Saint Francis Cancer Center Annual Report | 2019

2019

SAINT FRANCIS CANCER CENTER AN N UAL R E P O RT

ANNUAL REPORT | 2019

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.

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ANNUAL REPORT | 2019

2019 Annual Cancer Program Update: Saint Francis Hospital is pleased to report some of the significant improvements and achievements reached in 2019 for our cancer program. We remain committed to providing excellent clinical, patient-centered care and services.

Highlights for 2019 include the following: • Expansion and renovation at Saint Francis Cancer Center continues. Radiation oncology services will relocate from Saint Francis Hospital to the Saint Francis Cancer

• Saint Francis remains a nationally recognized Lung Cancer Alliance Screening Center of Excellence in the state of Oklahoma.

• The radiation oncology department at Saint Francis was

Center beginning January 22, 2020. The new portion of

recognized as “top radiation department in the country”

the cancer center will also house a new Warren Clinic

for patient satisfaction for the third year in a row.

Medical Oncology physician area.

• The Saint Francis cancer program was the first in

• Over $28,000,000 in outpatient drug patient assistance

Tulsa and northeastern Oklahoma to implement use

for infusion patients obtained to help deter the costs

of a new radioisotope treatment (Lutathera) for some

of treatment through drug replacement and/or drug

neuroendocrine tumors.

co-pay cards.

• Implementation of new outpatient palliative care program.

• One additional Warren Clinic medical oncologist.

• Sponsorship or hosting of multiple oncology community events for oncology patients/survivors such as Saint Francis Cancer Survivor Night at the Tulsa Drillers; American Cancer Society Relay for Life; American Cancer Society Cattle Barron’s Ball; American Cancer

Saint Francis Health System remains committed to being a leader in oncology care. Our services for eastern Oklahoma continue to focus on improving the health and outcomes of our patients as we carry out our mission: To extend the presence and healing ministry of Christ in all that we do.

Society’s Strides Against Breast Cancer; “Get Your Rear in Gear” Colon Cancer Coalition Race/Walk.

• In the first 10 months of 2019, Saint Francis provided

NANCY N. THOMAS, M.A., RHIA, CPHQ Director, Oncology Service Line Saint Francis Health System

545 breast health services to Oklahoma Project Woman patients (screening mammograms, diagnostic mammograms, ultrasounds, biopsies and MRIs).

These are female patients in Oklahoma with no health insurance and/or limited financial resources.

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ANNUAL REPORT | 2019

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 – Saint Francis Hospice 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 patients, 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 speech therapy services, including a lymphedema clinic provided by the oncology department with specifically trained therapists to help patients achieve improved functional status, decreased pain, etc.

• Pharmacy – registered pharmacists oversee technicians

lodging, etc.). In 2019, 207 patients received 359 rides to/ from treatment through the American Cancer Society’s “Road to Recovery” program.

Diagnostic services include: • Tomosynthesis (3D) digital mammography • Automated Whole Breast Ultrasound (ABUS) • Hand-held breast ultrasound • CT (computerized axial tomography) scan

who prepare all the chemotherapy drugs to be

• MRI and Breast MRI (magnetic resonance imaging)

administered intravenously to patients as well as oral

• PET scan (positron emission tomography)

drugs dispensed through our outpatient pharmacy.

• Nuclear medicine • Diagnostic radiology • Laboratory and pathology services • Genetics lab

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ANNUAL REPORT | 2019

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 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 Saint Francis 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.

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ANNUAL REPORT | 2019

2019 Prevention Programs/Outcomes

2019 Screening Programs/Outcomes

• Saint Francis WellNow – In 2019, 2,379 (40 percent) of Saint Francis employees covered by CommunityCare participated in the WellNow program. The program encouraged members to make healthy lifestyle choices, and provided education and support to make wellness a lifestyle.

It includes specific lifestyle habits that generate a risk level and health index score. Biometric screenings are offered, and include cholesterol, 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, which can result in discounts in health insurance premiums.

Screening programs detect cancers at an early stage, improving rates of survival.

• Annual Health Zone Fitness and Wellness Expo • 650 participants in the Annual Health Zone Fitness and Wellness Expo

• Lung Cancer Screening (Low-dose CT scans) • 846 screenings completed (January to November 2019)— a 16.2 percent increase from the previous year • Six positive diagnoses for lung cancer, all referred, four out of six (66.7 percent) were in the early stages • Saint Francis Breast Center • 26,907 screening mammograms performed (January to November 2019)—a 7.1 percent increase from the previous year • 548 biopsies from January – November 2019 • 249 positive for cancer (44.3 percent), all referred • Oklahoma Project Woman

• Six participants in the Clear Direction Smoking Cessation program

• 495 total mammograms performed (January to November 2019)

• 15 participants in the Shapedown (pediatric weight management) program

• 545 procedures performed, which included 13 biopsies

• 1,500 visits for ZoneFit adult classes of various types

• Colon Cancer Screening (iFOBT) • In coordination with CommunityCare, 1,741 patients of Warren Clinic were identified as being 50 years or older without documentation of any type of colon cancer screening; 1,741 fecal occult blood test kits and instructions were mailed to these patients, including a paid postage envelope, in order to facilitate ease of return to our lab for processing; 717 have been returned as of end of November 2019 with 47 (6.6 percent) being positive—all results go to the patients’ primary care physician.

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ANNUAL REPORT | 2019

2019 Annual Community Activities (Outreach)

Saint Francis oncology rehabilitation services outcomes:

• The Health Zone at Saint Francis Health Fair – Approximately 650 participants—breast cancer and lung cancer screening education and promotion

Below is some data demonstrating improvement in patient health status for those who have undergone oncology rehabilitation services while receiving cancer treatment.

• Shiloh Baptist Church Health Fair, Tulsa, OK – 100 participants—breast cancer screening education and promotion

Patients experienced a 35 percent improvement in pain.

• Union Public Schools Health Fair, Tulsa, OK – Over 150 participants—breast cancer screening education and promotion, and genetic counseling services promotion • American Cancer Society “Making Strides Against Breast Cancer” Walk – 200 participants—breast cancer screening education and promotion • Muskogee Creek Nation “Pink Party” Breast Cancer Awareness Event – Approximately 700 participants— breast cancer screening education and promotion • First Baptist Church Women’s Group, Muskogee, OK – 75 participants—breast cancer screening education and promotion • Home & Garden Expo with American Cancer Society, Tulsa, OK – 200 participants—breast cancer screening education and promotion

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5

Average Score (Scale 0 – 10; Lower = Better)

3.43 2.23

0 Rehab Initial

Rehab Discharge

Patients experienced a 29% improvement in fatigue.

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5

Average Score (Scale 0 – 10; Lower = Better)

4.76 3.48

0 Rehab Initial

Other notable activities and outcomes within the cancer program: • Each month, our Saint Francis oncology nurse navigators work with an average of 550 patients to help address barriers to care, facilitate care coordination, and provide education regarding disease and treatment.

• 13 head and neck cancer patients benefited from free dental services through Catholic Charities of the Diocese of Tulsa and Eastern Oklahoma Donated Dental Services.

• Oncology social worker has provided assistance to over 700 patients thus far in 2019 and averages assisting around 100 patients per month. Responsibilities include coordinating transportation to/from our facilities for care and other services related to their oncology treatment.

Rehab Discharge

Patients experienced a 61 percent improvement in six-minute walk test (being able to walk further).

600

Average Distance in Meters (Higher = Better)

400 200

330.81 206.09

0 Rehab Initial

Rehab Discharge

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ANNUAL REPORT | 2019

2018 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

48

31

79 (3.1%)

1

20

12

10

18

18

DIGESTIVE SYSTEM

226

171

397 (15.4%)

13

67

66

80

104

67

RESPIRATORY SYSTEM

223

198

421 (16.3%)

6

67

33

80

166

69

BONES AND JOINTS

1 0 1 (0.0%) 0 0 0 0 0

1

SOFT TISSUE

6

3

9 (0.3%)

0

0

0

3

0

6

AND SQUAMOUS

75

58

133 (5.2%)

56

44

11

10

4

8

BREAST

0

473

473 (18.3%)

56

248

71

30

42

26

FEMALE GENITAL SYSTEM

0

112

112 (4.3%)

1

51

9

16

14

21

MALE GENITAL SYSTEM

244

0

244 (9.5%)

0

102

70

37

21

14

URINARY SYSTEM

133

64

197 (7.6%)

0

70

20

27

24

56

BRAIN AND OTHER NERVOUS SYSTEM

34

61

95 (3.7%)

0

0

0

0

0

95

ENDOCRINE SYSTEM

24

71

95 (3.7%)

0

52

9

1

1

32

LYMPHOMA

56

50

106 (4.1%)

0

20

23

17

26

20

MYELOMA

15 22 37 (1.4%) 0 0 0 0 0

37

LEUKEMIA

45 27 72 (2.8%) 0 3 0 1 3

65

MESOTHELIOMA

3 1

4 (0.2%) 0 0 0 2 1

1

KAPOSI SARCOMA

1 0 1 (0.0%) 0 0 0 0 0

1

53 49 102 (4.0%) 0 0 0 0 0

102

SKIN, EXCLUDING BASAL

MISCELLANEOUS Total

1,188 1,391

2,579

133 744 324 314 424

640

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ANNUAL REPORT | 2019

2018 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 (4.3%) 1 1 2 0 0 0 0 0

2

RESPIRATORY SYSTEM 1 (2.1%) 1 0 1 0 0 0 0 0

1

BONE AND JOINTS

4 (8.5%)

1

SOFT TISSUE

1 (2.1%) 1 0 1 0 0 0 0 0

1

URINARY SYSTEM

4 (8.5%) 2 2 4 0 0 0 0 0

4

9 (19.1%) 6 3 9 0 0 0 0 0

9

ENDOCRINE SYSTEM 3 (6.4%) 1 2 3 0 1 0 1 0

1

LYMPHOMA

6 (12.8%) 5 1 6 0 1 0 1 1

3

16 (34.0%) 9 7 16 0 0 0 0 0

16

1 (2.1%) 0 1 1 0 0 0 0 0

1

1

3

4

0

0

3

0

0

BRAIN AND OTHER NERVOUS SYSTEM

LEUKEMIA MISCELLANEOUS Total

47 27 20 47 0 2 3 2 1

39

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ANNUAL REPORT | 2019

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

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