St.

John Providence Health System East Region

Shelley Corp RN. BSN. CCRP

St. John Providence Health System

Southeast Michigan's Leading Provider of Health Care
St. John Providence Health System is comprised of five hospitals plus more than 125 medical facilities in southeast Michigan. Every year at St. John Providence Health System, we touch thousands of lives in southeast Michigan through services such as heart, cancer, obstetrics, neurosciences, orthopedics, physical rehabilitation, behavioral medicine, surgery, emergency and urgent care.

Shelley Corp RN. BSN. CCRP

St. John Providence Health System

Ascension Health
St. John Providence Health System is a member of Ascension Health, a national faith-based health ministry sponsored by the Sisters of St. Joseph of Nazareth, the Daughters of Charity, and the Sisters of St. Joseph of Carondelet. Ascension Health is the largest not-for-profit Catholic Health Ministry in the United States, with acute care facilities in 20 states and the District of Columbia

Shelley Corp RN. BSN. CCRP

St. John Providence Health System

Mission St. John Providence Health System, as a Catholic health ministry, is committed to providing spiritually centered, holistic care which sustains and improves the health of individuals in the communities we serve, with special attention to the poor and vulnerable.

Vision Our passion for healing calls us to cultivate trust, advocate wellness and transform healthcare.
Values We are called to: Service of the Poor Generosity of spirit, especially for persons most in need Reverence Respect and compassion for the dignity and diversity of life Integrity Inspiring trust through personal leadership Wisdom Integrating excellence and stewardship Creativity Courageous innovation Dedication Affirming the hope and joy of our ministry
Shelley Corp RN. BSN. CCRP

Kathleen LaRaia-SJPHS Site Supervisor

Vice President, Weight Management and Oncology Center of Excellence
Kathy LaRaia develops and directs the long-term strategic vision, growth and development of the Weight Management and Oncology Centers of Excellence for St. John Providence Health System. She collaborates with physicians and operational leaders to lead and promote a unique coordinated care experience for patients across St. John Providences entire continuum of care. In this role, she is responsible for gaining physician alignment and their participation in strategic planning and growth initiatives. Through collaboration with physician and administrative leaders many new services have been initiated such as; pulmonary nodule clinics, Cancer Genetic services, and pediatric obesity clinics. . Known as a high-performer and well-rounded leader at St. John Providence, Kathy has been recognized for her achievements. She is also a certified Occupational Therapist and began her career in Rehabilitation providing direct patient care, clinical leadership and program development. Kathy earned her Masters degree from Central Michigan University and is a member of The American College of Healthcare Executives, The Association for Cancer Executives, and The American Society of Clinical Oncology to name a few.

Shelley Corp RN. BSN. CCRP

Lung Cancer Facts

According to the American Cancer Society (2013)

In the USA, Lung Cancer is the leading cause of cancer mortality. 27% of all cancer deaths in 2013 are expected to be from Lung cancer. The 5-year survival rate for all stages combined is only 16% Only 15% of lung cancers are diagnosed at a localized stage, for which the 5-year survival rate is 52%

Shelley Corp RN. BSN. CCRP

SJPH Thoracic Lung Program-Why?

High volume of thoracic cancer patients diagnosed within SJPHS (Cancer Registry) average of 400 newly diagnosed cases annually. Thoracic cancer care coordination at SJPHS is fragmented Majority of cases are diagnosed at late stage III, IV Variability in treatment No metrics currently exist to measure quality of care.

Shelley Corp RN. BSN. CCRP

SJPH Thoracic Lung Program

Objectives of Program

1.
2. 3.

4.

Improve the timeliness and quality of thoracic cancer care at SJPH Develop a Multidisciplinary team of thoracic specialists Develop a coordinated process to care for thoracic patients. Increase volume via early detection of stage I and II lung cancer patients.

Shelley Corp RN. BSN. CCRP

SJPH Thoracic Lung Program

Expected Goals & Outcomes

The SJPHS Thoracic Lung program will provide a coordinated, multidisciplinary lung cancer program that will have improved access, provides standardized evidenced based care, with timely thorough communication to patients and Primary Care Physicians.

Shelley Corp RN. BSN. CCRP

SJPHS Thoracic Lung Program

Current Status of SJPH Thoracic Lung Program
Improve timeliness and quality of Thoracic cancer care Investment in state of the Art equipment EBUS & Super D Presentation of educational events for patients and Primary Care Providers on the SJPH Lung cancer Program Developed process of flagging alerts for Pulmonary nodules Presentation of successful Lung Cancer Symposium to Physicians Develop a multidisciplinary team of Thoracic specialists Coordination of multidisciplinary Thoracic team including all stakeholders Development of Thoracic WORKING group for pathway development Development of Thoracic pulmonary nodule and cancer Care Pathway Programmatically defining the look of the Thoracic Program, including team members, flow of patients etc. Hiring of a Thoracic Nurse Navigator role for the program-Currently she has been in her role for 1 month

Shelley Corp RN. BSN. CCRP

Current Status cont.

Develop a coordinated process to care for thoracic patients

Utilizing a navigational database -to identify follow up on identified cases and track improvements Develop Lung nodule board to guide treatment decisions

Increase volume via early detection of stage I & II lung cancer patients

Introduce and make available Low Dose CT-screening (NSLC, 2011). Decreased cost of CT to be competitive with surrounding programs. Create view alert (diagnostic radiology for abnormal imaging suspicious for lung cancer) Develop Lung Cancer Screening Program for under/uninsured-Titled Breathe Easier Program

Total time invested to program development = 290 hours

Shelley Corp RN. BSN. CCRP

Next Steps..
1. 2. 3. 4.

5.
6.

7. 8. 9.

Further Integrate the navigator into the Multidisciplinary Thoracic team Complete Lung Nodule and Cancer Pathways Marketing campaign to community, Primary Care physicians, Ascension Health Michigan ministries Initiate Michigan BCBS/ STS (Society of Thoracic Surgeons ) Database to start January 1, 2014. Collect data on metrics and outcomes to report at Multidisciplinary Thoracic quarterly meetings. Continue to enhance Program - reach out to pulmonologists, surgeons, Radiation Oncologists, Medical Oncologists and PCPs to join group and attend meetings to provide input Develop a smoking cessation program to market to the community, Primary Care and oncology Physicians to assist their current patients. Write grants to assist SJPHS in offering free low dose CT screening to high risk individuals. Engage in research to add to body of knowledge for lung cancer care.

Shelley Corp RN. BSN. CCRP

References
Aberle, D. R., Adams, A. M., Berg, C. D., Black, W. C., Clapp, J. D., Fagerstrom, R. M., & Gareen, I. F. (2011). Reduced lung-cancer mortality with low-dose computed tomographic screening. The New England Journal of Medicine (pp.395-409). doi:10.1056/NEJMoa1102873 Chapple, A., Ziebland, S., & McPherson, A. (2004). Stigma, shame, and blame experienced by patients with lung cancer: Qualitative study. In BMJ.com, from Gale (10.1136/bmj.38111.639734.7C). Clark, R. L. (1981). The control of cancer through the interaction of community physicians and regional comprehensive cancer centers. Comprehensive therapy, 7(12), 7. Clifford, K., & Chaudhry, S. (2002). The need for a multidisciplinary approach to cancer care. The Journal of Surgical Research, 105(1). doi:10.1006/jsre.2002.6449 Freeman, H. P. (2004). A model patient navigation program: breaking down barriers to ensure that all individuals with cancer receive timely diagnosis and treatment. Oncology Issues, 44-46. Freund, K. M., Battaglia, T. A., Calhoun, E., Dudley , D. J., & Fiscella, K. (2008). National cancer institute patient navigation research program: Methods, protocol, and measures. Journal of Cancer, 113(12), 3391-3400. doi:10.1002/cncr.23960 Hunnibell , L. S., Rose, M. G., Connery, D. M., Grens, C. E., Hampel, J. M., Rosa, M., & Vogel, D. C. (2012). Using nurse navigation to improve timeliness of lung cancer care at a veterans hospital. Clinical Journal of Oncology Nursing, 16(1), 29-36. doi:10.1188/12.CJON.29-36

Shelley Corp RN. BSN. CCRP

References cont.
Rowlands, S., & Callen, J. (2012). A qualitative analysis of communication between members of a hospital-based multidisciplinary lung cancer team. European Journal of Cancer Care, 22, 20-31. doi:10.1111/ecc.12004

St.John Providence Health System. St. John Providence, 2012. Web. 12 Aug. 2013. <http://www.stjohnprovidence.org/aboutsjh/mission/>.
The Advisory Board, . (2004, April). Special Edition: Lung cancer management. The Oncology Watch. The American Cancer Society. (2013). Cancer facts & figures 2013 (pp. 15-17). Atlanta, GA: American Cancer Society. Tod, A. M., Craven, J., & Allmark, P. (2007). Diagnostic delay in lung cancer: A qualitative study. Journal of Advanced Nursing, 61(3), 336-343. doi:10.1111/j.1365-2648.2007.04542.x. Walsh, J., Harrison, J. D., Young, J. M., Butow, P. N., Solomon, M. J., & Masya, L. (2010). What are the current barriers to effective cancer care coordination? A qualitative study. In BMC Health Services Research, 10(1), 132. Walsh, J., Young, J. M., Harrison, J. D., Butow, P. N., Solomon, M. J., Masya, L., & White, K. (2010). What is important in cancer care coordination? A qualitative investigation. European Journal of Cancer Care, 20(2), 220-227. doi:10.1111/j.1365-2354.2010.01187.x Wood, D. E., Eapen, G. A., Ettinger, D. S., Hou, L., Jackman, D., Kazerooni, E., & Klippenstein, D. (2012). Lung cancer screening. In JNCCN.org.

Shelley Corp RN. BSN. CCRP