Surgical oncology clinics of North America
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There is ongoing debate on how to reform the health care system. Value-based systems have been proposed to account for both quality and cost. The primary goal of value-based health care is to achieve good health outcomes for patients with consideration of dollars spent. To do so, it is imperative that health care providers define meaningful outcome metrics for specific medical conditions and consider the full cycle of care as well as multiple dimensions of care.
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Surg. Oncol. Clin. N. Am. · Jul 2012
ReviewUnexpected readmissions after major cancer surgery: an evaluation of readmissions as a quality-of-care indicator.
Readmissions following major oncologic operation are common-affecting patient treatment, outcome, and hospital resources. The Center for Medicare and Medicaid Services mandates reporting of certain disease-specific readmissions and Congress is considering using individual hospital readmission rates as a performance measure. Studies using administrative data demonstrate that readmission rates following major cancer surgery are high. ⋯ Single-institution studies demonstrate length of hospital stay and comorbidities as risk factors. Discharge processes and outpatient healthcare utilization can be improved. Until studies on readmission rate are conducted, using readmission rates as a measure of quality should be pursued cautiously.
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Surg. Oncol. Clin. N. Am. · Jul 2012
Collaboration with the community cancer center: benefit for all.
Developing successful programs in a community cancer center involves collaborative efforts between employed and private practice physicians, hospital and cancer center administrations, support personnel, and significant resources, coupled with a vision that will lead to improved patient care and outcomes. Collaboration through a strong state cancer control program is another important component for a successful community cancer center. Delaware has one of the best state cancer control programs in the United States. In 2001, the Delaware Cancer Consortium was formed, which, in 2002, launched its first statewide program to screen all Delawareans older than 50 years with colonoscopy.
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Surg. Oncol. Clin. N. Am. · Jul 2012
Monitoring the delivery of cancer care: Commission on Cancer and National Cancer Data Base.
The primary objective of the Commission on Cancer (CoC) is to ensure the delivery of comprehensive, high-quality care that improves survival while maintaining quality of life for patients with cancer. This article examines the initiatives of the CoC toward achieving this goal, utilizing data from the National Cancer Data Base (NCDB) to monitor treatment patterns and outcomes, to develop quality measures, and to benchmark hospital performance. The article also highlights how these initiatives align with the Institute of Medicine's recommendations for improving the quality of cancer care and briefly explores future projects of the CoC and NCDB.
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Surg. Oncol. Clin. N. Am. · Jul 2012
Patient safety in surgical oncology: perspective from the operating room.
Despite knowledge that most surgical adverse events occur in the operating room (OR), understanding of the intraoperative phase of care is incomplete; most studies measure surgical safety in terms of preoperative risk or postoperative morbidity and mortality. Because of the OR's complexity, human factors engineering provides an ideal methodology for studies of intraoperative safety. ⋯ Existing methodologies for studying intraoperative safety are then outlined, focusing on video-based observational research. Finally, specific human and system factors examined in the OR are detailed.