Annual Report - Saint Alphonsus
Transcription
Annual Report - Saint Alphonsus
Healing Therapies 2014-2015 ANNUAL REPORT MISSION THE SAINT ALPHONSUS CANCER CARE CENTER Cancer Care Center has develop- is committed to enhancing the to healing. Our comprehensive quality of life for patients and methods their families. the-art techniques to diagnose ed an integrative care approach and integrate treat state-of- cancer, including imaging, radiation The diagnosis of cancer can have advanced a profound effect on patients and therapy, and chemotherapy, with their families, affecting physical, nutrition, psychological, and complementary therapies proven spiritual foundations. Mindful of to meet a patient’s physical, this reality, the Saint Alphonsus mental and spiritual needs. emotional, 2 | 2014-2015 Annual Cancer Care Center Report exercise and other TABLE OF CONTENTS TABLE OF CONTENTS Report from the Cancer Committee Chair...................................................4 2014-2015 Cancer Committee Membership................................................. 5 Donors to the Saint Alphonsus Cancer Care Center...........................6-7 Outreach and Education in the Community............................................8-9 •Cancer Screenings •Community Education Offerings •Community Event Participation •Highlights of Community Events Programs and Resources.............................................................................. 10-14 •Integrative Care Program •Breast Cancer Navigator •General Patient Navigator •Genetic Counseling •Clinical Research •Quality Oncology Practice Initiative (QOPI) •Performance Improvement Treatment Assessment and Evaluation.........................................................15 Cancer Registry Report.................................................................................16-22 Cancer Conferences..............................................................................................23 Meet Our Medical Staff................................................................................ 24-26 Locations & Phones...............................................................................................27 2014-2015 Annual Cancer Care Center Report | 3 CANCER COMMITTEE CHAIRMAN’S REPORT OUR PROGRAMS continue to focus on improving the care experience, providing high quality care, implementing state of the art treatment technologies, and meeting the needs of our patients through integrative care offerings. I want to recognize our team of highly skilled, dedicated staff who provides the expertise, resources and passion that allow us to meet our goals and expectations. Program highlights this year include: • Implementation of an oncology outpatient medical record – Improving patient safety, quality of care, and providing access to one medical record. • A Music Therapy Program – This Evidence Based Practice therapy has received so many accolades from our patients and staff. Music therapy addresses patient needs related to chronic pain and respiration (among many other patient needs). • Lung Screening Program – A service provided in all our clinic locations. Lung cancer is typically discovered at a late stage and our goal, through lung screenings, is to identify it at an earlier, curable stage. We are recognized as a Lung Screening Center of Excellence by the Lung Cancer Alliance. • Implementing new radiation technologies that can more effectively target tumors or deliver the course of treatment in fewer days: • High Dose Rate (HDR) radiation therapy for gynecologic and breast cancers • Rapid Arc • Respiratory Gating • Use of telemedicine to provide support to our Baker City practice for medical oncology on-treatment patient visits and for Genetic Counseling consults for Baker City and Grande Ronde patients. • Institution of Survivorship visits for patients who have completed their course of treatment. These visits provide patients with a summary of their care and a follow-up care plan. • Offering over 100 clinical trials for cancer patients to participate in. We are intentional as we develop our goals and expectations each year - using high quality, safe, comprehensive care as our roadmap. We value our patients and the trust they put in our care and we take that very seriously. It is a pleasure to share these accomplishments with you. 4 | 2014-2015 Annual Cancer Care Center Report 2014-2015 CANCER COMMITTEE 2014-2015 CANCER COMMITTEE MEMBERSHIP PHYSICIAN MEMBERS Michael Blumhardt, MD, Pulmonology Joseph Brooks, MD, Radiation Oncology Austin Cushman, MD, General Surgery Cancer Committee Chairperson Jack Chaffin, MD, Pathology Kevin Clifford, MD, Palliative Care Stephanie Hodson, MD, Medical Oncology John Knochel, MD, Radiology Alan Langerak, MD, Medical Oncology A. Scott Pierson, MD, Medical Oncology Kerry Pulver, MD, Medical Oncology Lindsay Sales, MD, Radiation Oncology Karl Schultheiss, MD, Medical Oncology Joseph Williams, MD, Urology Shauna Williams, MD, General Surgery NON-PHYSICIAN MEMBERS Loretta Amy, Clinical Research Associate Laura w, FNP-BC, Medical Oncology Nurse Practitioner Jackie Babb, Director of Women’s Health Lesa Breding, Social Worker Jessica Butterfield, MS, FNP, Medical Oncology Nurse Practitioner Jennifer Calvin, Rehabilitation Services Paula Coulter, Director or Oncology Services Amy Crunk, Genetics Counselor Jayne Freeman, BSN, RN Breast Cancer Navigator Ruth Goldthwaite, Chaplain Barbara Grant, Nutritionist Tiffany Hon, General Cancer Navigator Heather Jones, Cancer Registrar Priscilla Lynn, Outpatient Nurse Manager Kim Martin, Pharmacist Cheryl Nelson, Coordinator, Integrative Care Services Lindsay Nelson, American Cancer Society Patient Navigator Tessa Morrison, Cancer Registrar Tina Schied, Clinical Research Nurse Esther Sears, FNP-BC, Nurse Practitioner Tammie Sherner, CNS, Clinical Nurse Specialist Megan Skeem, Radiation Oncology Coordinator Tammy Stewart, Coordinator, Caldwell/Nampa Cancer Care Centers Holly Swensen, FNP-BC, Medical Oncology Nurse Practitioner Heather Webb, Clinical Research Associate 2014-2015 Annual Cancer Care Center Report | 5 2014-2015 DONORS TO THE SAINT ALPHONSUS CANCER CARE CENTER GIFTS, GRANTS, MEMORIALS AND TRIBUTES to the Saint Alphonsus Cancer Patient Financial Support for TreatmentRelated Services. The Patient Support Fund is Care Center are used to support patients and innovative cancer care, research and clinical trials. These gifts are also used to provide cancer screenings, awareness, education, prevention and integrative care programs. Some of the programs that benefit from donations are: intended to pay for services that are treatment- Amyx Family Resource Libraries/American Cancer Society Resource Centers for Patient Education. The libraries and resource centers are located on the first floor of the Cancer Care Center in related and considered important to the patient’s overall plan of care. Distributions of the Patient Support Fund are decided and based on patient need by a Cancer Care Center social worker and manager. •Fred Meyer Fundraiser. For five consecutive years, employees and customers of the Treasure Valley Fred Meyer stores have made donations totaling $15,481 to support the Patient Financial Support Fund. Boise and in the lobbies of the Nampa and Caldwell patients and members of the community easy access Susan G. Komen for the Cure, Idaho: Breast Care Patient Assistance Funds. Komen funds to reliable information and resources on cancer assist breast cancer patients with essential living prevention, early detection, diagnosis, treatment, expenses such as housing, groceries, utility bills, integrative therapies and survivorship issues. The daycare, transportation, and other essentials. Saint centers are staffed by American Cancer Society Alphonsus Cancer Care Center in Boise has been volunteers that are specially trained by both Saint fortunate to be awarded grant funds from the Boise Alphonsus and the American Cancer Society. Komen for the Cure every year since 2007 and now Cancer Care Centers. The centers provide our again in 2015. The Cancer Care Center is grateful to Nalen Fund: Patient Financial Assistance for the Boise Komen for the Cure for their continued Essential Living Expenses. The Nalen Fund is generous support that allows our center to help intended to help patients with essential living breast care patients in need across our service area. expenses that become a burden due to a patient being indigent, losing income due to their illness, Other Donations. We received donations from or having an unanticipated or overly burdensome several organizations and individuals to support our financial need. The Nalen Fund was established by cancer programs and our community and patient David Nalen, a man who had cancer and knew first- services: hand the challenges cancer can pose for patients and their families. The Nalen Fund has become a living tribute to his memory. One-hundred percent of contributions to the Nalen Fund are used to provide emergency financial assistance to patients and their families who are unable to afford basic expenses while going through cancer treatment. 6 | 2014-2015 Annual Cancer Care Center Report • Saint Alphonsus Auxiliary and the LIVESTRONG Foundation to support our new Music Therapy program. • Sockeye Brewing Company for breast cancer awareness efforts. • 13 donors gave generously to support our prostate cancer patient assistance fund. DONORS WITH SINCERE GRATITUDE FOR THEIR GENEROSITY The Physicians, Nurse Practitioners, and Staff of the Cancer Care Center extend their gratitude to the generous donors who gave July 1, 2014 through June 30, 2015. The funds have been used to further enhance the service and care provided at our centers. The following is a list the organizations and the names of these individuals and families. Amyx Foundation, Inc. James T. Owen Mitchell Ward Relief Society Anonymous Janet M. Davis Patricia Taylor Advanced Health Media Jeffrey C. Austin Peace in Jesus Lutheran Church Britta Nelson Jeffrey G. Fitzloff Ralph L. Hawkins Carrie S. Hall Joe A. Morrow Randy Schmitz Comfort Creations, Inc. Joyce Oswald Rebecca Critchfield Cynthia Mann Elementary School Judith O. Steindorf Robin Cazan David Nalen Foundation Kristin A. Hicks Russ Rowley Disabled American Veterans Lisa Tapp-Egusquiza Saint Alphonsus Auxiliary Fred Jacobi Marianne Hickman Shirley Crismon Fred Meyer, Inc. Mary Lou Lavery Sockeye Grill and Brewery Garrett L. Coburn Michael Willits Star Diamonds Greg Gass Michelle A. DeLeon Guerrero Stephanie R. Knepp Hayden Beverage Company Mildred S. Gass Susan A. Glick Jaclynn M. Stritzke Milligan & Associates Susan G. Komen for the Cure, Idaho The LIVESTRONG Foundation Travis Foster OUTREACH & EDUCATION COMMUNITY EDUCATION & OUTREACH EVENTS COMMUNITY EDUCATION OFFERINGS CANCER SCREENINGS July 2014 through June 2015 – Mobile Mammography Screenings: The Saint Alphonsus Breast Care Center mobile mammography coach is a patientfriendly, comfortable, convenient, efficient and technologically sophisticated vehicle designed to bring services to clinics, businesses, schools and community events where such services are not readily available. Over 4,300 women are screened for breast cancer annually using the mobile mammography. The coach made stops and provided screening mammograms to women in the following communities: Caldwell, Cascade, Central District Health in Caldwell & Mountain Home, Chula Vista/Farmway Village, Council, Emmett, Fruitland, Garden Valley, Hailey, Horseshoe Bend, Homedale, Idaho City, Jordan Valley, Marsing, Melba, Middleton, Mountain Home, Nampa, New Plymouth, Nyssa, Ontario, Parma, Payette, Shoshone, Terry Reilly Clinic, Weiser and Wilder. Free mammography screenings were available through the Susan G. Komen grant that Saint Alphonsus received. Year Round Screening Programs Each year, Saint Alphonsus Cancer Care Center strives to provide outreach and cancer prevention education to our surrounding communities through cancer screenings, educational offerings, and participation in local health fairs and cancer-related community events. The effectiveness of our outreach activities are enhanced through collaboration with our community partners, including the American Cancer Society, Susan G. Komen for the Cure, and the Leukemia & Lymphoma Society. Community Event Participation: July 2014: • American Cancer Society Relay for Life, Ada County August 2014: • American Cancer Society Relay For Life, Emmett • Caldwell Night Rodeo Buckaroo Breakfast • Caldwell Night Rodeo Power of Pink Night September 2014: • Iron Cross Warriors and Iron Cross Babes Ride for Men’s Health • A Slight Discomfort October 2014: Lung Screening Program: • Leukemia & Lymphoma Society Light the Night Walk Saint Alphonsus Cancer Center, dedicated to providing leading-edge technology and cancer diagnostics, started a low-dose CT lung screening program for those at increased risk for lung cancer. With the latest advances in imaging, lung cancer can be detected early on. High risk patients • Lung Cancer Symposium are scanned for nodules or masses growing in the chest. If these nodules or masses are small when found, treatment can be highly successful and significantly improve a patient’s chances for survival. 8 | 2014-2015 Annual Cancer Care Center Report • Breast Cancer Symposium April 2015: • Melanoma Cancer Symposium May 2015: • Komen Race for the Cure June 2015: • American Cancer Society Relay for Life, Nampa • American Cancer Society Relay for Life, Caldwell COMMUNITY EVENTS Highlights of 2014 – 2015 Community Events: American Cancer Society Relay for Life: The Cancer Care Centers co-sponsored the 2014 Relay for Life. Saint Alphonsus teams comprised of staff, family members, and patients participated in the overnight event and raised money to help fund research, education, and patient support programs and services of the American Cancer Society. Leukemia & Lymphoma Society Light the Night Walk: Saint Alphonsus was pleased to once again be a supporting sponsor of the Leukemia & Lymphoma Society’s (LLS) Light the Night Walk. Participants carried illuminated balloons to celebrate and commemorate lives touched by cancer—white for cancer survivors and red for supporters. Funds raised are used to support the LLS’s mission to cure leukemia, lymphoma, Hodgkin’s disease, and multiple myeloma, and to improve the quality of life of patients and families. Susan G. Komen for the Cure, Boise Affiliate ~ 2014 Race for the Cure Saint Alphonsus was again a presenting sponsor of the Komen Boise Race for the Cure, which raises funds for cancer research and local programs providing breast cancer education, screening, and treatment assistance. The day of the race, Cancer Care Center staff provided race participants with breast cancer prevention and screening information. 2014-2015 Annual Cancer Care Center Report | 9 PROGRAMS & RESOURCES Artists in Residence (AIRs) INTEGRATIVE CARE PROGRAM: Caring for Body, Mind and Spirit Our Integrative Care Program continues to provide excellent evidence based support for our patients, their loved ones and our community. Emotional and spiritual counseling, supportive care programming and support groups, massage, yoga and exercise, nutritional counseling, mindfulness meditation, Movement Therapy, and Survivorship programs remain core to our mission of healing body, mind and spirit. In November 2014, the Cancer Care Center initiated our Music Therapy Program, funded for one year by a generous grant from the LIVESTRONG Foundation. Music Therapy is an evidence-based, non-pharmacologic, non-invasive modality that is beneficial for managing pain and nausea, decreasing anxiety, increasing relaxation, and decreasing fatigue. These are all symptoms that many cancer patients contend with at some point in their treatment. With funding from the Saint Alphonsus Foundation, the Hospital Auxiliary, and the Canyon County CHI Grant, we will be able to continue our Music Therapy program through 2017. Music Therapy is available in Boise, Nampa and Caldwell. In 2014, the Nampa Cancer Care Center continued providing Integrative Care Programs in Canyon County thorough a generous grant. Social work, exercise and yoga classes, support groups in Spanish and English are all provided in Nampa and Caldwell. This year we also added our CLIMB program for children. Artists in Residence (AIRs) visit patients and caregivers in the infusion room and waiting rooms providing art as a positive distraction from the stress of cancer. Our AIRs are funded from a generous grant from Mission Integration and Foundation. CLIMB: Children’s Lives Include Moments of Bravery This six week program offers support for children and teens ages 6-18 that have a parent, grandparent or guardian with cancer. CLIMB is activities based with focus on cancer education, family communication, emotional coping and resiliency skill building. It is free to all families of the Treasure Valley affected by cancer and includes dinner. Funding is provided by a SARMC Foundation Endowment Grant and proceeds from the 2012 Capital Classic. Coping Connections Our monthly education and support program is open to the community, providing an opportunity for patients and caregivers to learn about various cancer related topics while supporting each other on the cancer journey. Topics include Spiritual Care and Advance Directives, Genetics, Cancer Related Fatigue, LIVESTRONG and Survivorship Education, Nutrition, Mindfulness-Based Stress Reduction, Pathology and many more. We also host an Ice Cream Social in July and a Holiday Party in December. The program includes dinner and is free of charge. Partnership with the YMCA LIVESTRONG Cancer Survivorship Program Our partnership continues to serve cancer survivors in Boise, Nampa and Caldwell. The Cancer Center staff offer their expertise in providing nutritional education, disease management expertise and emotional care in partnership with LIVESTRONG at the YMCA programs. Together we also offer a fall Women’s Cancer Survivor Healing Retreat and weekly Movement Therapy providing community based support and healing for all cancer survivors in our area. 10 | 2014-2015 Annual Cancer Care Center Report PROGRAMS & RESOURCES American Cancer Society Patient Navigator Our ACS Navigator assists patients with information pertaining to a cancer diagnosis and treatment as well as providing referrals to community resources. The ACS Navigator also works as a collaborative bridge for all ACS Community Programs such as Road to Recovery, Reach for Recovery, and Look Good Feel Better. Our ACS Navigator position is funded in part by a generous Endowment Grant from the Saint Alphonsus Foundation. Amyx Family Library and ACS Resource Center The Library and Resource Center has numerous additions to its shelves: books, CDs, computers and printers. The desk top and lap top computers make access to reputable cancer related websites easy. American Cancer Society volunteers provide information and education on what is available in the library to patients in the infusion room. Tours of the library are also provided upon request. Spiritual Counseling Chaplains provide support and spiritual guidance using a non-denominational approach. They honor the beliefs of each individual while offering a listening presence, spiritual support and the opportunity for ritual. Massage Massage appointments are offered by oncology trained massage therapists from our Family Center at greatly reduced rates for patients and caregivers. Exercise and Yoga Our exercise and yoga classes are offered to patients while on treatment and in follow up. Research indicates physical activity can offset the side effects and improve overall quality of life for patients both during treatment STAR Oncology Rehabilitation Cancer has become a chronic disease with more survivors than ever before! Seventy to eighty newly diagnosed cancer patients are seen in our Saint Alphonsus Cancer Care Center monthly. As patients go through treatment and into survivorship, many have difficulty returning to their previous level of activity because of weakness, lymphedema, chronic fatigue, lingering pain, incontinence, difficulty with memory or concentration, perceptual problems, balance problems, speech or swallowing problems, or difficulty with activities like bathing and dressing. Rehabilitation is a crucial element of a Survivor Care Plan. Saint Alphonsus Rehabilitation Services (STARS) and the Saint Alphonsus Cancer Care Center are committed to providing you with the best available services through our Survivorship Training and Rehab Program (S.T.A.R.). The S.T.A.R. Program is offered to everyone at any stage of cancer or phase of recovery in order to prevent, manage and heal the physical and psychosocial conditions that arise during and after treatment. Cancer and its related treatments (chemotherapy, radiation therapy and surgery) can cause side effects that interfere with daily function and well-being. Previously, cancer patients were not consistently being screened or evaluated regarding their functional abilities and emotional needs, during and after cancer treatments. A grant from the Saint Alphonsus Foundation provided the ability to train and certify 50 cancer care providers in our facility, making Saint Alphonsus the first certified facility in the Western United States! Physical and occupational therapists, speech therapists, nurses, social workers, physician assistants, navigators, dietitians and clergy are certified in the S.T.A.R. Program. The S.T.A.R. Program also provides continuing education and keeps us up to date on the latest research. This certification has elevated staff education and strengthened our ability to provide the highest level of care. and in follow up. A physician referral is required for participation. The classes are run by Saint Alphonsus Physical Therapy and Rehabilitation staff. More information on the S.T.A.R. Program can be found by calling (208) 367-STAR (7827) or going to our website www.starspt.org. 2014-2015 Annual Cancer Care Center Report | 11 PROGRAMS & RESOURCES Nutritional Counseling Registered dietitian nutritionists provide nutrition counseling and information to help patients feel better and stay stronger. They offer individualized information and care for patients’ nutrition-related concerns and questions before, during and after their cancer treatment. The Breast Cancer Navigator is responsible for guiding patients diagnosed with breast cancer through the medical, emotional and educational aspects of a breast cancer diagnosis. The program is designed to assure standard of care is provided to each patient once the initial diagnosis is determined. This is accomplished by eliminating barriers to care, ensuring timely delivery of services, and following through with a course of action determined by a panel of experts which include primary care practitioners, surgeons, radiologists, medical oncologists and radiation oncologists. Cancer Care and You Education Class Above all, Saint Alphonsus Breast Navigators focus on the patients’ quality of care, stretching beyond technology, treatment and medicine and touching the human side of cancer. In the end, patients experience care that isn’t just easier to navigate; it’s better as well. Our Cancer Care and You class is a two part educational program offered to all patients receiving care at the Cancer Care Center. Breast Cancer Navigator services are available at all Saint Alphonsus hospital locations. The first component of the program is designed for patients and caregivers to meet our Integrative Care Team and to receive information and literature on all the supportive care staff and programs available at the Cancer Care Centers. The second component of the program is chemotherapy education taught by an Oncology Certified RN. The information provided is a review of specific chemotherapy treatment, side effects, when to call the physician and other medical information related to chemotherapy. Breast Cancer Navigator When a patient hears the words “breast cancer” and before the reality of the words have had a chance to settle into their minds, they are thrust into a system of specialists, treatment and medical terms they might not understand. They may feel overwhelmed and find the healthcare system confusing or difficult to navigate. 12 | 2014-2015 Annual Cancer Care Center Report General Patient Navigator The Saint Alphonsus General Nurse Navigator provides a point of contact throughout the patient’s cancer journey. It is difficult to receive a cancer diagnosis and overwhelming trying to juggle emotions with understanding medical jargon, scheduling appointments, and multiple other new responsibilities. The Nurse Navigators are deeply committed, highly skilled oncology nurses navigating the medical system on behalf of patients and their families, working collaboratively with family physicians, surgeons, radiation oncologists, medical oncologists, radiologists, pathologists, dietitians, social workers and other health professionals. They know the patients, they know the hospital, and they know how to relay critical information between medical departments in a timely manner – making the experience easier and less stressful for everyone. PROGRAMS & RESOURCES Genetic Counseling Clinical Research Our genetic counselor has been very busy this past year. She led 443 genetic counseling sessions, doubling the number of sessions done the previous year. She sees patients in Boise, Nampa, Caldwell and Ontario, Oregon. She provides telemedicine sessions to Baker City, Oregon and to Grande Ronde Hospital in La Grande, Oregon. In addition the genetic counselor assists West Valley Medical Center with their Breast Center’s High Risk Program. The Saint Alphonsus Health System has partnered with the Michigan Cancer Research Consortium (MCRC) to bring more than 100 active adult cancer research trials to patients at the Cancer Care Centers in Boise, Nampa and Caldwell. MCRC is a wellestablished NCORP (NCI Community Oncology Research Program). First established at Saint Joseph Mercy Hospital in Ann Arbor, Michigan; the Michigan Cancer Research Consortium CCOP is one of only 34 community based research programs supported by the National Cancer Institute (NCI). Genetic testing keeps advancing. There are an increased number of genes we can test for. Our genetic counselor has seen patients diagnosed with breast, ovarian, uterine, colon, and thyroid cancers. She also sees individuals who have not been diagnosed with cancer, but are at an increased risk for cancer based on their family history. The Saint Alphonsus Cancer Genetics Program continues to collaborate with the City of Hope Clinical Cancer Genetics Department. This collaboration has provided the opportunity for patients to participate in the City of Hope Research Registry. We have consented 114 patients for participation in the registry in the past fiscal year. Through our membership in the MCRC, we ensure that our patients have access to the newest available treatments being studied nationwide. The Michigan Cancer Research Consortium NCORP provides access to a wide variety of research studies. These include treatment, prevention, along with control and symptom management studies for adult cancer or for those who seek to reduce their risk of cancer. We participate with the following national clinical trial cooperative group and leading research institutions to offer a broad range of trials for our patients: • ECOG-ACRIN NCORP Research Base • MD Anderson Research Base CCOP (MDA) • SWOG NCORP Research Base • NRG Oncology Research Base • Alliance for Cancer Clinical Trials NCORP Research Base • Cancer Trials Support Unit (CTSU) • Mayo Clinic Cancer Research Consortium (MCCRC) • Wake Forest NCORP Research Base • Fred Hutch University of Washington Cancer Consortium • City of Hope • Select Pharmaceutical Research Trials For a current list of active clinical trials please go to the Michigan Cancer Research Consortium Website at: http://www.mcrconline.org/active-clinical/index.php . Call (208) 367-7070 to speak with a clinical trial coordinator. 2014-2015 Annual Cancer Care Center Report | 13 PERFORMANCE IMPROVEMENT PERFORMANCE IMPROVEMENT The Performance Improvement Committee is a multidisciplinary team that identifies opportunities for improvement to patient care activities in the Cancer Care Center. They monitor and evaluate projects throughout the year and report quarterly to the Cancer Committee. Performance Improvement Studies are designed to measure the quality of care and outcomes for cancer patients by focusing on problematic quality-related issues. Noteworthy studies for 2014-2015 include: • EGFR and ALK Testing for Lung Cancer • LEAN: Radiation Oncology Productivity Implementation of new or improved processes, practices or services is another focus of the PI Committee as a commitment to providing high-quality cancer care. A few of the improvements implemented were: •Breast HDR — Providing quality outcomes for breast cancer patients with 10 treatments over 5 days instead of 6 1/2 weeks of treatment. •Distress Tool Update — Improved methodology for identifying patients with integrative care support needs. •Cancer Care Patient Advisory Forum and Survivorship Care Plan Enrollment — Provide opportunity for patients to enroll in survivorship plan and provide feedback to CCC on the patient experience. •LEAN - Patient Satisfaction — Patient Satisfaction is a priority focus of the health system. The Cancer Care Center identified the following as areas for improvement: Valet parking, patient education to survey process, wait time scripting, pharmacy chair side chemotherapy education, waiting room comment cards, waiting room education cards and patient orientation to staff and programs via TV monitors. Staff also completed patient experience training. • Nurse Practitioner Led Survivorship Program — Implemented a survivorship clinic with intent to provide patient with treatment summary and expectations for continuation of care. 14 | 2014-2015 Annual Cancer Care Center Report •LEAN: Pre-Auth Process — Improve efficiency amongst Physicians, nurses, Reimbursement Specialist, and Scheduling. Avoid providing unauthorized treatment and minimize patient’s wait. •Electronic Medical Record Implementation (EMR): RAD and MED Onc — Optimize the efficiencies that ARIA (cancer program EMR) provides and standardize practices between all sites and disciplines. •LEAN: ARIA patient scheduling — Improve efficiencies for patient scheduling with the implementation of the EMR. Decrease the number of errors or re-work caused by multiple attending physicians on record. •LEAN: ROMO — Improve document management in ARIA by standardizing use of “Journal” section, scanning and document naming conventions and high alert comments. •LEAN: Research Database Development — Increased efficiency in the research staff by creating a database for research patients. Improve ability to mine data for trends and reporting. Decrease time for entering and searching for patient information. Increase accuracy and access to information to provide continuity of care amongst research patients. TREATMENT ASSESSMENT & EVALUATION nnually, a physician performs a study A Carcinoma histology in 2012 was done. to assess whether patients within the repeat study was done with 2014 newly program are evaluated and treated according diagnosed Stage IV Non-Small Cell lung to national treatment guidelines. In 2013, cancers. while completing the chart data for The and analyzed using National Comprehensive Quality Oncology Practice Initiative (QOPI), Cancer Network (NCCN) guidelines for Stage documentation of Epidermal Growth Factor IV lung cancer. The findings revealed a 55% Receptor (EGFR) and Anaplastic Lymphoma EGFR order rate with a 13% positivity rate. Kinase was Per NCCN, cases that tested negative for thought to be insufficient. A baseline study EGFR are to then be tested for ALK. Results reviewing newly diagnosed Stage IV lung showed a 100% order rate for ALK testing cancers with a tissue proven Non-Small Cell with a 5% positivity rate. (ALK) gene rearrangement A In 2014, 49 cases were reported Carcinoma 2014-2015 Annual Cancer Care Center Report | 15 CANCER REGISTRY REPORT THE SAINT ALPHONSUS CANCER REGISTRY 1,086 of those cases were newly diagnosed and/or is an essential component of the American College treated at Saint Alphonsus Boise. of Surgeons (ACoS) approved cancer program and maintains an electronic database of case records on Beginning in 2011, the Cancer Registry began all tumor types diagnosed and/or treated at Saint abstracting Alphonsus Boise, Saint Alphonsus Nampa, and Saint Alphonsus Medical Center - Nampa and Saint Alphonsus Ontario. This data includes demographics, Alphonsus Medical Center - Ontario, formerly known primary site of each person’s cancer, diagnosis, as Mercy Medical Center and Holy Rosary Medical stage of disease, treatment and lifetime follow-up Center, respectively. reportable cancer cases for Saint of patients. Survival data provides medical staff the ability to address quality of care of Saint Alphonsus Previously, the Cancer Data Registry of Idaho cancer patients. consulted with Mercy Medical Center and Holy Data is maintained in accordance with state and national standards. Rosary in abstracting cancer cases. In 2014, the Cancer Registry abstracted data on 383 cancer cases Originally established in 1970, the Boise Cancer for Saint Alphonsus Nampa; 318 cases of which were Registry has 32,000 accessioned patients to date. To newly diagnosed and/or treated at the facility. The optimize quality of survival and follow-up data, our Registry abstracted data on 171 cancer cases for reference date is now January 1, 1995. In 2014, the Saint Alphonsus Ontario; 154 of which were newly Cancer Registry abstracted data on 1,228 cancer cases; diagnosed and/or treated at the facility. 16 | 2014-2015 Annual Cancer Care Center Report Boise - 5 YEAR CASE MIX 2014 2013 2012 2011 2010 Total Cases 1228 1088 1159 1170 1271 Analytical Cases 1086 976 1040 1050 1156 % of Total Case Mix 88.4% 89.7% 89.7% 89.7% 91.0% Nampa/Caldwell - 5 YEAR CASE MIX 2014 2013 2012 2011 2010* Total Cases 383 359 398 262 129 Analytical Cases 318 306 319 186 122 % of Total Case Mix 83.0% 85.2% 80.2% 70.9% 94.6% *Data per Cancer Data Registry of Idaho for Mercy Medical Center Ontario - 5 YEAR CASE MIX 2014 2013 2012 2011 2010* Total Cases 171 162 177 145 132 Analytical Cases 154 148 162 137 -- % of Total Case Mix 91.8% 91.4% 94.4% 94.5% -- *Data per Cancer Data Registry of Idaho for Holy Rosary Medical Center FOLLOW-UP ON CANCER REGISTRY PATIENTS — Boise only Total number of cases required to follow 4,315 Number deceased 1,202 Number of cases under follow-up activity 3,113 Number seen within last 15 months 2,864 Number lost to follow-up Overall follow-up rate for all patients Target rate is great than or equal to 80% Follow-up for patients diagnosed in past 5 years Target rate greater than or equal to 90% 249 92% 94% 2014-2015 Annual Cancer Care Center Report | 17 UNIFORMITY OF DATA COLLECTION IN ACCORDANCE WITH LAW REQUIREMENTS, the Cancer Registry submits its data to the Cancer Data Registry of Idaho (CDRI) monthly and to other government agencies annually such as the National Cancer Data Base (NCDB). The cancer program is accredited by the Commission on Cancer (CoC) through the ACoS. The Cancer Care Center participates in an on-site survey every three years performed by a physician surveyor with ACoS. The Cancer Registry is an integral part of the cancer program and consists of two registrars, both of whom are certified by the National Cancer Registrars Association (NCRA). The registrars had the opportunity to attend a local educational program in 2014 to stay informed about the latest advances in cancer care and the requirements of the ACoS and CoC. The registrars also attended a regional educational program in Portland, Oregon in March 2015. The registrars remain active in their professional associations including Idaho Association of Cancer Data Registrars (IACDR) and NCRA. We strive to provide the highest quality data. We achieve this through uniformity of data collection, monthly physician review of a random sample of our new cases, software edit checks, and accurate as well as timely follow-up on our patients. Our ultimate goal is to contribute to the prevention and treatment of cancer. All patient data is protected by HIPAA and secured by electronic safeguards. Boise 2014 Top 10 Sites % Per Total Analytic Cases (1086) Breast Breast Lung Lung Breast 256 23.6% Colon Colon&&Rectum Rectum Lung 155 14.3% Prostate Prostate Colon & Rectum 104 9.6% Prostate 69 6.4% Brain 59 5.4% Lymphoma Lymphoma Lymphoma 45 4.1% BoneMarrow Marrow Bone Bone Marrow 43 4.0% Kidney 42 3.9% Corpus Uteri 33 3.0% CorpusUteri Uteri Corpus Thyroid 31 2.9% Thyroid Thyroid Brain Brain Kidney Kidney 0 18 | 2014-2015 Annual Cancer Care Center Report 75 75 150 150 225 300 300 2014 TOP CANCER SITES Nampa/Caldwell 2014 Top 10 Sites Breast Breast % Per Total Analytic Cases (318) Lung Lung Colon&&Rectum Rectum Colon Breast 88 27.7% Lung 51 16.0% Colon & Rectum 32 10.1% Bone Marrow 18 5.7% Lymphoma 18 5.7% Other/Ill Defined 14 4.4% Kidney 12 3.8% Stomach 8 2.5% Brain 7 2.2% Corpus Uteri Bladder Bladder 7 2.2% Corpus Uteri Thyroid Corpus Uteri 7 2.2% Pancreas Pancreas 7 2.2% Ontario 2014 Top 5 Sites % Per Total Analytic Cases (154) BoneProstate Marrow Lymphoma Brain Other/Ill Defined Lymphoma Kidney Bone Marrow Stomach Kidney Brain 0 22.5 45 67.5 90 0 12.5 25 37.5 50 Breast Rectum Breast 48 31.2% Colon & Rectum 19 12.3% Lung 16 10.4% Brain 7 4.5% Other/Ill Defined 7 4.5% Melanoma 6 3.9% Melanoma Prostate 6 3.9% Prostate Lung Brain Other/Ill Defined 2014-2015 Annual Cancer Care Center Report | 19 Summary of Saint Alphonsus Boise Cancer Cases by Primary Site Combined Stage, and Sex - 2014 (pAJCC/cAJCC) I = in situ, L - local, R = regional, D - distant, U = unknown SITE STAGE I L R D U Total Head and Neck Lip Tongue Major salivary gland Floor of mouth Gum and other mouth Nasopharynx Tonsil Oropharynx Hypopharynx Pharynx, other buccal ca 0 0 0 0 0 0 0 0 0 0 0 8 0 4 1 1 1 0 1 0 0 0 13 0 6 1 1 0 1 2 2 0 0 3 0 0 0 0 1 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 25 0 10 3 2 2 1 4 3 0 0 Digestive System Esophagus Stomach Small Intestine Colon excluding rectum Rectum and rectosigmoid Anus, anal canal, anorec Liver Gallbladder Other biliary Pancreas Retroperitoneum Peritoneum Other digestive organs 1 0 0 0 1 0 0 0 0 0 0 0 0 0 72 2 3 2 28 18 4 7 1 1 6 0 0 0 65 7 6 0 22 14 4 5 1 2 3 0 1 0 63 8 6 2 11 9 0 5 2 1 16 0 3 0 5 0 1 0 1 0 0 0 0 2 1 0 0 0 Respiratory system Nasal Cavity/Sinus Larynx Lung and Bronchus Trachea, pleura and other 1 0 0 1 0 44 0 1 43 0 28 1 2 25 0 84 0 0 83 1 3 0 0 3 0 Bones and joints 0 2 0 1 0 3 0.3% 2 1 Soft Tissues 0 1 1 1 0 3 0.3% 2 1 Skin Melanoma Other Skin 3 3 0 6 5 1 4 2 2 2 2 0 1 1 0 16 13 3 1.5% 1.2% 0.3% 9 7 2 7 6 1 Breast SEX Male Female 2.3% 0.0% 0.9% 0.3% 0.2% 0.2% 0.1% 0.4% 0.3% 0.0% 0.0% 17 0 7 2 2 0 1 4 1 0 0 8 0 3 1 0 2 0 0 2 0 0 206 17 16 4 63 41 8 17 4 6 26 0 4 0 19.0% 1.6% 1.5% 0.4% 5.8% 3.8% 0.7% 1.6% 0.4% 0.6% 2.4% 0.0% 0.4% 0.0% 104 15 10 1 28 17 1 14 2 5 11 0 0 0 102 2 6 3 35 24 7 3 2 1 15 0 4 0 160 1 3 155 1 14.7% 0.1% 0.3% 14.3% 0.1% 73 0 2 70 1 87 1 1 85 0 % Total 29 142 77 8 0 256 23.6% 2 254 Female Genital System Cervix Corpus Uterus, NOS Ovary Vagina Vulva Other female genital org 0 0 0 0 0 0 0 0 31 6 22 0 2 0 1 0 12 1 9 0 1 0 1 0 11 2 2 0 7 0 0 0 0 0 0 0 0 0 0 0 54 9 33 0 10 0 2 0 5.0% 0.8% 3.0% 0.0% 0.9% 0.0% 0.2% 0.0% 0 0 0 0 0 0 0 0 54 9 33 0 10 0 2 0 Male Genital System Prostate Testis Penis Other male genital organ 0 0 0 0 0 58 50 8 0 0 16 14 1 1 0 4 4 0 0 0 2 1 1 0 0 80 69 10 1 0 7.4% 6.4% 0.9% 0.1% 0.0% 80 69 10 1 0 0 0 0 0 0 Urinary System Bladder Kidney and renal pelvis Ureter Other urinary organs Eye 5 4 1 0 0 0 47 13 31 3 0 1 8 6 2 0 0 0 9 1 8 0 0 0 0 0 0 0 0 0 69 24 42 3 0 1 6.4% 2.2% 3.9% 0.3% 0.0% 0.1% 37 13 23 1 0 1 32 11 19 2 0 0 Brain/Nervous System Brain Other nervous system 0 0 0 18 18 0 1 1 0 0 0 0 40 6 34 59 25 34 5.3% 2.3% 3.0% 32 17 15 27 8 19 Endocrine System Thyroid gland Other endocrine 0 0 0 19 18 1 13 12 1 1 1 0 9 0 9 42 31 11 3.9% 2.9% 1.0% 11 6 5 31 25 6 Lymphomas Hodgkin’s Disease Non-Hodgkin’s Lymphoma 0 0 0 9 0 9 10 5 5 25 0 25 1 0 1 45 5 40 4.1% 0.5% 3.7% 26 3 23 19 2 17 Multiple Myeloma 0 0 0 18 0 18 1.7% 9 9 Leukemia Acute lymphocytic Chronic lymphocytic Acute Myeloid Chronic Myeloid Other leukemia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 2 5 12 1 4 0 0 0 0 0 0 25 2 6 12 1 4 2.3% 2.0% 0.6% 1.1% 0.1% 0.4% 13 1 2 7 1 1 12 1 3 5 0 3 Other/Ill Defined 0 0 0 12 12 24 2.2% 14 10 39 458 248 267 74 1086 100.1% 432 654 Total 20 | 2014-2015 Annual Cancer Care Center Report Summary of Saint Alphonsus Nampa/Caldwell Cancer Cases by Primary Site Combined Stage, and Sex - 2014 (pAJCC/cAJCC) SITE I = in situ, L - local, R = regional, D - distant, U = unknown STAGE SEX I L R D U Total % Total Male Female Head and Neck Lip Tongue Major salivary gland Floor of mouth Gum and other mouth Nasopharynx Tonsil Oropharynx Hypopharynx Pharynx, other buccal ca 0 0 0 0 0 0 0 0 0 0 0 3 0 1 1 0 0 0 1 0 0 0 6 0 2 2 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 3 3 0 0 0 2 2 0 0 3.1% 0.0% 0.9% 0.9% 0.0% 0.0% 0.0% 0.6% 0.6% 0.0% 0.0% 6 0 1 2 0 0 0 2 1 0 0 4 0 2 1 0 0 0 0 1 0 0 Digestive System Esophagus Stomach Small Intestine Colon excluding rectum Rectum and rectosigmoid Anus, anal canal, anorec Liver Gallbladder Other biliary Pancreas Retroperitoneum Peritoneum Other digestive organs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 2 0 7 3 0 2 0 0 0 0 0 0 21 4 4 0 3 7 1 1 0 0 1 0 0 0 23 1 1 0 7 5 0 1 0 0 6 0 2 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 59 5 8 0 17 15 1 4 0 0 7 0 2 0 18.6% 1.6% 2.5% 0.0% 5.3% 4.7% 0.3% 1.3% 0.0% 0.0% 2.2% 0.0% 0.6% 0.0% 28 5 3 0 7 6 0 3 0 0 4 0 0 0 31 0 5 0 10 9 1 1 0 0 3 0 2 0 Respiratory system Nasal Cavity/Sinus Larynx Lung and Bronchus Trachea, pleura and other 0 0 0 0 0 8 0 0 8 0 15 1 1 13 0 29 0 0 29 0 1 0 0 1 0 53 1 1 51 0 16.7% 0.3% 0.3% 16.0% 0.0% 25 0 1 24 0 28 1 0 27 0 Bones and joints 0 0 0 0 0 0 0.0% 0 0 Soft Tissues Skin Melanoma Other Skin 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 2 2 0 0.3% 0.6% 0.6% 0.0% 0 2 2 0 1 0 0 0 Breast 11 43 31 3 0 88 27.7% 0 88 Female Genital System Cervix Corpus Uterus, NOS Ovary Vagina Vulva Other female genital org 0 0 0 0 0 0 0 0 8 1 4 0 0 0 2 1 3 0 3 0 0 0 0 0 8 1 1 0 5 0 0 1 0 0 0 0 0 0 0 0 19 2 8 0 5 0 2 2 6.0% 0.6% 2.5% 0.0% 1.6% 0.0% 0.6% 0.6% 0 0 0 0 0 0 0 0 19 2 8 0 5 0 2 2 Male Genital System Prostate Testis Penis Other male genital organ Urinary System Bladder Kidney and renal pelvis Ureter Other urinary organs 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 7 1 6 0 0 1 0 1 0 0 5 3 1 1 0 0 0 0 0 0 7 2 5 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 20 7 12 1 0 0.3% 0.0% 0.3% 0.0% 0.0% 6.0% 1.9% 3.8% 0.3% 0.0% 1 0 1 0 0 10 4 6 0 0 0 0 0 0 0 10 3 6 1 0 Eye 0 0 0 0 0 0 0.0% 0 0 Brain/Nervous System Brain Other nervous system 0 0 0 2 2 0 0 0 0 0 0 0 5 0 5 7 2 5 2.2% 0.6% 1.6% 2 1 1 5 1 4 Endocrine System Thyroid gland Other endocrine 0 0 0 3 3 0 1 1 0 1 1 0 3 0 3 8 5 3 2.5% 1.6% 0.9% 4 2 2 4 3 1 Lymphomas Hodgkin’s Disease Non-Hodgkin’s Lymphoma Multiple Myeloma 0 0 0 0 6 0 6 0 3 1 2 0 9 1 8 7 0 0 0 0 18 2 16 7 5.7% 0.6% 5.0% 2.2% 12 2 10 3 6 0 6 4 Leukemia Acute lymphocytic Chronic lymphocytic Acute Myeloid Chronic Myeloid Other leukemia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 5 3 2 1 0 0 0 0 0 0 11 0 5 3 2 1 3.8% 0.0% 1.6% 0.9% 0.6% 0.6% 5 0 2 2 0 1 6 0 3 1 2 0 Other/Ill Defined 0 0 0 9 5 14 4.4% 5 9 12 96 86 108 16 318 100.1% 103 215 Total 2014-2015 Annual Cancer Care Center Report | 21 Summary of Saint Alphonsus Ontario Cancer Cases by Primary Site Combined Stage, and Sex - 2014 (pAJCC/cAJCC) I = in situ, L - local, R = regional, D - distant, U = unknown SITE STAGE SEX I L R D U Total % Total Male Female Head and Neck Lip Tongue Major salivary gland Floor of mouth Gum and other mouth Nasopharynx Tonsil Oropharynx Hypopharynx Pharynx, other buccal ca 1 0 1 0 0 0 0 0 0 0 0 3 0 2 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 3 1 0 0 0 0 0 1 0 3.2% 0.0% 1.9% 0.6% 0.0% 0.0% 0.0% 0.0% 0.0% 0.6% 0.0% 4 0 2 1 0 0 0 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 Digestive System Esophagus Stomach Small Intestine Colon excluding rectum Rectum and rectosigmoid Anus, anal canal, anorec Liver Gallbladder Other biliary Pancreas Retroperitoneum Peritoneum Other digestive organs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 2 4 3 1 0 0 0 0 0 0 0 12 0 0 0 3 5 0 4 0 0 0 0 0 0 7 0 1 1 3 0 0 0 0 0 1 0 0 1 3 1 0 0 0 1 0 0 0 0 1 0 0 0 32 1 1 3 10 9 1 4 0 0 2 0 0 1 20.8% 0.6% 0.6% 1.9% 6.5% 5.8% 0.6% 2.6% 0.0% 0.0% 1.3% 0.0% 0.0% 0.6% 19 0 1 2 4 8 1 3 0 0 0 0 0 0 13 1 0 1 6 1 0 1 0 0 2 0 0 1 Respiratory system Nasal Cavity/Sinus Larynx Lung and Bronchus Trachea, pleura and other 0 0 0 0 0 2 0 0 2 0 1 0 0 1 0 13 0 0 13 0 0 0 0 16 0 16 0 0 10.4 0 10.4% 0.0% 0.0% 10.4% 0.0% 7 0 0 7 0 9 0 0 9 0 Bones and joints Soft Tissues 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0 0 0 0 Skin Melanoma Other Skin 0 0 0 4 4 0 0 0 0 0 0 0 2 2 0 6 6 0 3.9% 3.9% 0.0% 4 4 0 2 2 0 Breast 3 30 10 5 0 48 31.2% 1 47 Female Genital System Cervix Corpus Uterus, NOS Ovary Vagina Vulva Other female genital org 0 0 0 0 0 0 0 0 5 0 4 0 0 0 1 0 0 0 0 0 0 0 0 0 3 1 1 0 0 0 0 1 0 0 0 0 0 0 0 0 8 1 5 0 0 0 1 1 5.2% 0.6% 3.2% 0.0% 0.0% 0.0% 0.6% 0.6% 0 0 0 0 0 0 0 0 8 1 5 0 0 0 1 1 Male Genital System Prostate Testis Penis Other male genital organ 0 0 0 0 0 5 5 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 6 6 0 0 0 3.9% 3.9% 0.0% 0.0% 0.0% 6 6 0 0 0 0 0 0 0 0 Urinary System Bladder Kidney and renal pelvis Ureter Other urinary organs 2 2 0 0 0 2 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 5 4 1 0 0 3.2% 2.6% 0.6% 0.0% 0.0% 5 4 1 0 0 0 0 0 0 0 Eye 0 0 0 0 0 0 0.0% 0 0 Brain/Nervous System Brain Other nervous system 0 0 0 3 3 0 0 0 0 0 0 0 4 0 4 7 3 4 4.5% 1.9% 2.6% 2 2 0 5 1 4 Endocrine System Thyroid gland Other endocrine 0 0 0 2 1 1 1 1 0 1 1 0 2 1 1 6 4 2 3.9% 2.6% 1.3% 1 1 0 5 3 2 Lymphomas Hodgkin’s Disease Non-Hodgkin’s Lymphoma 0 0 0 1 0 1 1 0 1 2 1 1 1 0 1 5 1 4 3.2% 0.6% 2.6% 2 1 1 3 0 3 Multiple Myeloma 0 0 0 1 0 1 0.3% 1 0 Leukemia Acute lymphocytic Chronic lymphocytic Acute Myeloid Chronic Myeloid Other leukemia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 1 0 1 0 0 0 0 0 0 0 2 0 1 0 1 0 1.3% 0.0% 0.6% 0.0% 0.6% 0.0% 1 0 1 0 0 0 1 0 0 0 1 0 Other/Ill Defined 0 0 0 0 0 7 4.5% 5 2 Total 6 67 26 36 12 154 100% 58 96 22 | 2014-2015 Annual Cancer Care Center Report CANCER CONFERENCES Cancer Conferences Tumor Board Cancer Conferences are integral to improving the care of cancer patients by contributing to the patient management process, outcomes and providing continuing education to healthcare providers. Tumor Saint Alphonsus Cancer Conferences are held each week to provide an opportunity for specialists to review and discuss specialized cancer cases. Representatives from Medical Oncology, Radiation Oncology, Surgery, Radiology, and Pathology review the cases with surgeons and other health care professionals. Physicians from all Saint Alphonsus Medical Centers can attend Cancer Conferences via Webex teleconferencing. Board meetings are held Thursdays at noon. During 2014, 45 meetings were held with 174 total cases discussed. On average, 12 physicians attended each meeting. The major primary sites presented were lung, colon/ rectum, liver, unknown primary, and esophagus. The Cancer Registry acts as a liaison in scheduling and coordinating the essentials for each meeting. Breast Care Panel Breast Care Panel meets Tuesday mornings to review all positive breast biopsies. During 2014, 51 meetings were offered with a total of 479 cases presented. On Cancer Conference meetings are approved for one unit of CME (Continuing Medical Education) credit, in collaboration with Ada Canyon Medical Education Consortium (ACMEC). Providers in attendance at these meetings are eligible to receive one unit of CME credit to help fulfill their continuing education requirements. average, 12 physicians attended each meeting. The Breast Cancer Navigator schedules and coordinates each Breast Care Panel meeting. 2014-2015 Annual Cancer Care Center Report | 23 MEET OUR MEDICAL STAFF Saint Alphonsus Cancer Care Center Physicians & Nurse Practitioners S. MAYNARD BRONSTEIN, MD, PHD, MEDICAL ONCOLOGIST Dr. Bronstein, Medical Oncologist, is board-certified by the American Board of Internal Medicine in Internal Medicine, Medical Oncology and Hematology. He provides oncology and hematology services in Baker City and LaGrande, Oregon. He received his medical degree from Duke University Medical Center in Durham, NY and completed his residency in specialty medicine (Clinical Investigator) at Duke University Medical Center, Durham, NY. His fellowship in hematology was also completed through Duke University Medical Center. JOSEPH P. BROOKS, MD, RADIATION ONCOLOGIST Dr. Brooks is a board-certified radiation oncologist. He received his medical degree from Thomas Jefferson University in Philadelphia, PA and completed his residency in radiation oncology at the National Cancer Institute (NCI) in Bethesda, Maryland. Dr. Brooks has been involved in research and published numerous articles focusing on breast and prostate cancers. He has been the principle investigator on a multi-million dollar federal grant and has conducted several clinical studies focusing on improved tumor targeting in prostate cancer. Prior to relocating to Boise, Dr. Brooks was Major in the US Army and was Chief of Radiation Oncology at Madigan Army Medical Center in Tacoma, WA. PATRICK CONNOR, MD, GYNECOLOGIC ONCOLOGIST Dr. Connor is a board-certified Gynecologic Oncologist and fellow with the American College of Obstetrics and Gynecology. He received his medical degree and completed his residency at Georgetown University School of Medicine in Washington, D.C. His fellowship was through the University of Michigan. He has served as an instructor at the University of Michigan as well as a Clinical Assistant Professor in the Department of Obstetrics and Gynecology at both Louisiana State University and the University of North Carolina. He was named Professor of the Year at both LSUHSC and UNCW and was a principle investigator for the Gynecologic Group and board member of the Investigational Review. LINSEY ETHERINGTON, MD, PLASTIC & RECONSTRUCTIVE SURGEON Dr. Linsey Etherington attended Southern Utah University, Cedar City, UT, where she received her bachelor’s degree graduating summa cum laude. She received her medical degree at the University of Utah School of Medicine. Her general surgery residency was completed at the University of Utah Hospitals and Clinics followed by a plastic surgery residency, also at the University of Utah. She is a member of the American College of Surgeons and a candidate for membership in the American Society of Plastic Surgeons. 24 | 2014-2015 Annual Cancer Care Center Report STEPHANIE HODSON, MD, MEDICAL ONCOLOGIST/HEMATOLOGIST Dr. Hodson is our breast cancer specialist and the Director of the Saint Alphonsus Comprehensive Breast Care Program. With her expertise, the program provides state-of-the-art breast cancer therapy and participates in ongoing clinical research of promising new therapies. An Idaho native, Dr. Hodson received her medical degree from the University of Washington. She completed her internal medicine training at Providence Portland Medical Center in Portland, Oregon, then went on to complete subspecialty training in Hematology and Medical Oncology at Oregon Health and Science University in Portland, Oregon. She received additional training specifically in the therapy of breast cancer at Indiana University Medical Center. She is Board Certified in Medical Oncology, Hematology, and Internal Medicine. She joined Saint Alphonsus Cancer Care Center in 2002. ALAN LANGERAK, MD, MEDICAL ONCOLOGIST Dr. Langerak received his undergraduate degree from Arizona State University where he graduated summa cum laude. He received his medical degree from the University of Arizona College of Medicine. He fulfilled an internship and residency in internal medicine as well as a fellowship in Hematology and Oncology at the University of Arizona College of Medicine and Arizona Cancer Center. Dr. Langerak is board certified in internal medicine, hematology, and medical oncology by the American Board of Internal Medicine. He is a member of the American Society of Clinical Oncology, American Society of Hematology, and the Oklahoma Society of Clinical Oncology. Additionally, he is co-author of a handbook entitled “Chemotherapy Regimens and Cancer Care.” A. SCOTT PIERSON, MD, MEDICAL ONCOLOGIST CANCER CARE CENTER MEDICAL DIRECTOR Dr. Pierson is a board-certified medical oncologist and hematologist. He attended Princeton University as an undergraduate where he majored in political science. Dr. Pierson was a member of the Princeton varsity soccer team. He then attended Jefferson Medical College in Philadelphia and graduated magna cum laude. A native of the East Coast, following medical school he moved west completing his internal medicine residency and fellowships at the University of Colorado. During fellowship, Dr. Pierson did research with the Phase 1 and Gastrointestinal Oncology groups. He has particular interests in the treatment of Breast, Lung and GI cancers. ELIZABETH M. PRIER, MD, FACS, BREAST SURGEON Dr. Prier is a fellowship trained Breast Surgeon and will be the Medical Director of the Saint Alphonsus Comprehensive Breast Surgery Center. She is board certified in general surgery, and a fellow of the American College of Surgeons. She earned her medical degree from the University of Virginia School of Medicine in Charlottesville, VA. Her residency in general surgery was completed through the University of Colorado Health Science Center in Denver, CO and her Breast Surgical Oncology Fellowship was completed at the University of California San Francisco in San Francisco, CA. She has served as a Clinical Instructor in the Department of Surgery at the University of California, San Francisco, CA and was previously a general surgeon with Boise Surgical Group. Dr. Prier is a member of the American Society of Breast Surgeons, the American Society of Breast Disease and the Idaho Medical Society. 2014-2015 Annual Cancer Care Center Report | 25 MEDICAL STAFF (continued) Saint Alphonsus Cancer Care Center Physicians & Nurse Practitioners KERRY PULVER, MD, PhD, MEDICAL ONCOLOGIST/HEMATOLOGIST Dr. Pulver joined Saint Alphonsus in August 2002. He received a dual degree in medicine and a PhD in biochemistry at Louisiana State University Medical Center in New Orleans, Louisiana, in 1981. After completing his residency training in internal medicine, he went on to complete fellowship training in oncology and hematology at the Ochsner Clinic in New Orleans. Dr. Pulver is board certified in both medical oncology and hematology and internal medicine. He is the principal investigator for the research program at Saint Alphonsus Cancer Care Center. He has a strong interest in prostate cancer and brain tumors. LINDSAY SALES, MD, RADIATION ONCOLOGIST Dr. Lindsay Sales is a board-certified radiation oncologist. She received her medical degree from the University of Washington School of Medicine, and completed her residency at the University of Washington Medical Center in Seattle, WA. Her preliminary medicine internship was completed through Virginia Mason Medical Center, Seattle, WA. She was the Chief Resident at the University of Washington Medical Center 2012- 2013, has written numerous publications and received a number of awards including; University of Washington Radiation Oncology Resident Day Clinical Award (2012); University of Washington Georgiana Kirby Award (2008); and the Western Student Medical Research Forum Subspecialty Abstract Award (2006), to name a few. She is a member of the American Medical Association, American Society of Radiation Oncology, and American Society of Clinical Oncology. KARL SCHULTHEISS, MD, MEDICAL ONCOLOGIST/HEMATOLOGIST Dr. Schultheiss joined Saint Alphonsus Cancer Care Center in 2002. He received his M.D. from the University of Freiburg, Germany, where he also served as a post- doctoral research fellow. Dr. Schultheiss completed his internship at Presbyterian/ St. Luke’s Hospital in Denver, and his residency at Emanuel Hospital in Portland, OR. He completed his oncology/hematology fellowship at the University of Utah in Salt Lake City. He is strongly interested in clinical trials and has a special interest in lung, gastrointestinal, and lymphoid malignancies. Dr. Schultheiss is board certified in Oncology, Hematology, and Internal Medicine. Laura Asaro, FNP-BC Jessica Butterfield, MS, FNP 26 | 2014-2015 Annual Cancer Care Center Report Esther Sears, FNP-BC Holly Swensen, FNP-BC LOCATIONS & PHONES BOISE 1055 N. Curtis Road, Boise, ID 83706 (208) 367-DOCS (3627) CALDWELL 3123 Medical Drive, Caldwell, ID 83605 (208) 367-4810 NAMPA 319 E. Hawaii Avenue, Nampa, ID 83686 (208) 288-4679 EMMETT Walter Knox Hospital Rural Clinic 1202 E. Locust Street, Emmett, ID 83617 (208) 453-2033 ONTARIO 351 SW 9th Street, Ontario, OR 97914 (208) 288-4679 BAKER CITY 3325 Pocahontas Rd., Baker City, OR 97814 (541) 523-8112 Gynecologic Oncology (all locations) (208) 367-5050 2014-2015 Annual Cancer Care Center Report | 27 “Music speaks what cannot be expressed, soothes the mind and gives it rest, heals the heart and makes it whole.” 2014-2015 ANNUAL REPORT