Context for Patient-Centered Care Moderator: Sharon Murphy, Institute of Medicine Presentations and discussions in this session will focus on how to integrate patient preferences and information on treatment options and prognosis so that patients and their care providers, through a shared decision-making process, can decide upon a care plan. Speakers |
will discuss the competencies necessary to ensure that shared decision making is a core component of cancer treatment planning. | |
Patient perspective: Understanding patient preferences and engaging patients in decision making | |
• Jessie Gruman, Center for Advancing Health Research perspective: Are patient preferences currently incorporated in treatment decisions? | |
• Nancy Keating, Harvard Medical School and Brigham and Women’s Hospital Decision quality | |
• Karen Sepucha, Massachusetts General Hospital and Harvard Medical School Incorporation of comparative effectiveness research (CER) into shared decision making: Promises and challenges | |
• Sheldon Greenfield, University of California, Irvine Shared decision making in practice | |
• Jeffrey Peppercorn, Duke University | |
Discussion (30 minutes) | |
Questions: | |
• How can patient preferences be assessed in the context of medical decision making?Are patient preferences usually taken into account? |
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• What is the role of a patient when discussing a treatment plan? What is the role of the care team? |
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• What are the barriers to incorporating patient preferences and shared decision making in cancer treatment planning and which barriers can be modified? |
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• What is decision quality? How can biomedical research findings (for example, comparative effectiveness research) be communicated to patients to inform preference-sensitive decision making? |
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12:30 p.m. | Lunch |
1:30 p.m. | Session 3: Practice or Professional Perspectives on Communication |
Moderator: Anthony Back, University of Washington This session will discuss the importance of effective communication when creating a cancer treatment plan. Speakers will address patient needs and expectations regarding communication in the medical setting, as well as strategies for preparing patients to engage in these discussions. Speakers will also discuss communication issues and approaches from a variety of care team perspectives. | |
Eliciting patient preferences and preparing patients to shape their care | |
• Sherrie Kaplan, University of California, Irvine Culturally appropriate communication and care |
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• Linda Burhansstipanov, Native American Cancer Research Corporation Physician perspectives on communication |
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• Anthony Back, University of Washington Oncology nurses: Leveraging an underutilized communication resource in cancer treatment planning |
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• Marie Bakitas, Dartmouth-Hitchcock Medical Center |
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Psychosocial provider perspectives on communication | |
• Elizabeth Clark, National Association of Social Workers |
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Patient navigation | |
• Angelina Esparza, American Cancer Society Patient Navigator Program |
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Discussion (30 minutes) | |
Questions: | |
• How can we ensure that healthcare professionals are prepared to engage patients and family members (including adult learners, people in distress, older adults) in cancer treatment planning discussions? How do we build in these competencies in health professional training? |
• What matters most to patients when communicating with members of their care team? |
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• How can healthcare professionals tailor communication to individual patients’ needs? |
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• How can communication be improved when patients see multiple providers or are transitioning to different treatments? How can a treatment plan facilitate this? |
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4:15 p.m. | Break |
4:30 p.m. | Session 4: Patient Perspectives |
Moderator: Patricia Ganz, University of California, Los Angeles | |
This panel discussion will offer an opportunity for patients and family members to describe their experience with cancer treatment and to react to workshop presentations and discussions. | |
Panel Discussion | |
• Robert Erwin, Marti Nelson Cancer Foundation |
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• Mark Gorman, National Coalition for Cancer Survivorship |
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• Anne Willis, National Coalition for Cancer Survivorship |
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Questions: | |
• What is your (or your family member’s) experience with cancer treatment? Was there a treatment plan in place? Were shared decision making and good communication a part of the process? What could have been improved? |
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• What aspects of a cancer treatment plan are most important to patients? |
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• Did you find a particular presentation or discussion particularly compelling? Were there any discussion points that you strongly agreed or disagreed with? |
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5:30 p.m. | Adjourn, Day 1 |
March 1, 2010 |
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7:30 a.m. | Breakfast and Registration |
8:00 a.m. | Welcome Back, Overview of Day 2 |
Ellen Stovall, National Coalition for Cancer Survivorship | |
8:15 a.m. | Session 5: Models of Practice and Implementation |
Moderator: Thomas Smith, VCU Massey Cancer Center In this session, speakers will describe examples of care planning approaches in use that could serve as models for wider implementation. In addition, speakers and discussions will focus on how quality metrics and electronic tools can impact the implementation and effectiveness of cancer treatment planning. | |
Models | |
Evaluating treatment plans and summary templates in the Breast Cancer Registry Pilot | |
• Ann Partridge, Dana-Farber Cancer Institute Lessons learned in survivorship planning | |
• Deborah Mayer, University of North Carolina Advance care planning | |
• Thomas Smith, Virginia Commonwealth University Massey Cancer Center |
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• Ed Wagner, MacColl Institute-Group Health Research Institute |
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Tools and Metrics to Facilitate Cancer Treatment Planning | |
Electronic health records and care planning | |
• Lawrence Shulman, Dana-Farber Cancer Institute Measuring effectiveness: Quality metrics in cancer treatment planning | |
• Russell Hoverman, Texas Oncology and US Oncology |
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Discussion (45 minutes) | |
Questions: | |
• How can models of cancer treatment planning be evaluated and disseminated to encourage broader implementation? |
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• What are some of the lessons from different models of treatment planning that could improve implementation and quality of cancer treatment plans? |
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• In what ways can electronic health records facilitate cancer treatment planning?What electronic tools can assist the formation and discussion of a cancer treatment plan with a patient? |
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• Can quality metrics facilitate implementation of cancer treatment planning? What metrics are important for assessing the effectiveness of cancer treatment plans? |
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11:30 a.m. | Lunch (please pick up lunch and return for next session) |
12:00 p.m. | Session 6: Next Steps for Achieving Better Cancer Treatment Planning Moderator: Alison Smith, C-Change The concluding session of the workshop will provide a summary of key themes and issues that emerged from workshop discussions and presentations. Panelists and workshop participants can describe some of the lessons learned from past experiences with cancer treatment planning and have the opportunity to comment on important components of treatment planning that may improve oncology care. Discussions may also focus on policy or research needs that may encourage greater use of treatment planning in the future. |
Summary of Key Workshop Themes | |
• Alison Smith, C-Change |
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Panel Discussion | |
• Richard Boyajian, Dana-Farber Cancer Institute |
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• Robert Erwin, Marti Nelson Cancer Foundation |
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• Mark Gorman, National Coalition for Cancer Survivorship |
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• Elizabeth Goss, Turner & Goss LLP |
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• Sharon Murphy, Institute of Medicine |
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• Anne Willis, National Coalition for Cancer Survivorship |
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Questions: | |
• What are the barriers to implementing cancer treatment planning from the patient, professional, and system perspective? |
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• What are some potential policy opportunities in cancer treatment planning from a federal, state, institutional, or association perspective? |
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• What are the research priorities for driving policy and practice? |
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• What incentives could encourage greater engagement in cancer treatment planning by patients, professionals, and healthcare institutions? |
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2:00 p.m. | Adjourn |