Implementing Improvements Recommended by Patients and Families

February 26, 2016

Robert Colburn, Sue Fuller Blamey,

Tracy Lust, & Kris Gustavson

Provincial Out-Patient Cancer Care Survey

Survey sent to 20,000 BC patients

& families

All BC Cancer Centres and

Health Authorities cancer clinic

patients

Survey was in the field for 6 months

(patient in care from June – Dec

2012)

Patients participated from all over BC

BCCA Centres

Health Authorities

CON clinics

13,000 patients &

families included

Results to be proud of…

97.5 %

of survey respondents rated the “overall quality of the Out patient Cancer Care they received” as:

“Excellent, Very Good or Good”

Original Survey Question: Overall, how would you rate the quality of care at (location) in the past 6 months?

Response Options: Excellent, Very good, good, Fair, Poor

Overall Rating

for all Treatment Groups

PHSA 2005/2006 2012/13

Physical Comfort 77.4% 71.4%

Coordination & Continuity of Care 64.2% 65.4%

Information, Communication & Education

63.7% 60.1%

Respect for Patient Preferences 77.2% 75.7%

Access to Care 71.9% 72.4%

Emotional Support 46.3% 46.8%

Provincial Action Group

To explore the reasons for these lower scored survey responses a provincial committee was created with representatives from the

BC Cancer Agency and all health authorities. 56 leaders from BCCA centres and each Health Authority met for almost 2 years

Chose 2 Survey Questions that Scored Lower Throughout the Province for Focus

1. If you had any worries or concerns during your treatment/visit, did your care provider discuss them with you?

2. Did you know who to go to with questions?

Provincial Patient/Family and Staff focus Groups

Focus groups were held for patients, families and staff at each BCCA centre across the province to explore the reasons for lower scores for the specific survey questions

Focus Groups at BCCA Centres & CON sites

Focus groups

October 2014 –

January 2015

CN & Quesnel

(CON)

VIC, CSI & Comox,

Nanaimo, Kamloops

CON

VC & Powell River

Hospital CON

FVC, AC & Royal

Columbian Hospital

CON

Underlying Themes from the Survey & Focus Groups

1. Access to cancer care

2. Not enough information about specific concern

3. Lack of empathy or poor communication

4. Counseling

5. Coordination of care

Robert’s Story

What would have made a difference?

Knew that counselling services were available during cancer care, but did not know one could access them post-discharge from the BCCA

Would have liked to speak with someone that was going through the same type of cancer experience

What Patients need…Emotional Support 3.

To have

info about

support groups in

home community

2. To be offered support services throughout

their cancer care

1. To connect with other patients who are experiencing the same type

of cancer

Recommendations – Promote Top 4 Emotional Support Resources

1. CancerChatCanada- Professionally led online support groups for Canadian cancer

patients as well as their family members. 2. CancerConnection – A confidential telephone based peer support program.

Individuals are matched with a trained volunteer who has had a similar cancer experience. Volunteers listen and offer support.

3. Counselling – Services offered at different stages throughout the patient’s

cancer care journey to address both emotional and practical care such as returning to work, finances and aspects of daily living.

4. Support Groups – Information about how to access various support groups throughout British Columbia.

Emily Carr School of Art and Design - Vote 1. Fostering Connections. Building Community

Cancer support from professionals you trust and patients like you

2. Your Care Plan. Your Journey

We have support options for you at every step in your progress

3. Cancer isn’t a choice

Choose the support that’s right for you.

4. Every Experience is unique.

Cancer support for however you’re feeling

5. Living with Cancer, Together

Let’s explore your options for health.

Implementation of Promotional Material

Elevator Wraps for Cancer Centres

Business cards for patients to take away

Postcards with more information

Patient/Family Brochure

Evaluation

Indicators of Success:

# of cancer patients who joined the cancerchat on-line discussions

# of people who accessed cancerconnections

# of patients/families that participated in support groups

# of counselling sessions conducted at the BCCA

Patient/Family Surveys prior to and after implementation

Staff Surveys pre & post education and implementation

CancerChat.Canada

0

5

10

15

20

25

30

35

Number of Patients Registered in CancerChat: Jan - Dec 2015

Cancerconnection – 2014 and 2015

0

50

100

150

200

250

300

Clients Matches

Cancerconnection - Clients & Matches

2014

2015

Referrals to Professional Counselling

0

100

200

300

400

500

600

700

# of Referrals to Patient/Family Counselling Services BCCA

Support Group Participation

0

100

200

300

400

500

600

Jan-15 Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan-16

# of Patients/Families Attending Support Groups

Staff: Cancerchat and Cancerconnections

Yes24%

No76%

Pre: Staff Aware of Cancerchat

Yes52%

No48%

Post: Staff Aware of CancerChat

Yes37%

No63%

Pre: Staff Aware ofCancerconnections

Yes52%

No48%

Post:Staff Aware of Cancerconnections

Counselling, Support Groups and Action

Pre: 63% of staff were aware that they could share the info but only 24% knew where to find it

Post: 50% have shared info, 52% feel equipped to share and 44% knew where to find all of the info

0%

20%

40%

60%

80%

100%

Counsel Support

Staff Aware of Counselling and Support Groups

Pre

Post

Patient/Family Pre-post Survey Results

0%

10%

20%

30%

40%

50%

Cancerchat Cancerconnections

Patient Aware of Cancerchat & Cancerconnection

Pre

Post

0%

20%

40%

60%

80%

Counsel Support

Patient Aware of Counselling & Support Groups

Pre

Post

Campaign, Comfort Asking Questions 1. Have you seen the Emotional Support advertising?

Are you comfortable asking your care team about these resources?

Are you comfortable getting information from the BCCA website?

Campaign Ask questions Website

64%

97%

73%

Patient Aware of Initiative

Original Provincial Survey Questions

1. If you had any worries/concerns during your treatment/visit, did you care provider discuss them with you?

2. Did you know who to go to with questions?

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Worries Questions

Rating of Original Two Questions

Pre

Post

Next Steps

Emotional Support Resources advertising

campaign will be:

Shared with all Community Oncology clinics and physician offices throughout British Columbia.

Continued evaluation for effectiveness next in April and June 2016.

Supporting the Patient’s Experience…Together!

Thank you