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Thoracic Cancer Surgery Community of Practice Retreat
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Thoracic Cancer Surgery Community of Practice Retreat
Thoracic Cancer Surgery
Community of Practice
RETREAT PROCEEDINGS
Saturday October
28, 2006
On Saturday October 28, 2006, the Surgical
Oncology Program held a retreat for surgeons practicing thoracic cancer
surgery in Ontario. This meeting brought together representatives from
all LHINs to address immediate needs related to implementation of the
Thoracic Surgical Oncology standards.
Attendees:
Anderson, T., Ashrafi, A., Balachandra,
V., Behazadi, A., Chan, M., Chiasson, P., Compeau, C., Coughlin, M.,
Cook, R., Crossley, C., Darling, G., Dickie, J., Fung Kee Fung, M.,
Gehman, K., Gregory, W., Hunter, A., Inculet, R., Irish, J., Irshad,
K. Iu ,S., Jones, D., Keshavjee, S., Kilmurry, M., Langer, B.,
Mah, J., Marcus, H., Maziak, D., McDonald, S., Miller, J., Nichala,
P., De Perrot, M., Rosenblum, S., Salmon, E., Simone,
C., Shamji, F., Shargall, Y., Sharkey ,P., Talwar, M., Young,
T., Zeldin, R.
Presentations:
Dr. Donna Maziak welcomed
the participants and reviewed the retreat agenda, structure of the breakout
sessions and the prioritization process.
Dr. Bernard Langer summarized
the goals and priorities of the SOP and illustrated the program's
approach to quality improvement through the use of standards, guidelines,
and indicators. He also answered a few questions regarding non-punitive
disclosure of the regional performance data, volumes-outcomes correlation
and implementation of the thoracic surgical oncology standard at the
hospitals level.
Dr. Fung Kee Fung presented
an overview of the Knowledge Transfer concepts, introduced implementation
methodology for collaborative quality improvement projects, and gave
a few examples of successful Communities of Practice in other disease
site groups (DSG).
Dr. Maziak presented the results
of a needs assessment survey, demographics data on incidence and intensity
of the thoracic cancer surgery, and existing CCO outcome and evidence
quality indicators. She highlighted significant cross-province
variations in mortality rates in esophagectomy and lung resections and
in the completeness of pathology reporting for lung resections.
Dr. Maziak concluded with a detailed review of the Thoracic Surgical
Oncology standard.
Breakout Sessions:
The primary focus of discussions was
to identify the priority areas that the group can focus on to improve
the overall quality of care. The breakout leaders Dr. Zeldin,
Dr. Darling and Dr. Shamji facilitated a focused discussion on integration
of surgical expertise and knowledge to regional and provincial implementation
of the Thoracic Cancer Surgery Standards. Active involvement of surgeons
in the validation of the data, detailed risk analysis and collaborative
work with other disciplines was suggested to facilitate the development
of a local implementation capacity.
Retreat Outcomes:
Top Four Improvement Targets were identified
by the breakout discussions and by the prioritization process.
The leaders for each priority team were asked to set up the follow-up
teleconferences and define action plans.
Priority
Action Required
Lead/Team
1
Develop
a guideline and quality indicators in mediastinoscopy (i.e. #
of Lymph Nodes sampled at ("med"), % med's +, standard definitions, indications,
etc)
Form a liaison group to work with the
Surgical Oncology Program on development of quality tools
Dr. Darling
Dr. de Perrot, Dr. Chiasson, Dr. Maziak
2
Development of a province-wide Care
Pathway for the lung cancer surgery patient (ie Work-up to therapy)
Form a multidisciplinary working group
with surgical leadership and work with SOP/PEBC using their resources
Dr. R. Zeldin,
Dr. Compeau,
Dr. Chiasson, Dr.
Gehman,
Dr. Dickie
3
Identify opportunities to engage surgeons
without an MCC in their own region into the multidisciplinary case discussions
(video/teleconferencing, Intranet, etc.)
Establish different options for attending
MCC's (on-line, tele/ videoconferencing )
Dr. Keshavjee
Dr. Inculet
Dr. Gehman,
Dr. Young
4
To formally endorse by OATS the implementation
of a Thoracic Standard by LHINs and hospitals administration
Form a committee to work with hospital
administration and LHINS during the planning process
Interact with CCO re : implementation
Dr. Shamji, Dr. Maziak - co-chairs,
Dr. Inculet,
Dr. Zeldin,
Dr. Marcus,
Dr. Anderson, Dr. Keshavjee, Dr. Jones
Feedback from the retreat
62% (18 out of 29 respondents)
said that they plan to change their practice based on information they
received at the meeting. Examples of changes include: start to develop
clinical pathways for thoracic oncology in cooperation with other specialties,
make an adequate change in practice and influence resources, quality
tools utilization, participate in knowledge transfer cycle - how to
make it happen, watch more close own wait times, review coding for pathology
reporting, develop a care map, review a hospital pathology reporting
process, networking.
Majority of respondents agreed
that the retreat was relevant to their practice, met their learning
objectives, and was well organized.
24 respondents stated that
they would like to attend a follow-up workshop related to quality in
surgical oncology,
Call for project team members.
We invite surgeons and other inter-disciplinary
health care professionals across the province to participate in multidisciplinary
teams that move forward each of four identified priorities and address
the actions required. Our project leads are actively seeking team
membership. Please contact Elena Goubanova (<a href=mailto:egoubanova@ottawahosptal.on.caegoubanova@ottawahospital.on.ca, tel: 613.737.7700 ext. 70261) if you are interested
to participate in a particular improvement project.
Thoracic Cancer Surgery Community of Practice Retreat
Thoracic Cancer Surgery
Community of Practice
RETREAT PROCEEDINGS
Saturday October
28, 2006
On Saturday October 28, 2006, the Surgical
Oncology Program held a retreat for surgeons practicing thoracic cancer
surgery in Ontario. This meeting brought together representatives from
all LHINs to address immediate needs related to implementation of the
Thoracic Surgical Oncology standards.
Attendees:
Anderson, T., Ashrafi, A., Balachandra,
V., Behazadi, A., Chan, M., Chiasson, P., Compeau, C., Coughlin, M.,
Cook, R., Crossley, C., Darling, G., Dickie, J., Fung Kee Fung, M.,
Gehman, K., Gregory, W., Hunter, A., Inculet, R., Irish, J., Irshad,
K. Iu ,S., Jones, D., Keshavjee, S., Kilmurry, M., Langer, B.,
Mah, J., Marcus, H., Maziak, D., McDonald, S., Miller, J., Nichala,
P., De Perrot, M., Rosenblum, S., Salmon, E., Simone,
C., Shamji, F., Shargall, Y., Sharkey ,P., Talwar, M., Young,
T., Zeldin, R.
Presentations:
Dr. Donna Maziak welcomed
the participants and reviewed the retreat agenda, structure of the breakout
sessions and the prioritization process.
Dr. Bernard Langer summarized
the goals and priorities of the SOP and illustrated the program's
approach to quality improvement through the use of standards, guidelines,
and indicators. He also answered a few questions regarding non-punitive
disclosure of the regional performance data, volumes-outcomes correlation
and implementation of the thoracic surgical oncology standard at the
hospitals level.
Dr. Fung Kee Fung presented
an overview of the Knowledge Transfer concepts, introduced implementation
methodology for collaborative quality improvement projects, and gave
a few examples of successful Communities of Practice in other disease
site groups (DSG).
Dr. Maziak presented the results
of a needs assessment survey, demographics data on incidence and intensity
of the thoracic cancer surgery, and existing CCO outcome and evidence
quality indicators. She highlighted significant cross-province
variations in mortality rates in esophagectomy and lung resections and
in the completeness of pathology reporting for lung resections.
Dr. Maziak concluded with a detailed review of the Thoracic Surgical
Oncology standard.
Breakout Sessions:
The primary focus of discussions was
to identify the priority areas that the group can focus on to improve
the overall quality of care. The breakout leaders Dr. Zeldin,
Dr. Darling and Dr. Shamji facilitated a focused discussion on integration
of surgical expertise and knowledge to regional and provincial implementation
of the Thoracic Cancer Surgery Standards. Active involvement of surgeons
in the validation of the data, detailed risk analysis and collaborative
work with other disciplines was suggested to facilitate the development
of a local implementation capacity.
Retreat Outcomes:
Top Four Improvement Targets were identified
by the breakout discussions and by the prioritization process.
The leaders for each priority team were asked to set up the follow-up
teleconferences and define action plans.
Priority
Action Required
Lead/Team
1
Develop
a guideline and quality indicators in mediastinoscopy (i.e. #
of Lymph Nodes sampled at ("med"), % med's +, standard definitions, indications,
etc)
Form a liaison group to work with the
Surgical Oncology Program on development of quality tools
Dr. Darling
Dr. de Perrot, Dr. Chiasson, Dr. Maziak
2
Development of a province-wide Care
Pathway for the lung cancer surgery patient (ie Work-up to therapy)
Form a multidisciplinary working group
with surgical leadership and work with SOP/PEBC using their resources
Dr. R. Zeldin,
Dr. Compeau,
Dr. Chiasson, Dr.
Gehman,
Dr. Dickie
3
Identify opportunities to engage surgeons
without an MCC in their own region into the multidisciplinary case discussions
(video/teleconferencing, Intranet, etc.)
Establish different options for attending
MCC's (on-line, tele/ videoconferencing )
Dr. Keshavjee
Dr. Inculet
Dr. Gehman,
Dr. Young
4
To formally endorse by OATS the implementation
of a Thoracic Standard by LHINs and hospitals administration
Form a committee to work with hospital
administration and LHINS during the planning process
Interact with CCO re : implementation
Dr. Shamji, Dr. Maziak - co-chairs,
Dr. Inculet,
Dr. Zeldin,
Dr. Marcus,
Dr. Anderson, Dr. Keshavjee, Dr. Jones
Feedback from the retreat
62% (18 out of 29 respondents)
said that they plan to change their practice based on information they
received at the meeting. Examples of changes include: start to develop
clinical pathways for thoracic oncology in cooperation with other specialties,
make an adequate change in practice and influence resources, quality
tools utilization, participate in knowledge transfer cycle - how to
make it happen, watch more close own wait times, review coding for pathology
reporting, develop a care map, review a hospital pathology reporting
process, networking.
Majority of respondents agreed
that the retreat was relevant to their practice, met their learning
objectives, and was well organized.
24 respondents stated that
they would like to attend a follow-up workshop related to quality in
surgical oncology,
Call for project team members.
We invite surgeons and other inter-disciplinary
health care professionals across the province to participate in multidisciplinary
teams that move forward each of four identified priorities and address
the actions required. Our project leads are actively seeking team
membership. Please contact Elena Goubanova (<a href=mailto:egoubanova@ottawahosptal.on.caegoubanova@ottawahospital.on.ca, tel: 613.737.7700 ext. 70261) if you are interested
to participate in a particular improvement project.