Alliance to Advance Patient-Centered Cancer Care

Alliance to Advance Patient-Centered Cancer Care

According to the American Cancer Society, an estimated 1.7 million people in the United States receive a cancer diagnosis each year, and this number is projected to grow as the population ages.

Resources

 

While the past decade has marked significant advancements in cancer treatment, many cancer patients still do not receive timely, patient-centered care. Additionally, cancer care is often fragmented and poorly coordinated.

In its landmark 2013 publication, Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis, the Institute of Medicine (now the National Academy of Medicine) highlighted important gaps in the delivery of cancer care in the United States. In particular, the IOM underscored the need to strengthen patient-centered care and reduce disparities in care for underserved and vulnerable populations.

GOALS

In response to these needs, our company’s Foundation established the Alliance to Advance Patient-Centered Cancer Care (the Alliance) to increase timely access to patient-centered care and to reduce disparities in cancer care for vulnerable and underserved populations in the United States. The Foundation has committed $15 million over five years (2017–2021) to support the Alliance and its program partners in selected communities across the country.

The Alliance aims to:

  • Promote evidence-based, multifaceted interventions that:
    • Improve care coordination and integration
    • Enhance patient-provider communication
    • Empower patients to actively engage in their health care and treatment planning
    • Offer psychosocial support and other support services
  • Reduce disparities in access to high-quality cancer care for vulnerable and underserved populations
  • Improve patients’ satisfaction with their care and quality of life
  • Build sustainable community partnerships that advance patient-centered cancer care
  • Identify and disseminate best practices in patient-centered cancer care

ALLIANCE PROGRAM SITES

Through grants to six organizations, our company’s Foundation is supporting evidence-based, multifaceted programs to promote sustainable improvements in the delivery of cancer care. The program sites are:

The University of Michigan’s School of Nursing (Ann Arbor, Michigan) serves as the Alliance’s National Program Office (NPO). The NPO provides technical assistance to the program grantees, fosters collaboration among grantees and community partners to share lessons learned, and leads efforts to disseminate information to policy makers and other key stakeholders.

APPROACH

The Alliance programs will:

  • Strengthen patient-centered cancer care by implementing interventions in three critical areas:
    1. Coordination of cancer care and its integration with primary care and other specialty care
    2. Patient-provider communication and patient engagement in care
    3. Psychosocial care and other supportive care
  • Implement cross-cutting interventions that address multiple cancer types
  • Integrate components at different levels of the health care ecosystem:
    1. Patient
    2. Health care provider / health care team
    3. Health care system
  • Collaborate with community partners to foster sustainable programs to improve the delivery of cancer care

Cross-Site Evaluation
The Foundation is working with the University of Michigan Schools of Nursing and Social Work to conduct a cross-site evaluation of the Alliance and its programs. The cross-site evaluation will examine how patient-centered cancer care outcomes across program sites change over the course of the five-year Alliance. The RE-AIM Implementation Science framework guides the evaluation.1 This framework examines a program’s Reach, Effectiveness, Adoption, Implementation, and Maintenance. Through both quantitative and qualitative methods, the evaluators will assess changes in patient- and system-level outcomes over the course of the Alliance sites’ interventions. Key measures that will be captured in the cross-site evaluation are outlined below. The evaluation findings and program results will be widely disseminated to help advance patient-centered cancer care in the United States.

Key Measures

Reach

  1. Metric: Number and percentage of eligible patients who completed interventions supported through the Alliance
    Objective: To determine the extent to which patients who were eligible for services were exposed to those services
  2. Metric: Number and percentage of eligible patients who received navigator services supported through the Alliance
    Objective: To determine the extent to which patients who were eligible for patient navigation services received those services
  3. Metric: Number and percentage of patients (out of those screened for psychosocial needs) who received psychosocial services
    Objective: To determine the extent to which patients for whom psychosocial services were clinically indicated received those services

Effectiveness

  1. ACCESS TO CARE
    Metric
    : Time between the scheduling and attending of patients’ first appointment with a cancer provider
    Objective: To show a reduction or improvement in the time between the scheduling and first oncology appointment over time
  2. ENGAGEMENT IN CARE
    Metric: Percentage of patients who report they were actively engaged in the management of their cancer treatment and symptoms
    Objective
    : To show improved patient engagement in health care over time
  3. COMMUNICATION WITH HEALTH CARE PROVIDERS
    Metric: Percentage of patients who report “feeling heard” by providers in decisions about their care
    Objective: To show improvement in patient communication with health care providers over time
  4. ADHERENCE TO CARE
    Metric: Percentage of missed appointments by patients
    Objective: To show a decrease in the number and rate of missed appointments over time
  5. UTILIZATION OF HEALTH CARE
    Metric: Percentage of patients with emergency department (ED) visits for cancer-related issues
    Objective: To show more efficient utilization of health care services
  6. QUALITY OF LIFE
    Metric: The proportion of patients who report positive health-related quality of life
    Objective: To show an increase in the proportion of patients that report positive quality of life

Adoption, Implementation and Maintenance

The evaluators will also explore with program staff, providers and community partners:

  1. The extent to which program sites are succeeding in delivering their interventions, as planned
  2. Factors that promote or inhibit program implementation and how sites have adapted to challenges and capitalized on successes
  3. Plans to help ensure that programs can be sustained into the future
1. R E Glasgow, T M Vogt, and S M Boles, Evaluating the public health impact of health promotion interventions: the RE-AIM framework, American Journal of Public Health, 1999 September, 89(9): 1322–1327.