SAINT FRANCIS CANCER CENTER ANNUAL REPORT 2018
ANNUAL REPORT | 2018
Since 1975, the cancer program at Saint Francis Health System has provided state-of-the-art medical oncology and radiotherapy technology to residents in eastern Oklahoma and surrounding states. Committed to advancing oncology care, Saint Francis provides an array of oncology services to meet patient needs. The cancer center’s treatment practices include boardcertified physicians who provide multidisciplinary care in a professional, patient- and family-focused setting. Additionally, the cancer program is accredited by the American College of Surgeons as a Comprehensive Community Cancer Program.
1
ANNUAL REPORT | 2018
2018 Annual Cancer Program Update It has been another successful year of growth and improvement for our oncology (cancer) program and services within Saint Francis Health System. Continuing to provide excellent clinical and patient-centered care and services remains our goal.
Highlights of some of the major achievements
• Saint Francis remains the only nationally recognized
and improvements for 2018 include the following:
Lung Cancer Alliance Screening Center of Excellence in
• In April 2018, expansion and renovation work at the
the state of Oklahoma.
Saint Francis Cancer Center began. Radiation oncology
• Implemented a lung nodule clinic weekly whereby
services are being relocated to the cancer center from
patients found to have “incidental lung nodules” on
the hospital. Most outpatient services needed by cancer
imaging studies can be seen and evaluated by a
patients will now be available at the cancer center location.
pulmonologist as deemed appropriate with a determination
• Completion of implementation of the newest technology available in Breast Health Services, tomosynthesis
for any needed further testing. • The radiation oncology department at Saint Francis was
mammography (3D), at all the Saint Francis Tulsa area
recognized at a national patient satisfaction (experience)
locations (Natalie Building, Broken Arrow and Glenpool)
conference (PRC) as being the “Top Radiation Department
as well as Warren Clinic McAlester.
in the Country” for patient satisfaction for the second year
• Over $12,000,000 in outpatient oncology drug patient assistance obtained to help deter the costs of cancer
in a row. • Warren Clinic Medical Oncology entered its third year as a
treatment through drug replacement and/or drug
participant in the CMS Oncology Care Model (A national
co-pay cards.
program designed to promote improved care coordination
• One additional Warren Clinic medical oncologist joined Saint Francis Health System as well as an additional
and services for oncology patients while reducing costs of care.)
Warren Clinic breast surgeon and oncologic general
Saint Francis Health System remains committed to being a
surgeon.
leader in oncology care and services for eastern Oklahoma
• Sponsorship or hosting of multiple oncology community events for oncology patients/survivors such as Saint Francis Cancer Survivor Night at the Tulsa Drillers; Blood and Marrow Transplant Survivors Party; American Cancer
as we continue to be focused on improving the health and outcomes of our patients. This standard supports our health system as we carry out our mission: To extend the presence and healing ministry of Christ in all that we do.
Society Relay for Life; American Cancer Society Cattle Barron’s Ball; American Cancer Society’s Strides Against
NANCY N. THOMAS, M.A., RHIA, CPHQ
Breast Cancer; and “Get Your Rear in Gear” Colon Cancer
Director, Oncology Service Line Saint Francis Health System
Coalition Race/Walk. • In the first 10 months of 2018, Saint Francis provided 580 breast health services to Oklahoma Project Woman patients (screening mammograms, diagnostic mammograms, ultrasounds, biopsies and MRI). These are female patients in Oklahoma who have no health insurance and/or limited financial resources.
2
ANNUAL REPORT | 2018
Commission on Cancer Since 1978, the cancer program at Saint Francis Hospital has been continually accredited by the American College of Surgeons’ Commission on Cancer (CoC). The CoC is the only multidisciplinary accreditation program for cancer programs in the U.S. and recognizes cancer care programs for their commitment to providing comprehensive, high-quality and multidisciplinary patient-centered care. Membership and accreditation is voluntary for healthcare organizations with cancer programs. Saint Francis Hospital has a dedicated multidisciplinary cancer committee that meets quarterly to ensure the highest quality of care is being provided to our patients. This dedicated committee sets annual program and clinical goals, and implements improvement projects that focus on quality of care and services.
Ancillary and Support Services Ancillary services include:
• Pastoral care – members of the pastoral care/religion
• Nurse navigation – navigators serve as a coordinators
department are available to all oncology patients (as
of care and the central point of contact for patients and
well as their family) on an outpatient or inpatient basis
families throughout the oncology journey.
to provide support and minister to them as needed/
• Oncology social worker – assistance and guidance
requested, including providing Holy Communion.
in linking patients with appropriate resources in
• Hospice – the Saint Francis hospice team provides physical,
the community.
psychological, social and spiritual support to terminally ill
• Oncology financial counselor – assists patients with
patients and their families. The hospice team also serves
accessing any financial assistance available to them such as drug replacement, drug co-pay cards, patient foundation assistance funds, Medicaid, charity care, etc. • Genetic counselor – access to genetic counselors for understanding of genetic testing results and how it affects
as consultants for end-of-life care discussion. • Laureate Psychiatric Clinic and Hospital – licensed clinical psychologists and psychiatrists provide counseling and therapy services on both inpatient and outpatient basis. • American Cancer Society Resource Room – services
the patient individually, as well as potential implications
available at the Saint Francis Cancer Center (free wigs for
for family members.
female patient, patient assistance with transportation,
• Oncology registered dietitian – available to assist patients with addressing nutritional needs, concerns and issues to optimize patients’ nutritional status. • Oncology rehabilitation – physical, occupational and
lodging, etc.). Diagnostic services include: • Tomosynthesis (3D) digital mammography
speech therapy services, including a lymphedema clinic
• Automated Whole Breast Ultrasound (ABUS)
provided by the oncology department with specifically
• Hand-held breast ultrasound
trained therapists to help patients achieve improved
• CT (computerized axial tomography) scan
functional status, decreased pain, etc. • Pharmacy – registered pharmacists oversee technicians who prepare all the chemotherapy drugs to be administered intravenously to patients as well as oral drugs dispensed through our outpatient pharmacy.
• MRI and Breast MRI (magnetic resonance imaging) • PET scan (positron emission tomography) • Nuclear medicine • Diagnostic radiology • Laboratory and pathology services • Genetics lab
3
ANNUAL REPORT | 2018
About Saint Francis Cancer Center The Saint Francis Cancer program was established in honor of Natalie Warren Bryant, second daughter of hospital founders Mr. and Mrs. William K. Warren, Sr. Natalie passed away from breast cancer at age 49. Originally, cancer services were only provided to patients at Saint Francis Hospital, however, in 2013 outpatient cancer services were expanded to the newly acquired Saint Francis Cancer Center located at 11212 East 48th Street in Tulsa. Services provided through the cancer program are multidisciplinary in nature and are patient-centered and -focused.
Quality Patient-centered Cancer Care Maintaining a state-of-the-art, quality cancer treatment center requires teamwork among many different disciplines. Our multidisciplinary team approach is the key to providing excellent quality care for patients and their families. By combining the cancer center’s medical and other clinical teams’ expertise and specialized knowledge, a comprehensive care management plan is developed to meet the individual patient’s needs. The cancer center provides patients with the convenience of receiving most all ambulatory services needed in one location. Our cancer treatment center physicians and providers have access to the extensive resources of Saint Francis Hospital, including an acute inpatient oncology unit. Post-treatment care is available through Saint Francis Home Health as well as hospice and palliative care services.
Cancer Treatment Center with a Family Focus As advanced as our treatments are, we understand one of the most powerful tools in our patients’ fight against cancer is the support of their family and friends. We have support groups for both patients and caregivers that are facilitated by our outpatient oncology social workers.
Prevention and Screening Programs Offered through Saint Francis Saint Francis Hospital offers a variety of annual prevention and screening programs to the community. The Saint Francis Cancer Committee is committed to developing programs that have a direct impact on health. These programs provide early detection and promote a healthy lifestyle.
4
ANNUAL REPORT | 2018
2018 Prevention Programs/Outcomes Prevention programs identify risk factors and use strategies to modify attitudes and behaviors to reduce the chance of developing cancer.
• Health Zone
Prevention programs include:
• Shape Down pediatric/adolescent weight loss program had 30 participants with 44 pounds of weight loss
• Saint Francis WellNow – in 2018, 2,423 (43 percent) of Saint Francis health plan-covered employees participated in the WellNow wellness program. The program rewards covered members in making healthy lifestyle choices and provides education and support to make wellness a lifestyle. The program includes members participating in a health assessment, which involves answering questions about specific lifestyle habits, generating a risk level and health index score. Biometric screenings are offered, including cholesterol (total, HDL, LDL), triglycerides, cardiac risk, glucose, blood pressure, height, weight, BMI and waist measurement. Points are awarded to employees for participation in the member health assessment, biometric screening, tobacco cessation program (as applicable), preventive care compliance and program activities offered.
• 33 participants in the adult weight loss program with 250 pounds of weight loss
2018 Screening Programs/Outcomes Screening programs detect cancers at an early stage, improving rates of survival. Screenings in 2018 include: • Lung Cancer Screening (Low-dose CT scans) • 728 screenings completed (January – November 2018), representing an increase of 30.7 percent from the previous year • 7 positive diagnoses for lung cancer, all referred
• Annual Health Zone Fitness and Wellness Expo – hundreds of people (approximately 700) participated in various screenings and community education about wellness and prevention programs associated with Saint Francis, including screening mammography and lung cancer screening.
• Saint Francis Breast Center
• American Cancer Society Resource Center at Saint Francis Cancer Center – 320 patients received resources, including:
• 281 positive diagnoses for cancer (45.0 percent),
• Provided 73 patients information through National Cancer Information Center • Provided 214 personal health manager packets
• 25,114 screening mammograms performed (January – November 2018) • 625 biopsies (January – November 2018) all referred • Oklahoma Project Woman • 513 total mammograms performed (January – November 2018)
• 25 women attended a “Look Good Feel Better” session
• 580 procedures performed (January – October 2018),
• 96 women received a free wig
which included 25 biopsies performed with three being
• 48 patients were provided 1,089 rides to and from treatment in the “Road to Recovery” program
positive for cancer, all referred
• 7 patients received 44 nights of lodging through the hotel partners program • 72 patients were connected to other community resources through the resource referral program
• Colon Cancer Screening (iFOBT) • In coordination with Community Care Insurance Company, 1,659 patients of Warren Clinic were identified as being 50 years or older without documentation of having had any type of colon cancer screening; 1,659 fecal occult blood
• 66 patients received a gift item (head covering, blanket, etc.)
test kits and instructions were mailed to these patients
• Clear Direction tobacco cessation program
ease of return to SFH lab for processing; 604 have been
• 13 participants completed the program with 100 percent success in quitting use of tobacco products
returned as of early December, 2018 with 43 (7.1 percent)
including a postage paid envelope in order to facilitate
being positive with all results going back to the patients’ primary care physician.
5
ANNUAL REPORT | 2018
2018 Annual Community Activities (Outreach) • Annual Health Zone Fitness and Wellness Expo –
The Saint Francis oncology nurse navigators touched more
approximately 700 participants; breast cancer and lung
than 2,038 patients, helping address barriers to care and
cancer screening education and promotion
facilitate care coordination, education regarding disease and
• Sanctuary Apostolic Evangelical Church Health Fair,
treatment.
Tulsa, OK – 50 participants (breast cancer screening education and promotion) • Celebrating the Art of Healing – 120 participants; breast cancer screening education and promotion
17 head and neck cancer patients benefited from free dental services, including teeth extractions through Catholic Charities of the Diocese of Tulsa and Eastern Oklahoma Donated Dental Services in 2018.
• Saint Francis Glenpool new facility open house – 2,000 participants; breast cancer and lung cancer screening education and promotion • Union Public Schools Health Fair, Tulsa, OK – 225 participants; breast cancer screening education and
2018 Educational Programs Provided for Oncology Nursing Personnel:
promotion, and genetic counseling services promotion
• Titrating chemotherapy drugs/EPIC updates
• American Cancer Society’s “Making Strides Against
• IV program administration
Breast Cancer” walk – 1,000 participants; breast cancer screening education and promotion • Harvest Time Ministry Women’s Conference, Tulsa, OK –
• Hester Davis fall scale refresher • Continuous bladder irrigation
75 participants; breast cancer screening education and
• IV push drug dilution and administration
promotion
• Tracheostomy care/types
• Cherokee Nation “Pink Party” Breast Cancer Awareness Event – 567 participants; breast cancer screening education and promotion • St. Benedict Catholic Church Health Fair, Broken Arrow, OK – 50 participants; breast cancer screening education and promotion • First Annual Oncology Patient Resource Fair held at
• Prevalon heel boots • Blood administration vital signs policy update • Glucometer renewals • Car-T cell therapy • Cytarabine-induced keratoconjunctivitis • Cod antibodies and blood warm usage
Saint Francis Cancer Center on October 22, 2018, with 12 resource organizations/departments participating: Oxford Healthcare; Assistance in Healthcare; Life Senior Services; Family and Children’s Services; Hospitality House; Wyndham Hotel; Brookdale Senior Living Community; Saint Francis Hospice; Saint Francis oncology dietitian; Saint Francis Cancer Center financial counselor; Saint Francis Oncology Rehabilitation; and Saint Francis Oncology social worker.
6
ANNUAL REPORT | 2018
2017 Adult | Age 18-120 years
PRIMARY SITE
MALE
FEMALE
TOTAL (%)
STG 0 STG I STG II STG III STG IV
NO AJCC
STAGING SCHEME ORAL CAVITY AND PHARYNX
42
13
55 (2.6%)
1
10
5
4
25
10
DIGESTIVE SYSTEM
196
152
348 (16.4%)
6
65
78
71
105
23
RESPIRATORY SYSTEM
169
153
322 (15.1%)
7
84
34
58
125
14
BONES AND JOINTS
0 2 2 (0.1%) 0 2 0 0 0
0
SOFT TISSUE
7
3
3
10 (0.5%)
0
3
2
1
1
SKIN, EXCLUDING BASAL AND SQUAMOUS
63 40 103 (4.8%) 44 33 7 7 7
5
BREAST
4
468
472 (22.2%)
64
190
149
39
29
1
FEMALE GENITAL SYSTEM
0
65
65 (3.1%)
3
23
7
14
9
9
200
0
200 (9.4%)
2
52
113
17
13
3
94
45
139 (6.5%)
35
60
12
11
17
4
MALE GENITAL SYSTEM URINARY SYSTEM
BRAIN AND OTHER NERVOUS SYSTEM 30 34 64 (3.0%) 0 0 0 0 0
64
ENDOCRINE SYSTEM
23
51
74 (3.5%)
0
31
4
7
5
27
LYMPHOMA
50
45
95 (4.5%)
0
16
25
18
32
4
MYELOMA
16 15 31 (1.5%) 0 0 0 0 0
31
LEUKEMIA
39 26 65 (3.1%) 0 0 0 0 0
65
MESOTHELIOMA
1 0 1 (0.0%) 0 0 0 0 1
0
MISCELLANEOUS
0 39 79 (3.7%) 0 0 0 0 0
79
Total
975 1,151
2,126
162 569 436 247 369
343
7
ANNUAL REPORT | 2018
2017 Pediatric | Age at Diagnosis: 0-17 years
PRIMARY SITE
TOTAL (%)
M
F
ANALYTIC STG 0
STG I
STG II
STG III
STG IV
NO AJCC
STAGING SCHEME DIGESTIVE SYSTEM
2 (4.5%) 1 1 2 0 1 0 1 0
0
BONES AND JOINTS
1 (2.3%) 0 1 1 0 0 0 0 1
0
URINARY SYSTEM
2 (4.5%) 0 2 2 0 0 0 0 0
2
EYE AND ORBIT
2 (4.5%) 0 2 2 0 0 0 0 0
2
9 (20.5%) 5 4 9 0 0 0 0 0
9
ENDOCRINE SYSTEM 2 (4.5%) 2 0 2 0 0 0 0 0
2
LYMPHOMA
12 (27.3%) 6 6 12 0 1 5 1 5
0
LEUKEMIA
12 (27.3%) 8 4 12 0 0 0 0 0
12
2 (4.5%) 1 1 2 0 0 0 0 0
2
44 23 21 44 0 2 5 2 6
29
BRAIN AND OTHER NERVOUS SYSTEM
MISCELLANEOUS
Total
8
ANNUAL REPORT | 2018
County at Diagnosis | 2017
COUNTY
CASES
PERCENT (%)
Tulsa, OK
1,198
55.06%
Wagoner, OK
151
Creek, OK
COUNTY
CASES
PERCENT (%)
Hughes, OK
6
0.28%
6.94%
McCurtain, OK
5
0.23%
115
5.28%
Lincoln, OK
4
0.18%
Muskogee, OK
90
4.14%
Atoka, OK
3
0.14%
Rogers, OK
90
4.14%
Noble, OK
3
0.14%
Mayes, OK
60
2.76%
Montgomery, KS
3
0.14%
Okmulgee, OK
56
2.57%
Pushmataha, OK
3
0.14%
Cherokee, OK
55
2.53%
Benton, AR
2
0.09%
County Unknown
52
2.39%
Sebastian, AR
2
0.09%
Pittsburg, OK
38
1.75%
Canadian, OK
1
0.05%
Craig, OK
30
1.38%
Choctaw, OK
1
0.05%
Delaware, OK
23
1.06%
Cleveland, OK
1
0.05%
Mcintosh, OK
21
0.97%
Passaic, NJ
1
0.05%
Washington, OK
19
0.87%
Garvin, OK
1
0.05%
Sequoyah, OK
18
0.83%
Lycoming, PA
1
0.05%
Ottawa, OK
17
0.78%
Marshall, OK
1
0.05%
Osage, OK
15
0.69%
Pontotoc, OK
1
0.05%
Adair, OK
14
0.64%
Seminole, OK
1
0.05%
Haskell, OK
11
0.51%
Harris, TX
1
0.05%
Pawnee, OK
11
0.51%
Tarrant, TX
1
0.05%
Payne, OK
11
0.51%
Total
Latimer, OK
9
0.41%
Nowata, OK
8
0.37%
Okfuskee, OK
8
0.37%
Kay, OK
7
0.32%
Le Flore, OK
7
0.32%
2,176
100%
9
ANNUAL REPORT | 2018
2018 Summary
Prevention and Screening Program Outcomes: • Ongoing success of Saint Francis WellNow, the online wellness tool • Saint Francis Health Zone: Zone Fit adult weight loss program • 33 participants with 350 pounds total weight loss • Health Zone ShapeDown children’s weight loss program • 30 participants with 44 pounds total weight loss • Tobacco cessation program • 13 participants, 100 percent success in quitting use of tobacco products • Lung screenings • 799 performed; seven cancer diagnoses, all referred for treatment • Oklahoma Project Woman breast screenings • Saint Francis Breast Center performed 513 mammograms and • Saint Francis Broken Arrow performed 12 mammograms at no cost to the patients • Saint Francis Breast Center diagnosed 281 patients with breast cancer, all referred for treatment
10
ANNUAL REPORT | 2018
Mission To extend the presence and healing ministry of Christ in all we do
Vision Saint Francis Health System will be the leading integrated Catholic healthcare system providing high quality, comprehensive and innovative care across our regional continuum of services.
Values Excellence Promoting high standards of service and performance Dignity Respecting each person as an inherently valuable member of the human community and as a unique expression of life Justice Advocating for systems and structures that are attuned to the needs of the vulnerable and disadvantaged and that promote a sense of community among all persons Integrity Encouraging honesty, consistency and predictability in all relationships Stewardship Ensuring prudent use of talents and resources in a collaborative manner
11