Anniversary Oncology Days in Paris.

On June 14-16 2023, the 45th meeting of the General Assembly of Organization of European Cancer Institutes (OECI) dedicated to the 120th anniversary of the award of the first Nobel Prize in Physics for the discovery of radioactivity to Marie Sklodowska-Curie was held in Paris hosted by the Institut Curie. More than 130 leading specialized institutions and organizations that focus their efforts on finding ways and optimizing coordination to improve the quality of cancer care in Europe attended the OECI Oncology Days and the General Assembly. The first plenary session, chaired by S. Oberst and J.-B. Burrion, was devoted to the issues of quality in oncology and the role of research and education in optimizing healthcare services. It was noted that today, in the field of providing medical services to cancer patients in European countries, there are significant differences in access to digital, research and innovation technologies. The efforts of the team in the field of accreditation and certification of cancer centers within the framework of the European Cancer Plan help to improve and build the capacity of the EU member states to improve the quality of healthcare services. The OECI is working to support, improve and integrate cancer patient care, research and education in cancer care as well as survivorship to minimize inequalities in access to quality health care. A separate session chaired by E. Jolly was devoted to the role of patient organizations in improving the quality of cancer care, research and education. The reports presented the best experiences of cooperation between cancer centers and patient organizations in Central and Eastern Europe, as well as models of increasing interaction between clinical research centers and patient organizations in the European Union and Japan. The OECI is making considerable efforts to create an optimal model of the pathway that a patient should follow from the moment of diagnosis to palliative care and long-term survival. Optimization of European standards for the provision of high-quality specialized medical care and the development of quality indicators and patient-reported outcomes will improve the ability of researchers and healthcare providers to combine their efforts. On the one hand, the patient pathway is a tool for improving the quality of medical services and patient care, and on the other hand, it guarantees cost control and takes into account the patient's experience to make the best decision by a multidisciplinary team. At the session chaired by M. Nilsert, the best practices of oncology care provided by OECI-certified centres in Toulouse, Helsinki, Stockholm (Karolinska) and Dublin were presented. It is convincingly proven that the certification procedure helps to optimize the quality of medical services, communication with patients, research and improve the quality of education. Considerable attention at the special session chaired by G. Apolone and G. Brunelli was devoted to the issues of quality of life as the basis of cancer care. The EUonQoL project coordinated the optimization of research, the role of stakeholders in this process and the need to create an appropriate network of cancer infrastructure to reduce cancer in Europe. Today, as part of the development of the European Model Cancer Control Plan and with the support of the EU Mission and Horizon Europe, the goal of bringing together opportunities for the provision of high-quality healthcare services, joint research and innovation is under realization. The priority goal is to create comprehensive cancer infrastructures that will provide opportunities for the efficient use of national resources of European countries and associated EU members for improving the quality of healthcare services. At the plenary session chaired by G. Ciliberto and P. Mahon, dedicated to the role of digitalization as a factor of modern European opportunities, cancer centers presented pilot programs and trainings that contribute to the development and implementation of new opportunities to address complex cancer problems. A significant role in optimizing the coordination of European cancer centers should be played by the development and implementation of modern technologies in the creation and implementation of modern information databases that will improve the quality of research and health care services. Attention is focused on the role of the state policy of the OECI countries in supporting the development of digitalization of cancer centers. A significant event of the 45th OECI General Assembly was the plenary session on the preparation of the Ukrainian oncology service on the way to the European Union, chaired by T. Philippe and V. Chekhun. In his address on behalf of the Vice Prime Minister of Ukraine for European Integration Olha Stefanishyna, the First Deputy Minister of Health of Ukraine Serhii Dubrov welcomed the participants of the OECI Oncology Days and General Assembly. Francois Braun, Minister of Health of France, addressed the participants with a greeting and confirmed the comprehensive support for Ukraine on its way to the EU. The presentation of V. Chekhun and O. Rossylna focused on the current structure of the Ukrainian Cancer Service and the legislative framework for its transformation in the frames of reforms in the Ukrainian healthcare sector. The report of the OECI President highlighted the active position of OECI on the implementation of European standards to increase accessibility and improve the quality of cancer care for patients. T. Philippe drew special attention to the need to transform and optimize the oncology infrastructure network on the way of Ukraine's European integration efforts. The Ukrainian delegation's presentation was received with much enthusiasm from the audience. The participants from Moldova insisted on continuous support to Ukrainian medicine and patients. It was stressed that Ukraine fights not only for their territory but also for freedom in all Europe. As part of the OECI Oncology Days, the scientific session "The Cell as a Therapy" chaired by T. Philippe and G. Apolone was held to present new perspectives on cancer treatment. Below is a brief program of this conference: - Overview of the status of cancer cell therapy: theoretical and practical issues. - CAR-T Cells in the field of hematology: comparison between Western Europe and Eastern Europe. - The future of CAR-T in the field of solid tumors. - CAR-T allogenic, NK cells, TIL: other possible chapters for cell therapy. On the final day of the OECI General Assembly, T. Philip summarized the results of his program as a President, presented a financial report on the activities of OECI, and transferred the powers to the newly elected President G. Apolone for the period 2023-2026.

Sustainability and long-term effectiveness of the WHO surgical safety checklist combined with pulse oximetry in a resource-limited setting: two-year update from Moldova.

IMPORTANCE: Little is known about the sustainability and long-term effect of surgical safety checklists when implemented in resource-limited settings. A previous study demonstrated the marked, short-term effect of a structured hospital-wide implementation of a surgical safety checklist in Moldova, a lower-middle-income country, as have studies in other low-resource settings. OBJECTIVES: To assess the long-term reduction in perioperative harm following the introduction of a checklist-based surgical quality improvement program in a resource-limited setting and to understand the long-term effects of such programs. DESIGN, SETTING, AND PARTICIPANTS: Twenty months after the initial implementation of a surgical safety checklist and the provision of pulse oximetry at a referral hospital in Moldova, a lower-middle-income, resource-limited country in Eastern Europe, we conducted a prospective study of perioperative care and outcomes of 637 consecutive patients undergoing noncardiac surgery (the long-term follow-up group), and we compared the findings with those from 2106 patients who underwent surgery shortly after implementation (the short-term follow-up group). Preintervention data were collected from March to July 2010. Data collection during the short-term follow-up period was performed from October 2010 to January 2011, beginning 1 month after the implementation of the launch period. Data collection during the long-term follow-up period took place from May 25 to July 6, 2012, beginning 20 months after the initial intervention. MAIN OUTCOMES AND MEASURES: The primary end points of interest were surgical morbidity (ie, the complication rate), adherence to safety process measures, and frequency of hypoxemia. RESULTS: Between the short- and long-term follow-up groups, the complication rate decreased 30.7% (P = .03). Surgical site infections decreased 40.4% (P = .05). The mean (SD) rate of completion of the checklist items increased from 88% (14%) in the short-term follow-up group to 92% (11%) in the long-term follow-up group (P < .001). The rate of hypoxemic events continued to decrease (from 8.1 events per 100 hours of oximetry for the short-term follow-up group to 6.8 events per 100 hours of oximetry for the long-term follow-up group; P = .10). CONCLUSIONS AND RELEVANCE: Sustained use of the checklist was observed with continued improvements in process measures and reductions in 30-day surgical complications almost 2 years after a structured implementation effort that demonstrated marked, short-term reductions in harm. The sustained effect occurred despite the absence of continued oversight by the research team, indicating the important role that local leadership and local champions play in the success of quality improvement initiatives, especially in resource-limited settings.

Implementation of the World Health Organization surgical safety checklist, including introduction of pulse oximetry, in a resource-limited setting.

OBJECTIVE: To introduce the World Health Organization Surgical Safety Checklist into every operating room within a severely resource-limited hospital located in a developing country and to measure its impact on surgical hazards and complications. BACKGROUND: The checklist has been shown to reduce surgical morbidity and mortality, but the ability to successfully implement the checklist program hospital-wide in lower income settings without basic resources is unknown. METHODS: We conducted a pre- versus postintervention study of the implementation of the checklist, including the introduction of universal pulse oximetry at a hospital in Chisinau, Moldova, where only 3 oximeters were available for their 22 operating stations. We supplied data-recording oximeters for all operating stations and trained a local checklist implementation team. The primary outcomes were process adherence, major complications, and rates of hypoxemia (SpO2 <90%). Propensity score weighing was conducted to adjust process and outcome measures. Regression models were used to evaluate adherence to process measures and hypoxemia trends over time. RESULTS: Data from 2145 pre- and 2212 postintervention cases were collected. Adherence to all safety processes increased significantly from 0.0% to 66.9% (P < 0.001). After checklist implementation, the overall complication rate decreased from 21.5% to 8.8% (P < 0.001). Infectious and noninfectious complications decreased significantly after checklist implementation from 17.7% to 6.7% (P < 0.001) and from 2.6% to 1.5% (P = 0.018), respectively. The number of hypoxemic episodes lasting 2 minutes or longer per 100 hours of oximetry decreased from 11.5 to 6.4 (P < 0.002). CONCLUSIONS: Successful hospital-wide Surgery Safety Checklist implementation can be achieved in a resource-limited setting and can significantly reduce surgical hazards and complications.