Appendix C
Recommendations from Prior Selected Reports
TABLE C-1 Recommendations Addressing Psychosocial Services
Report |
Recommendations |
Assure Provision of Psychosocial Services |
|
Improving the Quality of Health Care for Mental and Substance-Use Conditions (IOM, 2006) |
Overarching Recommendation 1 Health care for general, mental, and substance-use problems and illnesses must be delivered with an understanding of the inherent interactions between the mind/brain and the rest of the body. |
Ensuring Quality Cancer Care (IOM, 1999) |
Recommendation 4 Ensure the following elements of quality care for each individual with cancer: …
|
NCCN Distress Management Clinical Practice Guidelines, (NCCN, 2006) |
|
Report |
Recommendations |
Clinical Practice Guidelines for the Psychosocial Care of Adults with Cancer (National Breast Cancer Centre and National Cancer Control Initiative, 2003) |
Emotional and Social Support Guideline: The extent to which a person with cancer has support and feels supported has been identified as a major factor in their adjustment to the disease. It is essential to check the extent of support available to the patient, to recommend additional support as required and to provide information about where this is available. Gender and psychosocial support Guideline: Clinicians and the treatment team need to consider that the psychosocial needs of men and women may vary both in extent and how they are expressed. Successful strategies for meeting psychosocial support needs may therefore differ for men and women. Where the delivery method is inappropriate or insensitive, men may simply not participate or not gain a benefit. |
Achieving the Promise: Transforming Mental Health Care in America (New Freedom Commission on Mental Health, 2003) |
Recommendation 1.1 Advance and implement a national campaign to reduce the stigma of seeking care and a national strategy for suicide prevention. Recommendation 1.2 Address mental health with the same urgency as physical health. Recommendation 2.3 Align relevant federal programs to improve access and accountability for mental health services. Recommendation 2.4 Create a Comprehensive State Mental Health Plan. Recommendation 3.1 Improve access to quality care that is culturally competent. Recommendation 3.2 Improve access to quality care in rural and geographically remote areas. Recommendation 4.1 Promote the mental health of young children. |
Meeting Psychosocial Needs of Women with Breast Cancer (IOM and NRC, 2004) |
Breast cancer care clinicians, such as oncologists and other medical professionals, responsible for the care of women with breast cancer should incorporate planning for psychosocial management as an integral part of treatment. They should routinely assess and address psychosocial distress as a part of total medical care. |
From Cancer Patient to Cancer Survivor: Lost in Transition (IOM and NRC, 2006) |
Recommendation 6 Congress should support the Centers for Disease Control and Prevention (CDC), other collaborating institutions, and the states in developing comprehensive cancer control plans that include consideration of survivorship care, and promoting the implementation, evaluation, and refinement of existing state cancer control plans. |
Screening |
|
NCCN Distress Management Clinical Practice Guidelines, (NCCN, 2006) |
|
Report |
Recommendations |
Clinical Practice Guidelines for the Psychosocial Care of Adults with Cancer (National Breast Cancer Centre and National Cancer Control Initiative, 2003) |
Clinic-based protocols should be developed to ensure that all patients are screened for clinically significant anxiety and depression. |
Achieving the Promise: Transforming Mental Health Care in America (New Freedom Commission on Mental Health, 2003) |
Recommendation 4.3 Screen for co-occurring mental and substance-use disorders and link with integrated treatment strategies. |
Improving the Quality of Health Care for Mental and Substance-Use Conditions (IOM, 2006) |
Recommendation 5-1 To make collaboration and coordination of patients’ mental and substance-use health care services the norm, providers of the services should establish clinically effective linkages within their own organizations and between providers of mental health and substance-use treatment. The necessary communications and interactions should take place with the patient’s knowledge and consent and be fostered by:
|
Patient-Centered Care |
|
Achieving the Promise: Transforming Mental Health Care in America (New Freedom Commission on Mental Health, 2003) |
Recommendation 2.1 Develop an individualized plan of care for every adult with a serious mental illness and child with a serious emotional disturbance. |
Report |
Recommendations |
Quality Improvement |
|
Improving Palliative Care for Cancer (IOM and NRC, 2001) |
Recommendation 6: Best available practice guidelines should dictate the standards of care for both physical and psychosocial symptoms. Care systems, payers, and standard-setting and accreditation bodies should strongly encourage their expedited development, validation, and use. Professional societies, particularly the American Society of Clinical Oncology, the Oncology Nursing Society, and the Society for Social Work Oncology, should encourage their members to facilitate the development and testing of guidelines and their eventual implementation, and should provide leadership and training for nonspecialists, who provide most of the care for cancer patients. |
NCCN Distress Management Clinical Practice Guidelines (NCCN, 2006) |
|
Meeting Psychosocial Needs of Women with Breast Cancer (IOM and NRC, 2004) |
Providers of cancer care should meet the standards of psychosocial care developed by the American College of Surgeon’s Commission on Cancer and follow the National Comprehensive Cancer Center Network’s (NCCN) Clinical Practice Guidelines for the Management of Distress. |
From Cancer Patient to Cancer Survivor: Lost in Transition (IOM and NRC, 2006) |
Recommendation 4 Quality of survivorship care measures should be developed through public/private partnerships and quality assurance programs implemented by health systems to monitor and improve the care that all survivors receive. |
Continuity of Care |
|
Living Beyond Cancer: Finding a New Balance (President’s Cancer Panel, 2004) |
Recommendation 1a Upon discharge from cancer treatment, including treatment of recurrences, every patient should be given a record of all care received and important disease characteristics, this should include, at a minimum: …
Recommendation 1b Upon discharge from cancer treatment, every patient should receive a follow-up care plan incorporating available evidence–based standards of care. This should include, at a minimum:
|
Report |
Recommendations |
Clinical Practice Guidelines for the Psychosocial Care of Adults with Cancer (National Breast Cancer Centre [NBCC] and National Cancer Control Initiative [NCCI], 2003) |
Clinic-based protocols should be developed to ensure that:
|
From Cancer Patient to Cancer Survivor: Lost in Transition (IOM and NRC, 2006) |
Recommendation 2 Patients completing primary treatment should be provided with a comprehensive care summary and follow-up plan that is clearly and effectively explained. This “Survivorship Care Plan” should be written by the principal providers(s) who coordinated oncology treatment. This service should be reimbursed by third party payors of health care. Such a care plan would summarize critical information needed for the survivor’s long term care, including … information on the availability of psychosocial services in the community and on legal protections regarding employment and access to health insurance. |
Report |
Recommendations |
Improving the Quality of Health Care for Mental and Substance-Use Conditions (IOM, 2006) |
Recommendation 5-2 To facilitate the delivery of coordinated care by primary care, mental health, and substance-use treatment providers, government agencies, purchasers, health plans, and accreditation organizations should implement policies and incentives to continually increase collaboration among these providers to achieve evidence-based screening and care of their patients with general, mental, and/or substance-use health conditions. The following specific measures should be undertaken to carry out this recommendation:
Recommendation 5-3 To ensure the health of persons for whom they are responsible, M/SU providers should:
|
Report |
Recommendations |
Patient Education and Illness Self-Management |
|
Living Beyond Cancer: Finding a New Balance (President’s Cancer Panel, 2004) |
Recommendation 2 Procedures should be established within diverse patient care settings to better inform patients/survivors and their caregivers about available legal and regulatory protections and resources [e.g., pertaining to employment and insurance.]. Recommendation 5a All survivors should be counseled about common psychosocial effects of cancer and cancer treatment and provided specific referrals to available support groups and services. |
Clinical Practice Guidelines for the Psychosocial Care of Adults with Cancer (National Breast Cancer Centre and National Cancer Control Initiative, 2003) |
Clinic-based protocols should be developed to ensure the following goals:
|
Achieving the Promise: Transforming Mental Health Care in America (New Freedom Commission on Mental Health, 2003) |
Recommendation 2.5 Protect and enhance the rights of people with mental illness. |
Meeting Psychosocial Needs of Women with Breast Cancer (IOM and NRC, 2004) |
The National Cancer Institute (NCI), the American Cancer Society (ACS), and professional organizations (e.g., American Society of Clinical Oncology, American College of Surgeons, American Association of Colleges of Nursing, American Psychosocial Oncology Society, American Society of Social Work, American Society for Therapeutic Radiology and Oncology, Oncology Nursing Society) need to partner with advocacy groups (e.g., National Breast Cancer Coalition, National Alliance of Breast Cancer Organizations, Wellness Community, National Coalition Cancer Survivorship [NCCS]) to focus attention on psychosocial needs of patients and resources that provide psychosocial services in local communities and nationally. |
Report |
Recommendations |
Public Education |
|
Living Beyond Cancer: Finding a New Balance (President’s Cancer Panel, 2004) |
Recommendation 4a National public education efforts sponsored by coalitions of public and private cancer information and professional organizations and the media (e.g., film, television, print, and broadcast news) should be undertaken to:
Recommendation 5c Providers should include psychosocial services routinely as part of comprehensive cancer care treatment and follow-up care and should be knowledgeable about local resources for such care for patients/survivors, caregivers, and family members. In particular:
|
Care Coordination |
|
NCCN Distress Management Clinical Practice Guidelines (NCCN, 2006) |
Licensed mental health professionals and certified pastoral caregivers experienced in psychosocial aspects of cancer should be readily available as staff members or by referral. |
Reimbursement |
|
Living Beyond Cancer: Finding a New Balance (President’s Cancer Panel, 2004) |
Recommendation 7b Adequate reimbursement for prosthetics must be provided and it must be recognized that:
Recommendation 7c [Health Insurance] Coverage should be routinely provided for psychosocial services for which there is evidence of benefit both during treatment and post-treatment as needed. |
NCCN Distress Management Clinical Practice Guidelines (NCCN, 2006) |
Medical care contracts should include reimbursement for services provided by mental health professionals. |
Report |
Recommendations |
From Cancer Patient to Cancer Survivor: Lost in Transition (IOM and NRC, 2006) |
Recommendation 2 Patients completing primary treatment should be provided with a comprehensive care summary and follow-up plan that is clearly and effectively explained. This “Survivorship Care Plan” should be written by the principal providers(s) who coordinated oncology treatment. This service should be reimbursed by third party payors of health care. Recommendation 9 Federal and state policy makers should act to ensure that all cancer survivors have access to adequate and affordable health insurance. Insurers and payors of health care should recognize survivorship care as an essential part of cancer care and design benefits, payment policies, and reimbursement mechanisms to facilitate coverage for evidence-based aspects of care. |
Support of Informal Caregivers |
|
Living Beyond Cancer: Finding a New Balance (President’s Cancer Panel, 2004) |
Recommendation 5b A caregiver plan should be developed and reviewed with a survivor’s caregiver(s) at the outset of cancer treatment. It should include, at a minimum:
Recommendation 8a Qualified providers in the treatment setting should train and assist parents to assume their crucial roles in helping the child with cancer return to school and becoming an educator and advocate with individual teachers and the school system. Recommendation 8b Pediatric cancer centers should offer and promote teacher training as a part of their community outreach efforts to help ensure that the needs of pediatric cancer survivors returning to the classroom are met. Internet-based training modules also should be considered to extend the geographic reach of these training efforts. If possible, continuing education units (CEUs) should be provided to participating teachers. Recommendation 8c NCI and the Dept. of Education should explore collaborative opportunities to improve the classroom re-entry and reintegration of young people with cancer or other chronic or catastrophic illnesses (e.g., remote learning, teacher training). Recommendation 9b As part of the process of transitioning survivors of childhood cancers into the adult care setting, information about young adult support groups, Internet sites, and other sources of information and support specific to this age group should be provided to survivors and their families. Recommendation 10 Cancer care providers should inform families of cancer patients about supportive services, including special camps for families and siblings. |
Report |
Recommendations |
|
Recommendation 12a Family members, primary care providers, cancer specialists, and others who are close to or provide medical care to adolescent and young adult survivors should be made aware that depression, anxiety, or other psychosocial issues may affect the survivor long after treatment ends and should be instructed on how to intervene should the survivor experience such difficulties. Recommendation 12b Adolescent and young adult survivors should be taught self-advocacy skills that may be needed to secure accommodations for learning differences resulting from cancer or its treatment. Physicians and other providers should act as advocates for survivors when necessary. Recommendation 16 Health care providers must ascertain the strength of an older survivor’s social and caregiver support system. This should be assessed at diagnosis, during treatment, and at intervals after treatment is completed. Oncology nurses, nurse practitioners, other advanced practice nurses, physician assistants, social workers, patient navigators, or other non-physician personnel may be best able to make these assessments and arrange assistance and services for survivors who lack adequate support. Recommendation 17 Health care providers should not assume that older cancer survivors and their partners are uninterested in sexuality and intimacy. Survivors should be asked directly if they have concerns or are experiencing problems in this area and should receive appropriate referrals to address such issues. |
Employment |
|
From Cancer Patient to Cancer Survivor: Lost in Transition (IOM and NRC, 2006) |
Recommendation 8 Employers, legal advocates, health care providers, sponsors of support services, and government agencies should act to eliminate discrimination and minimize adverse effects of cancer on employment, while supporting cancer survivors with short-term and long term limitations in ability to work. The following text follows the recommendation:
|
Report |
Recommendations |
|
|
Workforce Education |
|
NCCN Distress Management Clinical Practice Guidelines (NCCN, 2006) |
Educational and training programs should be developed to ensure that health care professionals and pastoral caregivers have knowledge and skills in the assessment and management of distress. |
Clinical Practice Guidelines for the Psychosocial Care of Adults with Cancer (National Breast Cancer Centre and National Cancer Control Initiative, 2003) |
Clinic-based protocols should be developed to ensure that all staff working with patients with cancer have participated in relevant communication skills training. |
Meeting Psychosocial Needs of Women with Breast Cancer (IOM and NRC, 2004) |
|
Report |
Recommendations |
|
|
From Cancer Patient to Cancer Survivor: Lost in Transition (IOM and NRC, 2006) |
Recommendation 7 The National Cancer Institute (NCI), professional associations, and voluntary organizations should expand and coordinate their efforts to provide educational opportunities to health care providers to equip them to address the health care and quality of life issues facing cancer survivors. (The text below follows the recommendation): Immediate steps to facilitate the development of programs include:
By specialty: Physicians
|
Report |
Recommendations |
|
Nurses
Social workers and other providers of psychosocial services
|
Research and Demonstrations |
|
NCCN Distress Management Clinical Practice Guidelines (NCCN, 2006) |
Conduct multicenter trials that … pilot treatment guidelines. |
Meeting Psychosocial Needs of Women with Breast Cancer (IOM and NRC, 2004) |
|
Report |
Recommendations |
|
|
Evidence Report on the Occurrence, Assessment, and Treatment of Depression in Cancer Patients (Pirl, 2004) |
More research is needed on factors that may cause varying rates of depression and that predict which patients are most at risk. Longitudinal studies are needed to estimate the incidence of depression starting at the time of or, ideally, before diagnosis of cancer. Many instruments with a wide range of complexity are currently being used to measure depressive symptoms…. Multiple methods of assessment make it difficult to compare studies. A consensus choice of instruments may help to standardize research on depression that is comorbid with cancer. |
From Cancer Patient to Cancer Survivor: Lost in Transition (IOM and NRC, 2006) |
Recommendation 5 The Centers for Medicare and Medicaid Services (CMS), National Cancer Institute (NCI), Agency for Healthcare Research and Quality (AHRQ), the Department of Veterans Affairs (VA), and other qualified organizations should support demonstration programs to test models of coordinated, interdisciplinary survivorship care in diverse communities and across systems of care. Recommendation 10 The NCI, CDC, AHRQ, CMS, VA, private voluntary organizations such as the American Cancer Society, and private health insurers and plans should increase their support of survivorship research and expand mechanisms for its conduct. New research initiatives focused on cancer patient follow-up are urgently needed to guide effective survivorship care. Research is especially needed to improve understanding of …
|
Report |
Recommendations |
|
|
TABLE C-2 Other Recommendations of Potential Relevance
Report |
Recommendations |
Access |
|
Ensuring Quality Cancer Care (IOM, 1999) |
Recommendation 9 Services for the un- and underinsured should be enhanced to ensure entry to, and equitable treatment within, the cancer care system. Recommendation 10 Studies are needed to find out why specific segments of the population (e.g., members of certain racial or ethnic groups, older patients) do not receive appropriate cancer care. These studies should measure provider and individual knowledge, attitudes, and beliefs, as well as other potential barriers to access to care. |
Data Systems |
|
Ensuring Quality Cancer Care (IOM, 1999) |
Recommendation 7 A cancer data system is needed that can provide quality benchmarks for use by systems of care (such as hospitals, provider groups, and managed care systems). |
Enhancing Data Systems to Improve the Quality of Cancer Care (IOM and NRC, 2000) |
Recommendation 2 Congress should increase support to CDC for the National Program of Cancer Registries (NPCR) to improve the capacity of states to achieve complete coverage and timely reporting of incident cancer cases. NPCR’s primary purpose is cancer surveillance, but NPCR, together with SEER, has great potential to facilitate national, population-based assessments of the quality of cancer care through linkage studies and by serving as a sample frame for special studies. Recommendation 3 Private cancer-related organizations should join the American Cancer society and the American College of Surgeons to provide financial support for the National Cancer Data Base. Expanded support would facilitate efforts underway to report quality benchmarks and performance data to institutions providing cancer care. Recommendation 4 Federal research agencies (e.g., NCI, CDC, AHRQ, Health Care Financing Administration) should support research and demonstration projects to identify new mechanisms to organize and finance the collection of data from cancer care quality studies. Current data systems tend to be hospital based, while cancer care is shifting to outpatient settings. New models are needed to capture entire episodes of care, irrespective of the setting of care. Recommendation 5 Federal research agencies (e.g., National Institutes of Health, Food and Drug Administration, CDC, VA) should support public private partnerships to develop technologies, including computer-based patient record systems and intranet-based communication systems, that will improve the availability, quality, and timeliness of clinical data relevant to assessing quality of cancer care. |
Report |
Recommendations |
|
Recommendation 7 Federal research agencies (e.g., NCI, AHRQ, VA) should expand support for health services research, especially studies based on the linkage of cancer registry to administrative data and special studies of cases sampled from cancer registries. Resources should also be made available through NPCR and SEER to provide technical assistance to states to help them expand the capability of using cancer registry data for quality improvement initiatives. NPCR should also be supported in its efforts to consolidate state data and link them to national data files. |
Achieving the Promise: Transforming Mental Health Care in America (New Freedom Commission on Mental Health, 2003) |
Recommendation 6.1 Use health technology and telehealth to improve access and coordination of mental health care, especially for Americans in remote areas or in underserved populations. Recommendation 6.2 Develop and implement integrated electronic health record and personal health information systems. |
Quality Improvement |
|
Childhood Cancer Survivorship: Improving Care and Quality of Life (IOM and NRC, 2003) |
Recommendation 1 Develop evidence-based clinical practice guidelines for the care of survivors of childhood cancer. The NCI should convene an expert group of consumers, providers, and researchers to review available clinical practice guidelines and agree upon an evidence-based standard for current practice. For areas where bodies of evidence have not been rigorously evaluated, AHRQ Evidence Based Practice Centers should be charged to review the evidence. When evidence upon which to make recommendations is not available, the expert group should identify areas in need of research. Recommendation 2 Define a minimum set of standards for systems of comprehensive, multidisciplinary follow-up care that link specialty and primary care providers, ensure the presence of such a system within institutions treating children with cancer, and evaluate alternative models of delivery of survivorship care.
|
Report |
Recommendations |
|
Recommendation 3 Improve awareness of late effects and their implications to long-term health among childhood cancer survivors and their families.
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Achieving the Promise: Transforming Mental Health Care in America (New Freedom Commission on Mental Health, 2003) |
Recommendation 5.2 Advance evidence-based practices using dissemination and demonstration projects and create a public-private partnership to guide their implementation. |
Report |
Recommendations |
Quality Measurement |
|
Ensuring Quality Cancer Care (IOM, 1999) |
Recommendation 3 Measure and monitor the quality of care using a core set of quality measures. Measures should:
|
Enhancing Data Systems to Improve the Quality of Cancer Care (IOM, 2000) |
Recommendation 1 Develop a core set of cancer care quality measures.
…
|
From Cancer Patient to Cancer Survivor: Lost in Transition (IOM and NRC, 2006) |
Recommendation 4 Quality of survivorship care measures should be developed through public/private partnerships and quality assurance programs implemented by health systems to monitor and improve the care that all survivors receive. |
Report |
Recommendations |
Childhood Cancer Survivorship (IOM, 2003) |
Recommendation 1 Develop evidence-based clinical practice guidelines for the care of survivors of childhood cancer. The NCI should convene an expert group of consumers, providers, and researchers to review available clinical practice guidelines and agree upon an evidence-based standard for current practice. For areas where bodies of evidence have not been rigorously evaluated, AHRQ Evidence Practice Centers should be charged to review the evidence. When evidence upon which to make recommendation is not available, the expert group should identify areas in need of research. |
|
Research and Demonstrations |
Ensuring Quality Cancer Care (IOM, 1999) |
Recommendation 8 Public and private sponsors of cancer care research should support national studies of recently diagnosed individuals with cancer, using information sources with sufficient detail to assess patterns of cancer care and factors associated with the receipt of good care…. Recommendation 10 Studies are needed to find out why specific segments of the population (e.g., members of certain racial or ethnic groups, older patients) do not receive appropriate cancer care. These studies should measure provider and individual knowledge, attitudes, and beliefs, as well as other potential barriers to access to care. |
Enhancing Data Systems to Improve the Quality of Cancer Care (IOM, 2000) |
Recommendation 1 b. Research sponsors (e.g., AHRQ, NCI, HCFA, VA) should invest in studies to identify evidence-based quality indicators across the continuum of cancer care. Recommendation 9 Federal research agencies (e.g., NCI, AHRQ, HCFA, VA) should fund demonstration projects to assess the application of quality monitoring programs within health care systems and the impact of data-driven changes in the delivery of services on the quality of health care. Findings from the demonstrations should be disseminated widely to consumers, payers, purchasers, and cancer care providers. |
Report |
Recommendations |
Bridging Disciplines in the Brain, Behavioral, and Clinical Sciences (IOM, 2000) |
Recommendation 1 Federal and private research sponsors should seek to identify areas that can be most effectively investigated with interdisciplinary approaches. Recommendation 2 Funding agencies and universities should remove the barriers to interdisciplinary research and training … by
Universities should:
|
Improving Palliative Care for Cancer (IOM and NRC, 2001) |
Recommendation 2 The NCI should add the requirement of research in palliative care and symptom control for recognition as a “comprehensive cancer center.” The Health Care Financing Administration should fund demonstration projects for service delivery and reimbursement that integrate palliative care and potentially life-prolonging treatments throughout the course of disease. |
Report |
Recommendations |
Childhood Cancer Survivorship (IOM, 2003) |
Recommendation 7 Public and private research organizations (e.g., NCI, National Institute of Nursing Research, ACS) should increase support for research to prevent or ameliorate the long-term consequences of childhood cancer. Priority areas of research include assessing the prevalence and etiology of late effects; testing methods that may reduce late effects during treatment; developing interventions to prevent or reduce late effects after treatment; and furthering improvements in quality of care to ameliorate the consequences of late effects on individuals and families.
|
Achieving the Promise: Transforming Mental Health Care in America (New Freedom Commission on Mental Health, 2003) |
Recommendation 5.1 Accelerate research to promote recovery and resilience, and ultimately to cure and prevent mental illness. |
Report |
Recommendations |
Workforce Education and Training |
|
Bridging Disciplines in the Brain, Behavioral, and Clinical Sciences (IOM, 2000) |
Recommendation 3 Scientific education at early career stages should be sufficiently broad to produce graduates who can understand essential components of other disciplines while receiving a solid grounding in one or more fields. Criteria for NIH-supported research training should include both breadth and depth of education. Funding mechanisms to support interdisciplinary training in appropriate fields should provide additional incentives to the universities and the trainees along the following lines:
Recommendation 4 Funding agencies should establish a grant supplement program to foster interdisciplinary training and research. This would be administratively modeled after the supplements that exist for minorities, people with disabilities, and for people reentering research after a hiatus. Investigators with research grants who have interdisciplinary training opportunities should be able to obtain supplemental funds for qualified candidates through a relatively short application with expedited review. Successful pilot efforts will provide data to support further applications for career development and research. |
Report |
Recommendations |
|
Recommendation 5 Funding opportunities for interdisciplinary training should be provided for scientists at all stages of their careers.
|
Childhood Cancer Survivorship: Improving Care and Quality of Life (IOM and NRC, 2003) |
Recommendation 4 Improve professional education and training regarding the late effects of childhood cancer and their management for both specialty and primary care providers.
|
Report |
Recommendations |
Achieving the Promise: Transforming Mental Health Care in America (New Freedom Commission on Mental Health, 2003) |
Recommendation 5.3 Improve and expand the workforce providing evidence-based mental health services and supports. |
Palliative Care |
|
Improving Palliative Care for Cancer (IOM and NRC, 2001) |
Recommendation 1 The NCI should designate certain cancer centers, as well as some community cancer centers, as centers of excellence in symptom control and palliative care for both adults and children. The centers will deliver the best available care, as well as carrying out research, training, and treatment aimed at developing portable model programs that can be adopted by other cancer centers and hospitals. Activities should include but not be limited to the following:
Recommendation 5 Organizations that provide information about cancer treatment (NCI, the American Cancer Society, and other patient-oriented organizations [e.g., disease-specific groups], health insurers, and pharmaceutical companies) should revise their inventories of patient-oriented material, as appropriate, to provide comprehensive, accurate information about palliative care throughout the course of disease. Patients would also be helped by having reliable information on survival by type and stage of cancer easily accessible. Attention should be paid to cultural relevance and special populations (e.g., children). |
Report |
Recommendations |
Reimbursement |
|
Improving Palliative Care for Cancer (IOM and NRC, 2001) |
Recommendation 4 Private insurers should provide adequate compensation for end-of-life care. The special circumstances of dying children—particularly the need for extended communication with children and parents, as well as health care team conferences—should be taken into account in setting reimbursement levels and in actually paying claims for these services when providers bill for them. |
Research |
|
Achieving the Promise: Transforming Mental Health Care in America (New Freedom Commission on Mental Health, 2003) |
Recommendation 5.4 Develop the knowledge base in four understudied areas: mental health disparities, long-term effect of medications, trauma, and acute care. |
Public Health |
|
From Cancer Patient to Cancer Survivor: Lost in Transition (IOM and NRC, 2006) |
Recommendation 6 Congress should support the CDC, other collaborating institutions, and the states in developing comprehensive cancer control plans that include consideration of survivorship care, and promoting the implementation, evaluation, and refinement of existing state cancer control plans. |
Other |
|
Crossing the Quality Chasm (IOM and NRC, 2001) |
Recommendation 1 All health care organizations, professional groups, and private and public purchasers should adopt as their explicit purpose to continually reduce the burden of illness, injury, and disability, and to improve the health and functioning of the people of the United States. Recommendation 2 All health care organizations, professional groups, and private and public purchasers should pursue six major aims; specifically, health care should be safe, effective, patient-centered, timely, efficient, and equitable. |
Report |
Recommendations |
|
Recommendation 4 Private and public purchasers, health care organizations, clinicians, and patients should work together to redesign health care processes in accordance with the following rules:
Recommendation 11 The Health Care Financing Administration and the Agency for Healthcare Research and Quality, with input from private payers, health care organizations, and clinicians, should develop a research agenda to identify, pilot test, and evaluate various options for better aligning current payment methods with quality improvement goals. |
Report |
Recommendations |
Childhood Cancer Survivorship: Improving Care and Quality of Life (IOM and NRC, 2003) |
Recommendation 5 HRSA’s Maternal and Child Health Bureau and its partners should be fully supported in implementing the Healthy People 2010 goals for Children with Special Health Care Needs. These efforts include a national communication strategy, efforts at capacity building, setting standards, and establishing accountability. Meeting these goals will benefit survivors of childhood cancer and other children with special health care needs. |
Achieving the Promise: Transforming Mental Health Care in America (New Freedom Commission on Mental Health, 2003) |
Recommendation 2.2 Involve consumers and families fully in orienting the mental health systems toward recovery. Recommendation 4.2 Improve and expand school mental health programs. |
REFERENCES
IOM (Institute of Medicine). 1999. Ensuring quality cancer care. Edited by M. Hewitt and J. V. Simone. Washington, DC: National Academy Press.
IOM. 2000. Bridging disciplines in the brain, behavioral, and clinical sciences. Edited by T. C. Pellmar and L. Eisenberg. Washington, DC: National Academy Press.
IOM. 2006. Improving the quality of health care for mental and substance-use conditions. Washington, DC: The National Academies Press.
IOM and NRC (National Research Council). 2000. Enhancing data systems to improve the quality of cancer care. Washington, DC: National Academy Press.
IOM and NRC. 2001. Interpreting the volume-outcome relationship in the context of cancer care. Washington, DC: National Academy Press.
IOM and NRC. 2001. Improving palliative care for cancer. Edited by K. M. Foley and H. Gelband. Washington, DC: National Academy Press.
IOM and NRC. 2001. Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.
IOM and NRC. 2003. Childhood cancer survivorship. Improving care and quality of life. Edited by M. Hewitt, S. L. Weiner, and J. V. Simone. Washington, DC: The National Academies Press.
IOM and NRC. 2004. Meeting psychosocial needs of women with breast cancer. Edited by M. Hewitt, R. Herdman, and J. C. Holland. Washington, DC: The National Academies Press.
IOM and NRC. 2006. From cancer patient to cancer survivor: Lost in transition. Edited by M. Hewitt, S. Greenfield, and E. Stovall. Washington, DC: The National Academies Press.
National Breast Cancer Centre and National Cancer Control Initiative. 2003. Clinical practice guidelines for the psychosocial care of adults with cancer. http://www.nhmrc.gov.au/publications/synopses/_files/cp90.pdf.
NCCN (National Comprehensive Cancer Network). 2006. Distress management—version 1.2007. http://www.nccn.org/professionals/physician_gls/PDF/distress.pdf (accessed September 14, 2007).
New Freedom Commission on Mental Health. 2003. Achieving the promise: Transforming mental health care in America. Final Report. DHHS Publication No. SMA-03-3832. Rockville, MD: Department of Health and Human Services.
Pirl, W. F. 2004. Evidence report on the occurrence, assessment, and treatment of depression in cancer patients. Journal of the National Cancer Institute Monographs 32:32–39.
President’s Cancer Panel. 2004. Living beyond cancer: Finding a new balance. President’s Cancer Panel 2003–2004 annual report. Bethesda, MD: National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services.