Category Archives: Uncategorized

Satisfaction

Those of us who work at academic cancer centers often talk about our three overlapping missions:

  • Research – Successful cancer centers conduct cutting-edge cancer research that helps advance cancer medicine so we can do more to help our patients in the future. To assess research productivity we count major research grants, important publications, and research advances that lead to better patient care.
  • Education – Successful cancer centers educate and train the next generation of cancer researchers and care givers, as well as the public about cancer. To assess education, we look at how competitive we are at attracting the best and brightest students to our education programs, as well as the accomplishments of our former trainees.
  • Clinical care – Successful cancer centers provide quality, state-of-the-art interdisciplinary care including cancer prevention, early detection and therapy. To assess clinical care, we track how well our patients do after they receive therapy from us by looking at survival and quality of life. We also track cancer incidence to evaluate the success of our cancer prevention efforts.

There is an additional component to clinical care that is more difficult to measure – delivery of quality service to our patients. Successful cancer centers work to provide a top-notch patient experience. Cancer centers are very different from settings such as retail where service excellence is a priority. Our patients never want to have to seek our services. They are scared and in unfamiliar surroundings, and they have great anxiety about the future. They should be treated not only for their life-threatening medical condition, but also based on their needs as a person.

How do we measure patient satisfaction and the patient experience in a consistent way? We ask patients about their experience through anonymous surveys distributed by an outside group (the company we work with is called Press Ganey). The results of these patient surveys are shared with us, including both ratings and comments from patients. This allows us to understand and track how well we are doing from the patient’s point of view, and what we can do better.

The surveys have been asking the same questions for a number of years which allows us to track patient satisfaction over time. Patients are asked to rank each question about our service on a simple scale of “very poor”, “poor”, “fair”, “good” and “very good”.

Here are the data on the percent of patients that ranked us at the top level (“very good”) over the past 3 years on three key questions.

“Efforts to include in decisions”HCCC patient satisfaction score graph for "efforts to include in decisions" metric

 

“Staff worked well together”HCCC patient satisfaction score graph for "staff worked well together" metric

 

“Likelihood of recommending practice”

 

It is wonderful to see this steady increase in patient satisfaction over the past three years (essentially all of the patients who did not give us a “very good” gave us a “good”). This is the result of incredible hard work and dedication by our cancer clinic leadership group (Mo Milhem, Hisakazu Hoshi, Zach Pollock, Tina Devery, Geri Quinn, Garen Carpenter and many others) as well as the entire cancer clinic team. They looked carefully at patient comments and suggestions, and used this information to improve the patient experience.

We want our patients to be satisfied with our service, yet we can never be fully satisfied with the service we provide. We recognize there is always room for improvement. We will continue to ask our patients about the areas they feel could be improved further. In recent surveys, these include “information about delays” and “wait time in clinic”. Our team is hard at work on these issues as we strive to provide ever improving service to our patients.

Yes, we must continue to focus on progress in cancer research, education, and cancer care. However, we can’t be satisfied solely with data demonstrating our success in these areas. We must also address the needs the patients themselves identify as important. Only then can we be satisfied that we are doing everything possible to reduce the burden of cancer for those we serve.

Cancer facts and the fight against cancer – Never the Twain shall meet?

Mark Twain spoke about “lies, damn lies, and statistics”.  His point was that statistics can be twisted to argue almost any point (something that we see every day in the current political climate).   Twain also said “Get your facts first, and then you can distort them as much as you please.”  When viewed and used appropriately, facts are a fantastic tool in helping us understand complex information.  In cancer, such facts help us understand complex molecular data as well as data reporting the pain and suffering from cancer.

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Making decisions based on facts we don’t like

Every day at Holden Comprehensive Cancer Center, we cancer specialists and researchers make decisions and recommendations based on facts we don’t like.  A patient’s cancer has recurred.  A treatment is not working.  The patient lacks the gene that would make them eligible for a promising clinical trial.  A highly promising research grant is not funded.  We can’t ignore the bad news.  Instead, we accept it, and do our best despite the bad news.

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Orion or ORIEN – The whole is greater than the parts

I am a bit of an astronomy buff.   When my kids were younger, I had an eight inch reflecting telescope I would set up in the backyard.  My kids and I would invite other families in the neighborhood to look at the night sky.  I recall one evening, we talked about the night sky while I was setting up.  The constellation Orion was particularly beautiful that evening.  We discussed about how the stars that make up Orion’s belt, legs, shoulders and sword, tell us a story we would not understand if we just looked through the telescope at each star separately.   We still wanted to look through the telescope (Orion’s sword was particularly interesting), but looking at the constellation as a whole told us an additional story.  The whole was greater than the parts.

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Biden’s next silo?

Vice President Biden spoke recently about how he will spend his time when he leaves government in a few weeks.  The “Cancer Moonshot” will be behind him, but his dedication to the cause of reducing the burden of cancer will not.  Through his Cancer Moonshot, he has spoken with passion and eloquence about the importance of breaking down cancer research silos that limit our ability to share information about the genetics of cancer.  He has challenged us to change our culture and develop new collaborative models for cancer research.

He also expressed concerns about the economics of cancer therapy.   More specifically, as we develop better cancer therapeutics, can we afford them?  This is one of the items he will address when his term as Vice President comes to an end.

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Rejuvenation of failed cancer research hypotheses

I just returned from one of my favorite meetings of the year, the annual American Society of Hematology (ASH) meeting that I have attended almost every year since becoming a cancer researcher  in the late 1980s.   At the ASH annual meeting, research and clinical advances in blood cancers and other blood disorders are presented and discussed by scientists and physicians.   Several presentations at this year’s meeting led me to think about my first ASH meetings.

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Disruptive Innovation in Cancer Medicine – See Cancer Differently

We are in a remarkable time in cancer medicine. The investment in cancer research over the past several decades has helped us in our understanding of the biology of malignant cells, and how such cells interact with their microenvironment, especially the immune system. We have learned that cancer is more complex at the molecular level more than we ever imagined.

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Cancer moonshot – all systems “go”

About a year ago, I blogged about “going to the moon” as a metaphor for cancer research. More recently, the phrase “cancer moonshot” has taken on new meaning. In his state-of-the-union address, President Obama charged Vice President Biden with refocusing the nation’s effort on cancer and cancer research. To quote the President – “Vice President Biden said that with a new moonshot, America can cure cancer… I’m putting Joe in charge of Mission Control.” The cancer research community was already energized by the amazing potential for cancer research to reduce the pain and suffering caused by cancer at this particularly point in time, and welcomed the renewed focus on cancer research. Nevertheless, there was also a degree of skepticism. Many wondered whether the “cancer moonshot” was another example of politicians over-simplifying the incredible challenge of cancer in the short term. They worried that the result would be raised expectations without significant change or meaningful acceleration of progress in the long term.

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