Dear Community Partners,
At the beginning of 2015, the Cancer Committee set forth a full agenda of items that we wanted to achieve for the betterment of our program. As in previous year’s, the common thread interwoven throughout the conversation was that our actions should improve the experience of individuals dealing with a life-changing diagnosis.
Improving the patient experience and meeting the quality standards set forth by The American College of Surgeons Commission on Cancer (CoC) remains the litmus test in our program evaluation. The CoC continually outlines quality standards that must be met by Comprehensive Community Cancer Programs in order to be recognized as an accredited organization. A number of new Quality of Care Measures were released by the CoC in 2015, two of which affect surgical resections performed at JFK Medical Center. The Cancer Committee in partnership with Surgical Services presented the new, evidence-based CoC guidelines regarding the surgical removal of lymph nodes for gastric, and lung surgical sites. I am pleased to share that our colleagues in Surgical Services have already exceeded the benchmarks defined by the CoC in several areas. We recognize there may be challenges in meeting all of the measures. However, working collaboratively with the surgical community, we expect to see continual progress across all surgical sites.
CoC accredited programs must also conduct a minimum of 2 quality studies each year in order to maintain accreditation. In 2015 we selected for evaluation: (1) analysis of re-excision rates for breast cancer; (2) breast oncology-related molecular marker concordance study. Both studies were selected because of the significant number of breast cancer patients diagnosed and/or treated at JFK Medical Center, and the importance of molecular testing in the determination of treatment.
The study looked at patients diagnosed with invasive breast cancer and initially treated with breast conservation surgery (lumpectomy/partial mastectomy). The analysis revealed that there has been a significant decrease in the rates of breast re-excision procedures down from approximately 21% in 2011 to 10% in 2014. While nationally there is no benchmark or compliance rate for this measure set by The American Society of Breast Surgeons, less than 30% is considered acceptable. Beginning in 2015, JFK Medical Center implemented the use of new equipment using Radiofrequency Spectroscopy for Margin Assessment to aid in further lowering the re-excision rates at this facility.
Molecular Marker Concordance Study
The second quality study focused on hormone receptors ER,PR and HER-2 molecular testing performed on breast tissue at JFK Medical Center’s core laboratory Integrated Regional Laboratories (IRL) and specimens sent out for pathology consultations. Results were compared with Oncotype Dx testing performed on the same breast tissue for concordance. The study looked at cases from 2013 and 2014. The analysis revealed appropriate concordance of 83% and 87% respectively. The conclusions were that Tumors showing low level positivity (<10%) with low intensity (1+/2+); show as negative for Oncotype Dx. Tumors with borderline IHC Her2 (2+) staining, frequently result in Non-Amplified by FISH (IRL) and concordant negative results with Oncotype Dx.
Signs of the continuing evolution of our cancer program are evident with the addition of new team members. Dawn Paynter, Survivorship ARNP and Maria Nieto, Registered Dietician have allowed for an expanded scope of practice on-site at the JFK Comprehensive Cancer Institute to ensure patients receive support during treatment and beyond. Standard 3.3 Survivorship Care Plan is a phase in Standard for 2015. Dawn works collaboratively with the principal care providers to develop survivorship care plans that are reviewed with the patient and provided t o t hem at the completion of treatment. Having a dedicated Survivorship ARNP will enrich the patient experience and allow for effective monitoring of care across multiple modalities. Nutrition Services have also been elevated with the addition of Maria Nieto, RD. Maria maintains close relationships with the physicians and nursing staff to identify patients that are in need of nutritional consultation and resources to help them thrive while undergoing the arduous task of receiving treatment. Maria also educates and connects patients to the resources they need to understand and address their specific needs well beyond treatment.
As we rapidly approach the end of another busy and successful year for the JFK Comprehensive Cancer Program, I like to note that at the core of our success and continued growth is the dedication and efforts of the Cancer Committee, Administration, Medical Staff and Ancillary Personnel. The challenges we face in this ever-changing health care landscape will require time, vigilance and dedication to solve. All of us here at JFK realize we are on a journey together. I am inspired by the dedication of my colleagues and their commitment to realize a world-class environment for our most important partners – our patients. Assuring that our patients receive the highest quality care with compassion, empathy, honesty and respect continues to be our number one priority.
Georges Hatoum, MD
Medical Director of Radiosurgery and Radiation Oncology