Tag Archives: ACCC 2016 Innovator Award Winner

Patient-Centered Cancer Care: Personal Pain Goals

By Susan van der Sommen, MHA, CMPE, FACHE

Stethescope with idea light

Pain relating to a cancer diagnosis is one of the most feared symptoms by patients. Pain is subjective and can be attributed to multiple factors: spiritual beliefs, physical pain, and psychological, or social issues. Additionally, pain is a common occurrence that can dramatically affect a patient’s quality of life during and after cancer treatment.

A 1993 study performed by the Eastern Cooperative Oncology Group  (ECOG) notes that 86% of practitioners felt their patients were under-medicated for adequate pain control and only 51% felt their practice controls patients’ pain effectively. Poor pain assessment, a practitioner’s reluctance to prescribe, and a patient’s unwillingness unwillingness to take the medication were reported as barriers.

More recently, in 2014 the Journal of Clinical Oncology published a landmark study by David Hui and Eduardo Bruera that discusses an evidence-based approach to personalized pain assessment and management that engages patients in identifying a personal “pain goal” they find acceptable.

As cancer programs and clinicians strive to improve upon the delivery of patient-centered oncology care, the need for continuing practitioner and patient education related to management of cancer-related pain is clear.

Education was one of the many factors considered by the team at Park Nicollet Oncology Research and Health Partners Institute in Minneapolis, Minnesota, when they instituted their quality improvement (QI) initiative in 2014 focused on pain control in their cancer patient population. Patient satisfaction and out-of-pocket costs for patients were other factors, as they realized that they weren’t meeting their patients’ goals with regard to their level of pain control and that the high cost of some pain medications was resulting in high out-of-pocket costs for patients. The ultimate goal of the Park Nicollet team was to improve their patients’ quality of life through improved pain control and minimizing side effects while curbing out-of-pocket costs.

One of the most innovative and patient-centered approaches Park Nicollet took in its QI initiative was documenting a patient’s personal pain goals. A study published in 2012 notes that the assessment is entirely feasible in a busy outpatient setting and that patients are fully capable of establishing their desired pain relief on a scale of 1-10. The team at Park Nicollet experienced the same results. They increased documentation of their patients’ personalized pain goals from 16% to 71% in one year. Today, approximately 85% of patients report that they have achieved their pain goal. Read the full story of their experience here.

Allowing patients to determine their comfort level – with the appropriate education, of course – is one more way cancer centers can put their patients at the center of their care and encourage genuine shared decision-making.


Contributing blogger Susan van der Sommen, MHA, CMPE, FACHE, is Executive Director, DSRIP, Bassett Healthcare Network, and Chair of the ACCC Editorial Committee.

Meals or Mammograms? A Decision No One Should Have to Make

By Renea Duffin

Guest blogger Renea Duffin is Vice President of Cancer Support and Outreach, Mary Bird Perkins Cancer Center in Baton Rouge, LA .

Mary Bird Perkins Cancer Center Mobile Medical Clinic

Mary Bird Perkins Cancer Center Mobile Medical Clinic

For many people living in Southeast Louisiana, choosing between paying for a mammogram (or other preventive health screening) or a meal for their family is a decision that can lead to a late- stage cancer diagnosis. And, unfortunately, this happens far too often in many Louisiana communities. Read on to learn how Mary Bird Perkins Cancer Center, a 2016 ACCC Innovator Award winner, has grown its outreach and screening efforts to improve early detection of cancer for the medically underserved.

Collaboration for Comprehensive Outreach

In Louisiana, one in five residents live in poverty, so it is no surprise the state’s cancer mortality rate is the fourth highest in the nation. There are only three other states with a greater uninsured population. In 2002, Mary Bird Perkins Cancer Center began its comprehensive community outreach program to address Louisiana’s disproportionate cancer death rates. Through this innovative initiative, the Center collaborates with many community partners and generous donors to provide free breast, prostate, colorectal, skin and oral cancer screenings for the underserved, underinsured and uninsured members of our 18-parish service area.

Integrating Patient Navigation to Improve Access

As the program continued to grow and evolve, it became evident that not only were screening participants medically underserved, but they faced many other barriers to care such as low health literacy levels, unreliable transportation, and other restricting socioeconomic factors. This led to the implementation of a patient navigation program in 2008 that assists patients receiving an abnormal screening result in accessing additional testing, physician specialists, financial resources, as well as removing other barriers to care.

By the Numbers—Education, Screening, & Early Detection

The following are some additional facts and information about the Center’s education and early detection program:

  • Each year, two mobile medical clinics deliver more than 8,000 free screenings for five types of cancer.
  • More than 74,000 screenings provided and 503 cancers diagnosed since 2002. The Cancer Center’s screening program rate of cancer diagnoses is nearly double the national rate per 1,000 adults screened.
  • Provides screenings outside regular business hours in convenient locations and in areas where they are most needed. Locations and populations are targeted based on zip code data using a powerful database solution.
  • Average time from screening to resolution (diagnosis or all clear) is 10 days compared to the national standard of care, which is 60 days. This expedited timeline is due to collaborative, close working relationships with service providers and the patient navigator’s hands-on approach to patient interactions.

After over a decade of providing education, early detection and navigation services to the medically underserved, we know there is still much to do. We constantly reassess our programs and strategies to ensure we are meeting the needs of those we serve in the hope there will be a day when no one must choose between accessing healthcare services and feeding their family.

At the upcoming ACCC 33rd National Oncology Conference October 19-21, in St. Louis, Missouri, Mary Bird Perkins Cancer Center and all the 2016 ACCC Innovator Award winners will describe their inspirational approaches to complex challenges in delivering quality care to serve their communities. View conference agenda and register today!