2020
SAINT FRANCIS CANCER CENTER ANNUAL REPORT
ANNUAL REPORT | 2020
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 board-certified 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.
2
ANNUAL REPORT | 2020
2020 Annual Cancer Program Update: Saint Francis Hospital has navigated the pandemic true to our mission, vision and values, and while many programs and events were unable to occur, our cancer program was still able to achieve improvements and growth. We remain committed to providing excellent clinical, patient centered care and services.
Highlights from 2020 include the following:
• The radiation oncology department at Saint Francis was recognized as a “top radiation department in the country”
• The Saint Francis Cancer Center expansion and renovation
for patient satisfaction for the fourth year in a row.
project continued in 2020. As new spaces are completed, clinical services relocate into their new areas. A significant
• Saint Francis was selected as one of six programs in the
milestone in the project was the relocation of Radiation
country to participate in a national quality improvement
Oncology from Saint Francis Hospital to the Saint Francis
project with Association of Community Cancer Centers
Cancer Center. Additionally, the Warren Clinic Oncology
regarding improving care for non-small lung cancer patients.
physician offices moved into their new space. • Implementation of a new outpatient palliative care program in • Over $38,000,000 in financial assistance was obtained
January 2020 with positive outcomes thus far.
to help deter the costs of treatment through drug replacement and/or drug co-pay cards for outpatients undergoing infusion treatments. • A new medical oncologist was recruited to Warren Clinic Oncology. • In 2020, Saint Francis provided 328 services to patients with no health insurance and/or limited financial resources through Oklahoma Project Woman. These services included screening
• Implementation of NextGen genetic testing through Saint Francis Genetics Lab
Saint Francis Health System remains committed to being a leader in oncology care. We continue to focus on improving the health and outcomes of our patients in eastern Oklahoma as we carry out our mission: To extend the presence and healing ministry of Christ in all that we do.
mammograms, diagnostic mammograms, ultrasounds, biopsies and MRIs. • Saint Francis remains a nationally recognized Lung Cancer
NANCY N. THOMAS, M.A., RHIA, CPHQ Director, Oncology Service Line Saint Francis Health System
Screening Center of Excellence in the state of Oklahoma.
3
ANNUAL REPORT | 2020
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 Commission on Cancer 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 programmatic and clinical goals and implements improvement projects that focus on quality of care and services.
Ancillary and Support Services Ancillary Services include: • Nurse navigation – navigators serve as coordinators of care and are the central point of contact for patients/families throughout the oncology journey. • Oncology social worker – assist and guide patients in linking with appropriate resources in the community • Oncology financial counselor – assists patients with accessing any patient financial assistance available to them, such as drug replacement, drug co-pay cards, patient foundation assistance funds, Medicaid, charity care, etc. • Genetic counselor – helps patients understand genetic testing results and how it affects the patient individually, as well as potential implications for family members, etc. • Oncology registered dietitian – assists patients with addressing nutritional needs, concerns and issues to optimize
• Hospice – Saint Francis Hospice provides physical, psychological, social and spiritual support to terminally ill patients and their families. The hospice team also serves 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 an inpatient and outpatient basis. • Outpatient palliative care (supportive care) – consults with oncology advanced care provider, oncology nurse and social worker as a team to understand the benefits of palliative care, and ongoing visits and dialogue with these providers (without charge) to help cancer patients and their families with comfort and support
Diagnostic Services include: • Tomosynthesis (3D) digital mammography
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 who prepare all the chemotherapy drugs to be administered intravenously to patients, as well as oral drugs dispensed through our outpatient pharmacy. • Pastoral care – members of the department of religion are routinely available to all oncology patients (as well as their families) on an outpatient or inpatient basis to provide support and minister to them as needed/requested, including
• Automated Whole Breast Ultrasound (ABUS) • Hand-held breast ultrasound • CT (computerized axial tomography) scan • MRI and Breast MRI (magnetic resonance imaging) • PET scan (positron emission tomography) • Nuclear medicine • Diagnostic radiology • Laboratory and pathology services • Genetics lab
providing Holy Communion.
4
ANNUAL REPORT | 2020 The Saint Francis Genetics Laboratory utilizes molecular genetic and cytogenetic methods to provide clinicians with a genetic biomarker analysis of a cancer, which is used to personalize the treatment of a patient. In June 2020, the laboratory expanded their Next Generation Sequencing molecular technology capacity by launching a Pan Cancer 523 gene panel, which captures informative biomarkers for many cancer types that align with key NCCN cancer treatment guidelines and many clinical trials. The comprehensive genomic profile derived from this Pan-Cancer assay also includes new emerging biomarkers used for the latest cancer treatment options such as immunotherapy. The Saint Francis Genetics Laboratory is on the forefront of molecular oncology, being the only laboratory in Oklahoma to offer these NGS testing services, and continues to develop new assays that align with emerging cancer diagnostics and therapeutics.
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.
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 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 are designed to provide early detection and promote a healthy lifestyle.
5
ANNUAL REPORT | 2020
2020 Prevention Programs/Outcomes
2020 Screening Programs and Outcomes
• Saint Francis WellNow – In 2020, 2,100 (34 percent) of
The Saint Francis Cancer Center is committed to offering
Saint Francis employees covered by CommunityCare
screening programs to detect cancers at an early stage,
participated in the WellNow program. The program
improving rates of survival.
encouraged members to make healthy lifestyle choices and provided education and support to make wellness a lifestyle. Biometric screenings were offered, and include cholesterol,
• Lung Cancer Screening (Low-dose CT scans) • 1,050 screenings completed (calendar year 2020)—
triglycerides, cardiac risk, glucose, blood pressure, height,
a 13.3 percent increase from the previous year in spite of
weight, BMI and waist measurement. Points were awarded
the pandemic.
to employees for participation in the member health assessment, biometric screening, tobacco cessation program (as applicable), preventive care compliance and program activities offered. Once a certain level of points were achieved, employees could qualify for a discount in their health insurance premiums.
• 14 positive diagnoses for lung cancer, all referred, ten out of fourteen (71.4 percent) were in the early stages • Saint Francis Breast Center • 24,782 screening mammograms performed (calendar year 2020)
• Annual Health Zone Fitness and Wellness Expo • There were more than 500 participants in the Annual Health Zone Fitness and Wellness Expo. There were eight participants in the Clear Direction Smoking Cessation program. Unfortunately, the program had to be suspended due to the COVID-19 pandemic.
• 704 biopsies performed • 296 biopsies positive for cancer (42 percent), all referred • Oklahoma Project Woman • 279 total mammograms performed (calendar year 2020) • 328 procedures performed, which included 12 biopsies • Colon Cancer Screening (iFOBT) • In coordination with CommunityCare, 1,675 patients of Warren Clinic were identified as being between the ages of 50 and 75 years without documentation of having had any type of colon cancer screening or being up to date with such; 1,675 fecal occult blood test kits and instructions were mailed to these patients, including a postage paid envelope, in order to facilitate ease of return to Saint Francis Hospital lab for processing; 758 were returned (44.6 percent) with 45 (5.9 percent) being positive—all results went to the patients’ primary care physician.
6
ANNUAL REPORT | 2020
2020 Annual Community Activities (Outreach)
OUTCOMES % Improvement
50 45
• Wellness event at the Health Zone at Saint Francis • Approximately 500 participants
40 35
36.1
30
• Breast cancer and lung cancer screening education and promotion
32.1
20
22.0
15
Due to the national public health emergency (COVID),
10
other community outreach activities were unable to be
5
held in 2020
0 PAIN
work with an average of 581 patients helping address barriers
100.0
to care, facilitate care coordination, and provide education
95.0
regarding disease and treatment.
90.0 85.0
to assist patients was helping to arrange over 800 one way
65.0
rides to and from Saint Francis Hospital or the Saint Francis
60.0
Cancer Center for care and services, as well as provide gas
55.0
cards to some individuals. This was made possible in large
50.0
Saint Francis Oncology Rehabilitation Services Outcomes:
undergoing treatment for cancer:
**Timed Up & Go test
95.1
96.4
90
77
GOAL
part due to an American Cancer Society transportation grant.
having utilized Oncology Rehabilitation Services while
TUG**
% Rated as Excellent
75.0 70.0
improvement in patient health status in 2020 for those
LLIS*
80.0
social worker. One of the many ways social workers were able
• To the right are some important data demonstrating
6’ WALK
THERAPISTS’ RESPONSIVENESS TO NEEDS
• Each month, our Saint Francis oncology nurse navigators
with 1,557 (80 percent) needing contact by an oncology
FATIGUE
*Lymphedema Life Impact Scale
Other Notable Activities and Outcomes within the Cancer Program:
• 1,936 oncology distress screening forms were completed,
30.9
29.2
25
2018
2019
2020
OVERALL QUALITY OF THERAPIST CARE % Rated as Excellent
100.0 95.0 90.0 85.0
96.9
96.3
2019
2020
90 85
80.0 75.0 70.0 65.0 60.0 55.0 50.0 GOAL
2018
7
ANNUAL REPORT | 2020
Results of participation in national Quality Improvement Project through Association of Community Cancer Centers in 2020: • After the implementation of a nurse navigation specific follow-up process in 2020, a 20 percent improvement was seen for patients with non-small cell lung cancer receiving immunotherapy who required admission to the hospital due to side effects/ symptoms as a result of treatment.
Percent of non-small cell lung cancer patients receiving immunotherapy treatment who experienced an immunotherapy related side effect and required admission to hospital:
20.0
15.0
16.7
13.3
10.0
5.0
0.0 CY 2019
CY 2020
8
ANNUAL REPORT | 2020
2019 Adult | Age 18-120 years
PRIMARY SITE
M
F
TOTAL (%)
STG 0
STG I
STG II
STG III
STG IV
88’s & Unknown
ORAL CAVITY & PHARYNX
51
14
65 (2.7%)
2
16
12
13
12
10
DIGESTIVE SYSTEM
226
187
413 (17.0%)
8
50
64
82
129
80
RESPIRATORY SYSTEM
175
150
325 (13.4%)
1
60
33
67
115
49
BONES & JOINTS
1
0
1 (0.0%)
0
1
0
0
0
0
SOFT TISSUE (including Heart)
8
4
12 (0.5%)
0
3
1
2
0
6
SKIN EXCLUDING BASAL & SQUAMOUS
71
56
127 (5.2%)
63
26
6
9
8
15
BREAST
2
426
428 (17.6%)
48
242
40
37
22
39
FEMALE GENITAL SYSTEM
0
89
89 (3.7%)
0
40
7
10
9
23
MALE GENITAL SYSTEM
261
0
261 (10.8%)
1
99
73
38
25
25
URINARY SYSTEM
120
67
187 (7.7%)
30
71
24
17
28
17
BRAIN & OTHER NERVOUS SYSTEM
43
56
99 (4.1%)
0
0
0
0
0
99
ENDOCRINE SYSTEM
32
81
113 (4.7%)
0
67
10
1
0
35
LYMPHOMA
49
39
88 (3.6%)
0
18
19
16
28
7
MYELOMA
25
10
35 (1.4%)
0
0
0
0
0
35
LEUKEMIA
47
29
76 (3.1%)
0
0
0
0
0
76
MESOTHELIOMA
2
2
4 (0.2%)
0
0
0
2
0
2
MISCELLANEOUS
54
48
102 (4.0%)
0
0
0
0
0
102
1,167
1,258
2,425
153
693
289
294
376
620
TOTAL:
*88’s & Unknowns- is a combination of 88’s not applicable or not defined by AJCC and Unknown (the criteria for the stage classification has not been met or it is unknown if it has been met)
9
ANNUAL REPORT | 2020
2019 Pediatric Cases | Age at Diagnosis: 0-17 years
PRIMARY SITE
TOTAL (%)
M
F
ANALYTIC
STG 0
STG I
STG II
STG III
STG IV
88
ORAL CAVITY & PHARYNX
1 (1.9%)
0
1
1
0
0
1
0
0
0
DIGESTIVE SYSTEM
1 (1.9%)
0
1
1
0
0
0
0
1
0
BONES & JOINTS
2 (3.8%)
0
2
2
0
0
0
0
0
2
SOFT TISSUE
2 (3.8%)
0
2
2
0
1
0
0
0
1
URINARY SYSTEM
2 (3.8%)
1
1
2
0
0
0
0
0
2
BRAIN & OTHER NERVOUS SYSTEM
12 (23.1%)
7
5
12
0
0
0
0
0
12
ENDOCRINE SYSTEM
10 (19.2%)
2
8
10
0
3
0
0
0
7
LYMPHOMA
5 (9.6%)
4
1
5
0
0
1
2
1
1
LEUKEMIA
13 (25.0%)
8
5
13
0
0
0
0
0
13
4 (7.7%)
3
1
4
0
0
0
0
0
4
52
25
27
52
0
4
2
2
2
42
MISCELLANEOUS
TOTAL
*88- not applicable or not defined by AJCC
10
ANNUAL ANNUALREPORT REPORT|| 2020 2019
Mission To extend the presence and healing ministry of Christ in all we do
Vision Inspired to create a sustainable justleading healthcare system, Saint Francis will be the Saint Francis Health System willand be the integrated Catholic healthcare technology-enabled ministry that delivers highsystem providing highhealth quality, comprehensive andintegrated, innovative market-leading, care across our regional quality, affordable care through engaged caregivers to the people of eastern Oklahoma. 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
9
11