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UNC REX Cancer Care Annual Report 2017

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UNC REX Cancer Care Annual Report 2017 UNC REX CANCER CARE ANNUAL REPORT 2017 A COMPREHENSIVE COMMUNITY CANCER PROGRAM Accredited by the American College of Surgeons Commission on Cancer National Accreditation Program for Breast Centers Cary East Raleigh Garner Raleigh Main Raleigh Blue Ridge Wakefield On the cover: UNC REX Cancer Care of Wakefield 11200 Governor Manly Way, Raleigh, NC 27614 UNC REX Cancer Care locations Cary ~ East Raleigh ~ Garner ~ Raleigh Main ~ Raleigh Blue Ridge ~Wakefield For more information or to schedule an appointment with UNC REX Cancer Care Call 919-784-3105 www.REXhealth.com ANNUAL REPORT | 3 UNC REX Cancer Care Mission and Core Values Mission Our mission at UNC REX Cancer Care is to provide our patients with exceptional cancer care and to ensure timely and convenient access to the most effective strategies that prevent, treat, and ultimately cure cancer in the future. UNC REX Cancer Care provides expert, compassionate care to patients with cancer through close collaboration among providers across all disciplines of oncology. Core Values Impact We strive to provide timely access to care in a caring and compassionate setting close to patients’ homes and to relieve the burden of disease now and for the future through our research, clinical care, education, outreach and advocacy. Excellence We pursue excellence relentlessly and with integrity in all that we do, adhering always to the highest standards of conduct. Compassion and Respect We strive to exceed expectations for compassion and respect for those in our care and for one another. ANNUAL REPORT | 4 UNC REX Cancer Care Annual Report 2017 Table of Contents Page . Mission and Core Values 3 . Introduction 5 . Accreditations and Eligibility Requirements 6 . Feature: Prevention and Screening Programs 7 . Patient Family Advisory Council 14 . Tumor Registry and Site Distribution 15 . Clinical Trials 17 . Publications and Presentations 2017 18 . Comprehensive Community Cancer Care 19 . Cancer Care Services and Locations 20 ANNUAL REPORT | 5 Introduction The REX Cancer Care Committee is the designated multidisciplinary body for program leadership, administrative oversight, development, and review of oncology services at UNC REX Cancer Care. The Cancer Care Committee is a committee of the UNC REX Hospital Medical Staff responsible for the overall direction of the oncology program including coordination with Hospital and UNC Health System leadership. Its composition, as required by the Commission on Cancer, includes Board-certified physicians from Surgery, Medical Oncology, Radiation Oncology, Diagnostic Radiology, and Pathology, along with the Cancer Liaison Physician, Clinical Research Manager, Palliative Care Specialist, and representatives from Hospital Administration, Nursing, Pharmacy, Psychosocial Services, Cancer Registry and Quality. Annually, as required by the Commission on Cancer, the UNC REX Cancer Care Committee prepares an annual report with a focus on program outcomes. For 2017, the Committee selected CoC Standards 4.1 and 4.2: Prevention and Screening Programs as the focus for the Annual Report. These findings, published here in the UNC REX Cancer Annual Report, are also made publicly available to the organization and the community. Cancer Care Committee Membership 2017 . Courtney Bui, MD Committee Chair . Yale Podnos, MD ACoS Cancer Liaison Physician/ Surgical Oncology . Susan Moore, MD Medical Director, Rex Hematology Oncology Associates . David B. Eddleman, MD Surgeon / Breast Care Committee Chair . Tom Grates, MBA Executive Director, UNC REX Cancer Care . Chad Lefteris, MHA VP Operations UNC Rex Health . Hiren Mehta, MD Pulmonologist, Chair Cancer Conference Committee . Charles Eisenbeis, MD Hematology Oncology . Nathan Sheets, MD Radiation Oncology . Keith Volmar, MD Pathology . Jay Alley, MD / Duncan Chapman, MD Radiology . Kathleen Foote, MBA, CTR Cancer Registry Manager . Nancy Burns, RN, OCN Cancer Research Manager . Cynthia Jones, BS, CPHQ Quality Coordinator . Kimberly Fradel, MSW,LCSW Social Work /Psychosocial Services Coordinator . Jan Kimball, NP/ Ann Yeager, MD Palliative Care . Mendy Moody, MSN, OCN Oncology Nurse Manager (OP) / Clinical Leadership . Catherine Fine, MS, CGC / Ofri Leitner, MS, CGC Genetic Counseling . Emmeline Madsen, MPH Community Outreach Coordinator / Director Additional Supporting General Membership 2017 Matthew Strouch, MD ~ Surgery Douglas Hammer, MD ~ Family Practice Meena Mohan, MD ~ Hospitalist Robert Wehbie, MD ~ Medical Oncology Jon Gerber, PharmD ~ OP Pharmacy Becky Jones, PharmD ~ IP Pharmacy Jennifer Headen, MHA ~ RHOA Administrator Heather Sasser, RN, OCN Nancy Reifsteck, OTR ~Rehab Suzanne Smith, RD, CSO, LDN~ Nutrition Gordon McGirt, MBA ~ Manager (OP RHOA) Kelsey Williams, RN, Manager (IP) Katie Hardison, BS ~Staff /Committee Assistant Robbie Tilley ~American Cancer Society ANNUAL REPORT | 6 UNC REX Cancer Care Accreditations UNC REX Cancer Care is voluntarily accredited by the American College of Surgeons Commission (ACoS) per the Commission on Cancer (CoC) Standards as a Comprehensive Community Cancer Program (CCCP). The pro- gram assesses more than 2,800 newly diagnosed cancer cases each year, provides a full range of diagnostic and comprehensive treatment services as noted below, either on-site or by referral, as well as participates in cancer- related clinical research and cancer-related clinical trials, per CoC Standards. UNC REX Cancer Care is voluntarily accredited by the National Accreditation Program for Breast Centers (NAPBC), which holds organizations to the highest standards of care for patients with diseases of the breast. UNC REX Care is also accredited by the Joint Commission and ACR Breast Imaging Center of Excellence. UNC REX Cancer Care meets and /or exceeds the Commission on Cancer’s 12 Eligibility Requirements: Eligibility Requirements Specifications Cancer Committee Responsibilities Annual monitoring, assessing, and identifying changes that are needed in each of the eligibility requirements. Facility Accreditation The facility is accredited by a recognized federal, state, or local authority. Cancer Committee Authority Bylaws or policy and procedure define the cancer committee’s authority and responsibility for the program. Cancer Conference Policy Program policy addresses the frequency, format, multidisciplinary attendance, attendance rate, prospective case presentations and total case presentations, discussion of stage and treatment planning, clinical trial options, and methods to address opportunities. Oncology Nurse Leadership An oncology nurse provides leadership within the program. Cancer Registry Policy and Procedure Policy and procedure addresses the use of Commission on Cancer data and all other cancer registry activities. Diagnostic Imaging Services are provided. * Radiation Oncology Services Radiation treatment service locations are currently accredited by a recognized authority or, if not accredited, follow standard quality assurance practices. * Systemic Services Policies or procedures are in place to guide the safe administration of systemic therapy.* Clinical Trial Information A policy or procedure is used to inform patients about clinical trials. Psychosocial Services A policy or procedure is in place to ensure patient access to psychosocial ser- vices.* Rehabilitation Services Rehabilitative services are provided. * Nutrition Services Nutrition services are provided.* Source: CoC, 2016 * Services are available either on-site, at locations that are facility owned, or by referral. ANNUAL FEATURE ANNUAL REPORT | 7 UNC REX Cancer Care: Prevention and Screening Programs UNC REX Cancer Care has a strong history of community engagement and outreach to increase awareness of cancer risk, prevention and early detection. Our programs are developed to align with community areas of need, to build on successful strategies and to be consistent with evidence-based practices. COMMUNITY NEEDS ASSESSMENT UNC REX Cancer Care uses information from multiple community health needs assessments to in- form our community outreach activities. Each year findings from the following community health needs assessments are reviewed by the Cancer Care Committee: . UNC REX Cancer Care Incidence and Mortality Trends . American Cancer Society Facts and Figures . Wake County Community Health Needs Assessment . Komen Community Health Needs Assessment. Behavioral Risk Factor Surveillance System UNC REX Healthcare participates in a collaborative Wake County Com- munity Health Needs Assessment (CHNA) that identifies the health needs of Wake County residents as well as the resources available to address those needs. The CHNA is conducted every three years through the col- laborative efforts of Wake County Human Services, Advance Community Health, Duke Raleigh Hospital, UNC REX Healthcare, WakeMed Health and Hospitals, United Way of the Greater Triangle, and the Wake County Medical Society Community Health Foundation. The CHNA identified the following county priority areas to be addressed through community health improvement efforts: Health Insurance Coverage, Transportation, Access to Health Service, Mental Health and Substance Abuse. In the capital city of Raleigh, NC, there are nu- merous community resources available to resi- dents that may not be available in surrounding counties. The UNC REX Cancer Care service area includes Wake, Franklin, Johnston, and Harnett counties. Not surprisingly, the Komen Community Health Needs Assessment identified the highest priority cancer risk reduction and prevention activities need
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