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1.
Clin J Oncol Nurs ; 21(5): 561-566, 2017 Oct 01.
Article in English | MEDLINE | ID: mdl-28945724

ABSTRACT

BACKGROUND: Value-based cancer care warrants an exploration of ways that nurses can influence quality for patients with cancer, particularly in the community setting, where the majority of patients with cancer are treated.
. OBJECTIVES: The purpose is to explore how community cancer centers met and sustained key quality breast cancer care indicators through implementation of the National Cancer Institute Community Cancer Centers Program Rapid Quality Reporting System (RQRS) and patient navigation projects.
. METHODS: The authors identified and interviewed staff at three sites that achieved significant increases in concordance with three breast cancer outcome measures. FINDINGS: Three main themes emerged through analysis.


Subject(s)
Neoplasms/therapy , Quality of Health Care , Humans , Neoplasms/nursing , Oncology Nursing , Patient Navigation
2.
J Oncol Pract ; 12(2): 155-6; e157-68, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26464497

ABSTRACT

PURPOSE: The role of multidisciplinary care (MDC) on cancer care processes is not fully understood. We investigated the impact of MDC on the processes of care at cancer centers within the National Cancer Institute Community Cancer Centers Program (NCCCP). METHODS: The study used data from patients diagnosed with stage IIB to III rectal cancer, stage III colon cancer, and stage III non­small-cell lung cancer at 14 NCCCP cancer centers from 2007 to 2012. We used an MDC development assessment tool­with levels ranging from evolving MDC (low) to achieving excellence (high)­to measure the level of MDC implementation in seven MDC areas, such as case planning and physician engagement. Descriptive statistics and cluster-adjusted regression models quantified the association between MDC implementation and processes of care, including time from diagnosis to treatment receipt. RESULTS: A total of 1,079 patients were examined. Compared with patients with colon cancer treated at cancer centers reporting low MDC scores, time to treatment receipt was shorter for patients with colon cancer treated at cancer centers reporting high or moderate MDC scores for physician engagement (hazard ratio [HR] for high physician engagement, 2.66; 95% CI, 1.70 to 4.17; HR for moderate physician engagement, 1.50; 95% CI, 1.19 to 1.89) and longer for patients with colon cancer treated at cancer centers reporting high 2MDC scores for case planning (HR, 0.65; 95% CI, 0.49 to 0.85). Results for patients with rectal cancer were qualitatively similar, and there was no statistically significant difference among patients with lung cancer. CONCLUSION: MDC implementation level was associated with processes of care, and direction of association varied across MDC assessment areas.


Subject(s)
Neoplasms/diagnosis , Neoplasms/therapy , Patient Care Team , Patient Care , Adolescent , Adult , Aged , Aged, 80 and over , Cancer Care Facilities , Combined Modality Therapy , Female , Guideline Adherence , Humans , Male , Middle Aged , Neoplasm Staging , Neoplasms/epidemiology , Patient Care/methods , Patient Care/standards , Patient Care Planning , Prospective Studies , Retrospective Studies , Time-to-Treatment , Young Adult
3.
Prog Transplant ; 15(2): 178-84, 2005 Jun.
Article in English | MEDLINE | ID: mdl-16013468

ABSTRACT

The scarcity of human organs available for transplantation is clearly evident. Efforts to maximize the use of available organs and to increase the number of donors have increased the number of transplantations performed, but at a rate that remains far behind the rate of growth of the waiting list. Thus, the likelihood of a patient with severe liver disease receiving a liver replacement is decreasing. In order to offer treatment to most patients with liver disease, alternatives to whole-organ replacement must be found. Cell-based treatments, in which suspensions of liver cells are injected into patients with liver failure and reconstitute the patient's liver functions, may be that alternative. Here, we report on a regulatory-compliant process for the production of a cryopreserved cell therapy product that yields viable, metabolically active hepatocytes that can be infused directly into patients with the goal of reconstituting liver function.


Subject(s)
Hepatocytes/transplantation , Liver Failure/therapy , Cell Separation/methods , Cell Survival , Cell Transplantation/methods , Clinical Trials, Phase I as Topic , Coumarins/metabolism , Cryopreservation/methods , Epitopes , Flow Cytometry/methods , Hepatocytes/metabolism , Humans , Patient Selection , Tissue and Organ Harvesting/methods , Tissue and Organ Procurement , Transplantation, Homologous/methods , United States , United States Food and Drug Administration , Urea/metabolism
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