2015 Cancer
Program Report
2015 Cancer
Program Report
Incorporating a statistical summary of
the 2014 cancer registry data.
Page 2 Schneck Medical Center
INDEX
Chairman’s Message 3
Cancer Committee 4
Screenings, Support & Education 5
Cancer Registry Report 6
Schneck Data 7
Perspective 9
Lung Cancer Analysis 10
Nurse Navigation Update 14
Directory of Terms 14
Palliative Care Program 15
Schneck Medical Center (812) 522-2349
Toll Free (800) 234-9222
Cancer Services Center (812) 522-0480
Cancer Registry (812) 522-0475
Screening Information Line (812) 522-0477
Community Wellness (812) 523-5861
Diagnostic Imaging (X-Ray) (812) 522-0144
Diagnostic Laboratory (Lab) (812) 522-0152
Home Services & Hospice (812) 522-0460
Nutrition Services (812) 522-0148
Pain Center (812) 524-4253
Patient Services (812) 522-0440
(Social Work, Case Management, Discharge Planning)
Psychological Services (812) 522-5739
Rehab Services (812) 522-0177
Schneck Foundation (812) 524-4244
Smoking Cessation Classes (812) 522-0401
Wound Care (812) 522-0177
The vision of the Cancer Program at Schneck Medical Center is to be the provider of choice for cancer care in our community. Our mission is to provide excellence in prevention, diagnosis, and treatment throughout the continuum of cancer care. Schneck Medical Center’s Community Cancer Program is based on the standards prescribed by the American College of Surgeons, Commission on Cancer (ACoS, CoC). Schneck is accredited with Commendation by the ACoS, CoC. The CoC recommends that this program publish an annual report. A time lag is caused by the length of time which may occur between diagnosis and first course of treatment and the time required for generation of data.
SERVICE DIRECTORY
2015 Annual Cancer Program Report Page 3
CHAIRMAN’S MESSAGE The Cancer Center at
Schneck Medical Center
again succeeded in providing
excellent care to the
patients of Jackson and its
surrounding counties in
2015. This was facilitated by
the strong leadership of Dr.
Dolores Olivarez, our full-
time medical oncologist. Dr. Higinia Cardenes
joined us this year as the cancer center’s full-time
radiation oncologist, adding her expertise and
drive to our talented staff. Dr. Amanda Dick
continued to serve as our cancer liaison physician.
Dr. LeAnn Stidham also continued as our
radiologist and Dr. Whitler as our pathologist.
Anita Collins, a nurse practitioner, joined the
cancer center this year with dedication to the
Palliative Care program.
As cancer treatment requires the most up-to-date
innovations and technology, the Schneck Cancer
Center met this challenge by transitioning to
electronic medical records. This allowed the vital
chemotherapies and other orders to be entered
electronically, improving patient safety. We also
purchased a new nasopharyngeal scope to
visualize and aid in the treatment of head and
neck cancers. In addition to these updated
technologies, we began a research project
involving an enhanced treatment process called
photodynamic therapy. These cases are being
discussed in the context of our “All Things Chest”
cancer conference which served to augment our
continuing breast conferences with the addition
of lung cancer cases.
Lynda Richey, an experienced nurse at the
cancer center, has continued in the role as our
Patient Navigator. This role serves to guide the
patient through the emotional and
overwhelming terrain on their path to diagnosis
and treatment, and we continued to solidify this
process with improved treatment plans and
communication goals. In conjunction with this
process, the cancer center has a more cohesive
survivorship care plan that communicates to the
patient expectations once treatment is
completed.
The Schneck Cancer Center continues to flourish
in 2015 as the incredible staff and innovative
technologies aid us in marrying art and science
to provide excellent cancer care.
Grant J. Olsen, M.D.
2014 Distribution by County Schneck Medical Center Total Analytic Cases 220
Schneck serves Jackson County as well as
many surrounding counties in Indiana.
Jackson 147 Jennings 38 Scott 17 Bartholomew 6 Rush 3
Lawrence 2 Washington 2 Clark, Dubois, Greene, Harrison, and Jefferson 1 each
Page 4 Schneck Medical Center
CANCER COMMITTEE The Cancer Committee is comprised of physicians and other healthcare professionals dedicated to providing the community with state-of-the-art cancer control efforts in prevention, early diagnosis, pre-treatment evaluation, staging, treatment, rehabilitation, and surveillance. The Committee provides leadership to plan, initiate, stimulate, and assess all cancer-related activities at Schneck. Members include:
Sally Acton, RN, BSN, OCN, MSM, Director, Cancer & Palliative Care Services (Cancer Program Administrator) Aaron Banister, PhD, HSPP, Mental Health & Wellness (Psychosocial Services Coordinator)
Donna Butler, MSN, ANP-BC, OCN, ACHPN, FAAPM, Palliative Care
Higinia Cárdenes, M.D., Ph.D., Radiation Oncologist
Debbie Clontz, RN, BSN, OCN, Oncology Nurse, Cancer Services
Leighana Crenshaw, MSW, LSW, Case Manager, Patient Services
Tammi Covert, OTR, Rehab Coordinator, Rehab Services
Amanda Dick, M.D., General Surgeon (ACoS Cancer Liaison Physician)
Sherry Dowling, CTR, Cancer Registrar, Cancer Services (Cancer Conference Coordinator)
Vicki Johnson-Poynter, MSN, RN, NE-BC, CSSBB, VP of Nursing Services and Chief Nursing Officer
Suzie McDonald, RN, BSN, MHA, Nurse Manager, Hospice Services
Dolores Olivarez, M.D., Medical Oncologist (Clinical Research Representative)
Grant Olsen, M.D., Hospitalist (Chairman)
Lynda Richey, RN, BSN, OCN, Oncology Nurse and Nurse Navigator, Cancer Services (Community Outreach Coordinator)
LeAnn Stidham, M.D., Diagnostic Radiologist
Ann Wenderoth, Coordinator, Health Initiatives, Great Lakes Division, American Cancer Society
J. Wesley Whitler, M.D., Pathologist (Quality of Cancer Registry Data Coordinator) Suki Wright, MSM, CSSBB, Director, Organizational Excellence and Innovation (Quality Improvement Coordinator)
2015 Annual Cancer Program Report Page 5
COMMUNITY OUTREACH
Lynda Richey, Community Outreach Coordinator, monitors outreach activity, assuring that materials and staff are available for screening and educating the community. She reports these events to the Cancer Committee.
Screenings Early detection is the key to finding cancer in an early stage, thus providing a better chance for cure. Screenings can detect cancers in early stages, before symptoms would prompt a physician office visit. Schneck Medical Center provided the following screenings:
ColoCare, a test for detecting blood in the stool, was distributed for colon cancer screening at numerous health events.
Skin cancer screenings were held by a local dermatologist at the Cancer Center. Prostate cancer screenings were held in September by Dr. McAleese at the Cancer Center. Breast health screenings were held in May and September; a cervical screening was included. Oral screening was performed by Dr. Hiester-Stout at the community health fair. CT lung cancer screening is available through Schneck Diagnostic Imaging.
Public Education Public education is provided through many venues. Professional staff of the Schneck Cancer Center provides information about prevention, detection, and good health habits to various community organizations. In addition, instruction and literature about various cancer topics are provided at community events.
Support Psychological services and social workers are available to provide emotional support and assistance with community resources throughout the disease process. Other venues for support include the following:
Research Computers with internet access are located in our Resource Center with easy access to the National Cancer Institute and clinical trials. Patient tracking of those participating in clinical trials is being done by the cancer center staff.
Lynda Richey, RN, BSN, OCN
Community Outreach Coordinator
Cancer support group Leukemia & Lymphoma support group Fresh Start Smoking Cessation program Nutritional counseling Genetic testing and counseling through referral Cancer navigation program
Grief counseling Free wig bank (ACS) Look Good Feel Better program (ACS) Road to Recovery (ACS) Reach to Recovery (ACS) Palliative Care Team
Page 6 Schneck Medical Center
SCHNECK CANCER REGISTRY SUMMARY
A follow-up rate of 80% for all analytic patients is required by the ACoS, CoC.
SCHNECK CANCER PATIENTS ENTERED IN THE LAST FIVE YEARS SUMMARY
A follow-up rate of 90% for analytic patients entered in the last five years is required by the ACoS, CoC. Calculations based on September 2015 follow-up. Cancer Registry reference date: January 1, 1986
Total number of cases in registry since 5894
Total number of cases requiring follow-up 4412
Less number of deceased cases 2846
Total number of cases followed 1566
Cases with current follow-up 1289
Total follow up rate 93.7%
Total number of cases in registry last five years 869
Total number of cases requiring follow-up 869
Less number of deceased cases 358
Total number of cases followed 511
Cases with current follow-up 478
Total follow up rate 95.6%
Quality of the Cancer Registry is monitored and reported quarterly to the Cancer Committee. This includes monitoring of case finding, accuracy of data collection and staging, abstracting timeliness (RQRS), follow-up, and data reporting.
As a pathologist, Dr. Whitler also oversees the quality of the pathology reporting system.
J. Wesley Whitler, M.D. Quality of Registry Data
Coordinator
Cancer Registrars monitor, report, and analyze all types of cancer diagnosed or treated in an institution. Maintaining a cancer registry ensures that health officials have accurate and timely data for treatment, research,
and educational purposes. Fundamental research on the epidemiology of cancer is initiated using the accumulated data reported to central (state/national) registries.
Our Cancer Program is accredited by the American College of Surgeons, Commission of Cancer, CoC, with commendation level of compliance on all required standards, therefore receiving the CoC Outstanding Achievement Award.
Our registry has implemented the CoC Rapid Quality Reporting System (RQRS) to actively monitor and assess compliance with several National Quality Forum endorsed measures to support efforts in maintaining a high-level of evidence-based cancer care.
Currently, I am honored to serve as treasurer of the Indiana Cancer Registry Association. As a member of the National and State Cancer Registrars’ Associations, I have the opportunity to interact with registrars across the nation and to stay current with required changes in coding documentation.
Please take a few moments to look over the graphs on the following pages. While the cancer registry compiles the data, this is truly a reflection of everyone working together to care for our patients.
Sherry L. Dowling, CTR, Cancer Registrar
CANCER REGISTRY REPORT
2015 Annual Cancer Program Report Page 7
SCHNECK CANCER CASES BY PRIMARY
0 5 10 15 20 25 30 35 40 45
Other/Ill Defined/Unknown
Tongue
Ovary
Leukemia
Melanomas
Soft Tissue (incl. head)
Liver
Cervix Uteri
Multiple Myeloma
Larynx
Hodgkin's disease
Kidney and Renal Pelvis
Stomach
Rectum and Rectosigmoid
Thyroid Gland
Corpus Uteri
Pharynx other bucca
Non-Hodgkin's Lymphoma
Pancreas
Urinary Bladder
Prostate
Colon
Breast
Lung & Bronchus
Analytic
Non-Analytic
*Other includes sites with frequency of two or less.
Breast cancer is our top analytic site, followed by lung, colon, prostate, and urinary bladder cancers. Lung cancer is highlighted later in this report by Dr. David Wilson. Our top sites coincide with the top sites nationally.
2014 Frequency by Primary Site 261 Total: Analytic 220, Non-Analytic 41
35/8
36/3
18/7
22/0
11/10
12/1
10/3
7/1
8/0
2/1
5/0
5/0
3/0
2/1
4/0
1/2
3/0
8/1
4/3
6/0
6/0
4/0
4/0
4/0
Page 8 Schneck Medical Center
SCHNECK CANCER CASES BY PATIENT DISTRIBUTION
6
14 15
18
37
128
41
19
14
25
11
0
5
10
15
20
25
30
35
40
45
In Situ I II III IV N/A or Unknown
Male Female
1
8
23
31
23
14
24
10
22
3230
17
3
0
5
10
15
20
25
30
35
30-39 40-49 50-59 60-69 70-79 80-89 90-99
Male Female
2014 Age by Gender at Diagnosis 220 Analytic Cases: 102 male, 118 female
2014 AJCC Stage by Gender at Diagnosis 220 Analytic Cases: 102 male, 118 female
Cancer incidence rises with age, with most cases affecting adults in mid-life or older. Females
predominated at 118 of the total 220 cases.
The stage of cancer at diagnosis refers to the extent of cancer growth or spread. Detecting cancer in an earlier stage can often lead to a higher survival rate. The majority of females were diagnosed at Stage II or earlier.
2015 Annual Cancer Program Report Page 9
PERSPECTIVE Lung cancer is the leading cause of cancer death in the U.S. and as such presents tremendous challenges. But, the opportunity for improved diagnosis and care is great. With this backdrop of challenges and opportunities, Schneck implemented new technology for lung cancer detection and therapy in late 2014. But first, let’s detail the
lung cancer experience at Schneck for 2014.
There were 36 cases of Lung cancer in 2014. Demographically 25% occurred at less than 60 years of age. The sixth decade of life was the most common for incident lung cancer at 41.7%. 22.2% occurred in the age range of 70-79 and only 11.1% greater or equal to the age of 80.
This roughly mimics the U.S. experience as a whole. Detection strategies with lung cancer screening should improve earlier disease recognition. Presumably, this would lower the age incidence. The National Lung Cancer Screening Trial defined a screening benefit with low dose Chest CT scans that promises to aid in early detection of lung cancer. Many insurers and CMS now cover low dose Chest CT for lung cancer screening.
Stage remains the most important predictive factor in lung cancer outcomes, and 26 patients presented at Stage III and IV disease. This is actually better than national data. Stage III and IV disease at Schneck is at 67%, while nationally this number is closer to 85%. 10 cases presented at Stage I and II which carry a much better prognosis. Lung cancer survival remains at only 15% nationally. This is defined as cancer free status at five years from diagnosis.
The location of lung cancer has slowly moved further to the periphery and away from the central airways. The 2014 Schneck experience shows this to be accurate. Only two cases, or 5.6%, were in main airways (trachea/Main stem bronchi). Upper lobe predominance was present at 55.5%. This is also nationally and historically the case. Lower lobe disease occurrence was less at 19.4%.
Treatment regimens at Schneck were multi-modality with combinations of surgical, chemotherapeutic, and radiation therapy. No one approach predominated. This is very common and expected given the complex nature of lung cancer. Eleven patients in the cohort chose no therapy or were beyond the point of tolerating therapy. Again, this is a tragic malignancy and detection at a late stage often limits therapy options.
Challenging diseases also create enormous opportunities. Schneck embraced opportunities to improve lung cancer detection by investing in the Veran Navigational Bronchoscopy/Percutaneous Biopsy System in late 2014. Combined with Transthoracic Needle Biopsy with CT guidance, it gives Schneck the ability to have three non-surgical methods to detect earlier stage lung cancer. This has also lead to re-thinking the Cancer Nurse Navigator role to include identification of abnormal chest x-rays and chest CTs. The hope of early detection is promising. Surgery is the most curative therapy. But, surgery is best with early stage disease. Lung cancer surgical case volumes at Schneck began to rise in late 2014 largely due to identifying early stage disease.
Newer therapy modalities were embraced in 2014 as well. Schneck has implemented the only Photodynamic Therapy (PDT) program for lung cancer treatment in the state. Patients with lung cancer have better therapeutic outcomes if tumors occluding airways are destroyed. Many methods exist to eradicate airway tumors, but PDT with Laser excitation of a cytotoxic photophryn drug is reemerging as a preferred method because it is less traumatic to the patient. This PDT program has treated many patients to improve their ability to undergo chemotherapy and radiation therapy. The future of lung cancer detection and treatment remains optimistic.
David S. Wilson MD, FCCP
Page 10 Schneck Medical Center
3
6
15
8
31
0
5
10
15
20
40-49 50-59 60-69 70-79 80-89 90-99
SCHNECK NON-SMALL CELL CARCINOMA CANCER DATA
2, 5%
20, 56%
1, 3%
7, 19%
6, 17%Main Bronchus
Upper lobe,lung
Middle lobe,lung
Lower lobe,lung
Unknown
46 6
20
0
5
10
15
20
25
I II III IV
The sixth decade of life was the most common for incidence, 41.7%, of lung cancer.
Twenty six patients, or 67%, presented at Stage III and IV. This is better than the national data in which closer to 85% of patients present at Stage III or IV.
2014 Age at Diagnosis 36 Analytic Lung Cases
2014 AJCC Stage at Diagnosis 36 Analytic Lung Cases
2014 Topography at Diagnosis 36 Analytic Lung Cases
More than half, 55.5%, of our patients presented with cancer in the upper lobe.
11, 31%
3, 8%
3, 8%
5, 14%
9, 25%
2, 5%
1, 3% 2, 6%No Treatment
Surgery alone
Chemotherapy alone
Radiation alone
Radiation / Chemo
Surgery / Chemo
Surgery / Radiation
Surgery / Radiation / Chemo
2014 Treatment at Diagnosis 36 Analytic Lung Cases
Treatment at Schneck follows national standards. Unfortunately, due to late stage diagnosis, patients may not be able to tolerate therapy and may opt to forgo treatment due to the progression of cancer.
2015 Annual Cancer Program Report Page 11
NON-SMALL CELL CARCINOMA CANCER NCDB COMPARATIVE ANALYSIS
1
7
20
29 29
13
11
5
16
3032
15
1
0
5
10
15
20
25
30
35
30-39 40-49 50-59 60-69 70-79 80-89 90+
SM C
NCDB
107
30
51
2
25
8
22
37
8
0
10
20
30
40
50
60
I II III IV Unknown
SMC
NCDB
Percentage of Cases, Age at Diagnosis* Schneck Medical Center & NCDB 2003-2013 Total Analytic Cases: 247 Schneck, 1,320,025 NCDB
Percentage of Cases, AJCC Stage at Diagnosis* Schneck Medical Center & NCDB 2003-2013 Total Analytic Cases: 247 Schneck, 1,320,025 NCDB
Incidence of cancer increases with age, with most cases affecting adults in mid-life or older. Schneck’s age groups at initial diagnosis track national trends closely.
The stage of cancer at diagnosis refers to the extent of cancer growth or spread. Data shows the majority of lung cancers are diagnosed in the later stages of disease .
Page 12 Schneck Medical Center
NON-SMALL CELL CARCINOMA CANCER ANALYSIS (CONT.)
5.7
26.3
0.8 2.4
29.2
13.4
2.4 1.6
18.220.2
14.2
1.1
4.9
21
13
2.92.4
20.3
0
5
10
15
20
25
30
35
Surge ry Only RadiationOnly
Surgery &Radiation
Surgery &Chemo
Radiation &Chemo
Chemo Only Surgery,Radiation &
Chemo
OtherSpecified
Therapy
No FirstCourse of
Treatment
SMC NCDB
Percentage of First Course of Treatment* Schneck Medical Center & NCDB 2003-2013 Total Analytic Cases: 247 Schneck, 1,320,025 NCDB
Schneck’s first course of treatment very closely matches national statistics. Many patients only require surgery. Depending upon the stage of disease, national guidelines recommend additional treatment.
* Comparison data provided by 2015 National Cancer Data Base (NCDB) / Commission on Cancer (CoC) as of Tuesday, October 20, 2015.
RESEARCH Schneck joined Indiana University in a lung cancer screening research study, “Measuring Stigma and Health Beliefs about Lung Cancer Screening in Long-Term Smokers.” This study should help us better understand factors that may influence screening behavior and help us identify effective recruitment methods.
2015 Annual Cancer Program Report Page 13
NCBD, CP3R Performance Rate Comparisons*
NON-SMALL CELL CARCINOMA CANCER ANALYSIS (CONT.)
2011 2012 2013
SMC IN NCDB SMC IN NCDB SMC IN NCDB
L no Surgery—Surgery is not the first
course of treatment for cN2, cM0 lung
cases.
100% 91.6% 89.9% 100% 91.3% 90.8% 100% 93.8% 91.6%
LCT—Systemic chemotherapy is
administered within 4 months to day
preoperatively or day of surgery to 6
months postoperatively or it is
considered for surgically resected
(pN1) and (pN2) NSCLC.
100% 89.1% 85.6% N/A 90.9% 90.3% N/A 91.5% 88%
National performance measures are used to measure treatment practices. Schneck monitors and compares data in an effort to maintain a high-level of cancer care. Schneck’s performance rate exceeds others across the nation.
Schneck Medical Center is leading the way for improved cancer care for patients in our community. As Dr. Wilson outlined earlier in this report, unique therapies, including photodynamic therapy and navigational bronchoscopy, are now being offered as
part of our approach to treating lung cancer.
Current treatment guidelines for lung cancer recommend consideration of chemotherapy for lymph node positive (pN1 and pN2) non-small cell lung cancer within 4 months pre-operatively or 6 months post-operatively. In 2011, every patient treated at Schneck Cancer Center met that guideline. Additional goals include appropriate selection of patients for surgical treatment. Recommendations are for non-surgical treatment as the first course for node positive non-small cell
lung carcinoma. We met that guideline 100% of the time. Surgical treatment of lung cancer here at Schneck is a relatively new occurrence. Optimal outcomes and appropriate surgical therapy will remain a focus as we continue to treat more lung cancer patients here at Schneck.
Cancer prevention through education of both patients and providers as well as preventative care measures will help reduce the incidence of cancer. Community outreach and education regarding causes of lung cancer and who is appropriate to seek screening tests will be a big focus for the coming year. Timely diagnoses and nationally recognized care are paramount to potential cure and faster return to their lives and loved ones.
Amanda Dick, M.D. Cancer Liaison Physician
Page 14 Schneck Medical Center
NURSE NAVIGATION
DIRECTORY OF TERMS
AJCC Stage of Diagnosis: Depending on the TNM classifications or anatomic extent of disease, cases are placed into “Stage Groupings” or levels of disease. Early disease is classified as Stage 0 with the stage increasing with the amount of disease present.
Analytic: Cases diagnosed and/or treated initially at Schneck Medical Center since the Cancer Registry reference date of January 1, 1986.
Non-Analytic: Cases diagnosed and/or treated elsewhere; cases diagnosed and treated at Schneck Medical Center prior to the Cancer Registry reference date of January 1, 1986, and which have returned with recurrent disease during the current year; cases diagnosed at autopsy; or known cases diagnosed and initially treated in a staff physician’s office.
Survival: Observed rate is the calculation made without correcting for other types of mortality.
OUR NURSE NAVIGATOR HELPS PATIENTS THROUGH
A COMPLEX CANCER DIAGNOSIS.
DEDICATED TO GIVING PATIENTS MORE CONTROL OF THEIR CANCER
As our Cancer Center Nurse Navigator, Lynda Richey, RN, BSN, OCN, focuses
on helping each patient after their diagnosis no matter what type of cancer it
is. This includes providing education to patients, giving emotional support, and
connecting them to crucial resources in the surrounding area. With more than
25 years of experience in cancer care, Lynda helps our cancer patients and
their families move through the healthcare process from diagnosis through
treatment and into survivorship. Lynda continues to stay in contact with
physician offices, providing treatment plans and updates as needed. She
focuses on addressing the barriers of cancer patients on an individual level
using interdisciplinary resources as appropriate.
For referrals, please call 812-523-5210.
2015 Annual Cancer Program Report Page 15
PALLIATIVE CARE PROGRAM
Rev. Stephen Barrett has been a Hospice/Palliative Care Chaplain at Schneck since 2011. A pastor for twelve years, he is a member of the Association of Professional Chaplains.
Aaron Banister, Ph.D., is a licensed counseling psychologist specializing in health psychology, cognitive behavioral therapy, and anxiety-based disorders. He has been with Schneck since 2013.
Donna Butler, MSN, ANP- BC, OCN, ACHPN, FAAPM, has been focusing on palliative care since 2003. She is certified in oncology, advanced hospice, and palliative care nursing and a fellow of the American Academy of Pain Management.
Anita Collins, MSN, FNP-BC, has been a nurse practitioner since 2008, focusing on pain management. She recently joined palliative care. She has worked at Schneck Medical Center since 1991.
Leighana Crenshaw, MSW, LSW, has been a social worker since 1994, joining Schneck in 2000. She has been active in the Palliative Care program since 2011. David Hartung, DO, is the medical director of the Palliative Care Program. Dr. Hartung joined Schneck’s medical staff in 2005. He is board certified in family medicine.
Schneck’s palliative care team will work with primary care physicians to combine pain and symptom
control in all aspects of our patient’s care plan.
Colette Mills, RN, BSN, CHPN, has been an RN since 1989. With Schneck Hospice since 2008, she has served on the Palliative Care team since 2011. She is a certified Hospice and Palliative Care nurse.
Dana Prieto, RN, BSN, is an experienced nurse with training in pediatrics, medical/surgical, ICU and oncology. She become an RN in 2007, joining Schneck in 2010. Dana has served on the Palliative Care team since 2012.
PALLIATIVE CARE PROGRAM UPDATES
Since beginning the program in 2011, Donna Butler
has expanded Schneck’s program to encompass a
wide range of patients. The goal of the program is
to improve quality of life both for the patient and
their family by addressing goals of care, life goals,
and advance care planning. Donna has mentored
regional programs, helping other organizations
initiate or improve their palliative care programs.
Performance improvement is continually
monitored and demonstrates improved symptom
management.
Sally Acton, Cancer Center Director, spoke about
the program in November at the Center to
Advance Palliative Care. In her poster
presentation, Sally highlighted Schneck’s
commitment to advancing the services provided at
Schneck by training more nurse practitioners. This
strategic initiative allowed for Anita Collins to join
the palliative care program in 2015.
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