Public HealthQuality Of Care Delivery In Colorectal Cancer Improved By Educational Initiatives
A study of targeted educational initiatives between the clinical staff at Fox Chase Cancer Center and the hospitals within their Partners program suggest that educational interventions by academic cancer centers can improve quality of care for cancer patients at community hospitals. The study, to be presented at the 2009 Annual Meeting of the American Society of Clinical Oncology, looked specifically at the number of lymph nodes that were surgically removed in colorectal cancer patients at Fox Chase"s partner hospitals and the impact that educational initiatives by clinical staff had on improving the number of nodes removed.
Investigators on the study chose to focus their educational efforts on node retrieval because although research shows that the standard number of lymph nodes that should be removed during colorectal cancer surgery is 12 and that patients who have 12 or more nodes removed and examined have more accurate staging and improved survival, there are still a number of hospitals who are not reaching this goal.
"We wanted to pick a quality metric which was easily quantifiable and could be measured over time to determine the impact of our educational initiative," said Steven Cohen, MD, associate medical director for Fox Chase Cancer Center Partners and senior author of the study.
The educational interventions were conducted at 12 of Fox Chase"s partner hospitals between 2004 and 2006 and included group presentations at hospital tumor boards, cancer committees, quality committees, and regional Continuing Medical Education conferences. In addition, individual presentations to staff pathologists and surgeons were held. The study utilized tumor registries to gather data on patients that had undergone curative surgery for colon cancer from 2003 (pre-intervention) to 2006 (post-intervention).
The study showed that the percentage of colon cancer operations with at least 12 lymph nodes retrieved increased significantly over the four years that the educational interventions took place.
"Studies like this show how groups of hospitals, like those involved in the Fox Chase Cancer Center Partners Program, can work together to improve quality of care for cancer patients," said Cohen.
Other investigators involved in the study were Margaret O"Grady, Samuel Litwin, Karyn Stitzenberg, Elin Sigurdson, Neal Meropol, and Paul Engstrom of Fox Chase Cancer Center, Brendan Curley of Hahnemann Univeristy Hospital , Harry Armitage of Crozer Keystone Health System and Ashok Bapat of Virtua Health System.
Abstract #6524:
Assessing the impact of a targeted educational initiative on colorectal cancer lymph node retrieval: A Fox Chase
Cancer Center Partners" quality initiative.
Poster Discussion, Sunday, May 31
8:00 a.m.-12:00 p.m. EṢ€"Level 3, W315A
11:30 a.m.-12:30 p.m.̣€"Level 2, W203C
Diana Quattrone
Fox Chase Cancer Center