Held last month from October 9—11, the Association of Cancer Care Centers’ (ACCC) 41^st National Oncology Conference (NOC) was an opportunity to educate colleagues and share resources to help attendees enact positive change at their cancer programs and practices. Following Dr. Fiori’s keynote address on Day 2 of the conference, afternoon sessions were split into 2 tracks. Read about track 2—whose sessions closely aligned with the 2024-2025 ACCC President’s Theme—in this blog. The track 1 sessions are discussed below.

A Point of Care Model Improves Genetic Testing at a Community Practice

Amy L. George, MS, LCGC, genetic counselor, Clearview Cancer Institute, outlined the vital role of genetic counselors in enhancing genetic testing processes within community settings through integration into multidisciplinary teams to streamline patient care, improve access to testing, and ensure personalized treatment plans.

The traditional model of pre-test genetic counseling is evolving to address the increasing demand for germline genetic testing, especially in urgent cancer cases. George highlighted the effectiveness of the point of care (POC) model, which allows for rapid decision-making about results of genetic tests. In this approach, genetic counselors review requests, select appropriate tests, and facilitate post-test counseling, ensuring that patients receive timely information and support. This model not only enhances patient satisfaction and understanding but also improves overall care quality by incorporating genetic expertise directly into clinical workflows.

With ongoing education and leadership support, community practices can successfully implement POC genetic testing, ultimately benefiting patients and their families through more informed health care decisions and increased access to vital genetic information. “The key element here is cascade testing…and how can we take this information and change the trajectory of the future of families’ lives,” said George. The ripple effect of this model fosters a community-wide impact, emphasizing the interconnectedness of hereditary genetics in family health.

Series Express: Reimagining Check-in at Multi-treatment Cancer Centers

Brian Graziano, director of service design, Patient & Market Experience, Providence Health Services, and I-Nong Lee, senior program manager, Swedish Cancer Institute, highlighted a transformative initiative to improve patient check-in processes within the Swedish Cancer Institute. Recognizing the inefficiencies faced by both patients and front desk staff during the check-in for complex treatments, they introduced a virtual triage model designed to streamline operations. The presentation outlined the challenges associated with repetitive check-ins, which often lead to burnout among caregivers and dissatisfaction among patients. “Our patients’ most precious resource is not money, and it is not land—it is time,” commented Lee.

To address this, the team adopted a skateboard approach to pilot design—an iterative process that allows for manageable, small-scale changes while fostering creativity and feedback. Key improvements include the implementation of the Series Express card system, which simplifies the check-in experience for patients. This system not only enhances the clarity and speed of registration but also reduces the administrative burden on in-person staff. As a result, patient satisfaction scores and on-time arrivals have improved significantly.

Overall, Graziano and Lee emphasized the importance of balancing technology with human interaction, ensuring that caregivers remain supported while optimizing the patient experience and providing a valuable roadmap for oncology centers seeking to enhance operational efficiency and patient care.

Virtual Remote Nurse Triage: Impact on RN Recruitment, Clinic-Based Nursing Workload, and Improved Patient Satisfaction in a Community-Based Oncology Practice

Blake Hoegger, BSN, RN, shared the transformative effects of implementing a virtual nursing team and how this innovative approach addressed several pressing challenges faced by health care practices, particularly during the COVID-19 pandemic.

Hoegger outlined how transitioning to a virtual triage model significantly reduced the time to hire nursing positions. The standardization of a 6-week onboarding process, including 1:1 training and regular check-ins, fostered a supportive culture that retains talent—resulting in 18 months without voluntary turnover.

The impact on clinic workload has been substantial, with in-person nurses reporting an 8% decrease in patient calls and a 75% satisfaction rate with the virtual triage team. This model allows clinic staff to focus on direct patient care, enhancing the overall patient experience. Patient satisfaction scores for clinical telephone interactions have improved significantly, with symptom management resolutions occurring faster than before.

Hoegger’s findings demonstrate that integrating a virtual nursing team not only streamlines operations but also boosts morale and improves the quality of patient care in community oncology practices. This approach serves as a valuable blueprint for addressing nursing shortages and enhancing patient support.

Strategies for Growing an Oncology Nutrition Program

Shelley L. West, RN, OCN, MSN, MBA, director of Oncology Nursing and Infusion Services, Cape Cod Healthcare, Cape Cod Hospital, outlined a transformative journey at the Davenport-Mugar Cancer Center (DMCC) at Cape Cod Hospital aimed at enhancing nutritional support for oncology patients. The initiative responds to the significant challenges faced by cancer patients, including malnutrition and dehydration due to treatment-related side effects.

West discussed the critical need for targeted nutritional services, noting that many patients were falling through the cracks despite high-risk screening. Implementation of a streamlined referral process within the electronic medical record (EMR) system led to the automatic referral of patients identified as needing nutritional support—especially those with head and neck and gastrointestinal cancers—to a dietitian upon diagnosis.

The program also addresses the management of enteral feeding through a newly established workflow that simplifies the ordering process, significantly reducing delays. Collaborative efforts with the Rehabilitation Department have further integrated speech pathology services into the nutrition program, providing patients with comprehensive evaluations and support.

With these enhancements, the DMCC noted increased utilization of nutritional services, improved patient follow-up, and a decrease in no-show rates for appointments. West’s presentation exemplifies how dedicated process improvements can significantly impact patient care and outcomes in oncology, making nutritional support an essential component of comprehensive cancer treatment.

Staging Compliance: How Utilization of Lean Six Sigma and the DMAIC Process Impact Quality Improvement

In their presentation, Molly Mendanhall, MBOE, BSN, RN, LSSBB, director of quality and compliance, and David Waterhouse, MD, MPH, director of early phase clinical trials, highlighted critical advancements in cancer staging at Oncology Hematology Care (OHC) in Cincinnati, Ohio. They focused on the importance of accurate staging and how effective quality improvement processes can bridge gaps in patient care.

Mendanhall and Waterhouse outlined the serious implications of staging errors, noting that accurate staging is essential for treatment decisions, billing, and research. They emphasized the use of the Define, Measure, Analyze, Implement, Control (DMAIC) process to systematically identify and rectify these gaps. By implementing this structured DMAIC approach, OHC improved the consistency of their staging processes and significantly increased the percentage of patients with stage IV disease who received timely biomarker testing from 68.1% to 92.2%.

The presentation underscores that quality improvement is not merely about achieving favorable outcomes; it is about embedding a culture of operational excellence across all levels of care. By engaging physician champions and fostering leadership buy-in, OHC demonstrated that good quality is beneficial for both patient care and good business.

For those looking to enhance their quality improvement initiatives, the presenters encouraged making quality a regular agenda item, nominating physician champions, and sharing successes to foster a collaborative environment. This approach not only improves patient outcomes but also strengthens the organization’s overall efficiency and effectiveness.