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IOM: Cancer treatment requires patient-centered care

Monday June 13, 2011
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The Institute of Medicine has issued a report on improving the quality of oncology care through patient-centered treatment planning.

Noting that “most providers lack the tools, time and resources needed to efficiently and effectively prepare” cancer treatment plans with their patients, the IOM’s National Cancer Policy Forum held a workshop Feb. 28-March 1 to discuss ways to construct a more coordinated, patient-centered cancer treatment planning process.

Speakers and participants representing patients, providers, nonprofits and other groups identified obstacles to achieving patient-centered care planning in practice. Issues included poor communication between patients and providers and a lack of adequate reimbursement for the time needed to develop, discuss and document a treatment plan.

Potential solutions, according to the panel, include improved training of physicans, nurses and other providers “in the components of optimal communication with patients and families, and improved education of patients and families about how to be more proactive and assertive to optimize interactions with healthcare providers.”

Nurses who specialize in oncology “have several assets that can aid the communication process, including being trusted by and accessible to patients,” said panelist Marie Bakitas, APRN, DNSc, AOCN, FAAN, associate professor of anesthesiology at Dartmouth Medical School. Bakitas noted that a systematic review of 46 studies found that “the nurses’ role as information providers for cancer patients is prominent, especially after the initiation of treatment, and that nurses are effective in providing information.”

Bakitas also referred to studies illustrating the benefits for patient outcomes of using oncology nurses. One study found that patients who received a standardized nursing protocol — including comprehensive clinical assessments, monitoring and teaching — had better two-year survival rates than a control group. Another study found that nurse communication with family members reduced caregiver burden and improved the caregiver’s ability to cope.

Despite these benefits, Bakitas noted, last year’s IOM/Robert Wood Johnson Foundation report on “The Future of Nursing: Leading Change, Advancing Health” found that nurses are underutilized in many areas of healthcare. Bakitas called for “making the communication role of the oncology nurse explicit through cancer treatment planning guidelines.”

To read the online version of the report, visit http://bit.ly/kyUlLZ.

Nick Hut is news editor.

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