Expanding a Comprehensive Lung Cancer Screening Program

1 Expanding a Comprehensive Lung Cancer Screening Program By Buffy Jansak, RN, MBA, OCN. Executive Summary OhioHealth is central and central Ohio served by OhioHealth, can- north central Ohio's largest and most cer is the second leading cause of death, The OhioHealth Lung Cancer Screening preferred health system. It is a nationally and rates of new cases of lung and bron- Program is a high quality multi-disci- recognized, faith-based, not-for-profit, chus Cancer are higher than the rest of plinary Program that was launched in charitable healthcare organization with Ohio and the United July 2013 at OhioHealth Riverside a family of 28,000 associates, physicians, Given these statistics and the release Methodist Hospital, OhioHealth Doc- and volunteers.

2 OhioHealth includes Riv- of the National Lung Cancer Screening tors Hospital, and OhioHealth Grant erside Methodist Hospital, Grant Medical Trial results, which demonstrated a 20%. Medical Center in Columbus, Ohio. Center, Doctors Hospital, Grady Memo- reduction in lung Cancer mortality with With the assistance of the AHRA & rial Hospital, Dublin Methodist Hospi- low-dose chest CT, OhioHealth Cancer Toshiba Putting Patients First grant, we tal, Hardin Memorial Hospital, Marion Services implemented its Lung Cancer were able to expand community access General Hospital, Rehabilitation Hos- Screening Program on July 22, for people at high risk of developing pital, O'Bleness Hospital, MedCentral The Program uses a low-dose chest CT.

3 Lung Cancer by opening several more programs at OhioHealth Marion Gen- Mansfield Hospital, MedCentral Shelby scan to identify lung Cancer at its earli- eral and OhioHealth Grady Memorial Hospital, and Westerville Medical Cam- est stages, before symptoms develop. Hospitals. pus, as well as many health and surgery Because the best chance of a cure is early centers, urgent care, wellness, hospice, detection, the OhioHealth Lung Cancer A subsequent patient educational video was developed to highlight the and home health providers throughout Screening team collaborates promptly Comprehensive Program , nurse naviga- central Ohio and a 40 county area.

4 In with referring physicians to develop a tional involvement, potential risks, addition, OhioHealth routinely works plan of care based on radiologists' rec- benefits, and tobacco cessation. with many independent physicians who ommendations. Specifically, the com- The tobacco cessation educational treat their patients in its hospitals and prehensive, multi-disciplinary Screening skills of the OhioHealth Lung Nurse who are also vital partners in providing Program includes: Navigators were enhanced with the high quality care.

5 Completion of the Tobacco Treatment The opportunity to make a difference Low-dose chest CT scan Specialist certification. in the communities that OhioHealth Dedicated team of radiologists serves is now. Lung Cancer continues Nurse navigation to have the highest number of Cancer Patient education about Screening and related deaths in men and women smoking cessation more than breast, prostate, and colorec- Tobacco treatment specialists for tal cancers In fact, Ohio is patients who are ready to quit smoking ranked sixth among all states in the Follow-up evaluations and consulta- United States, with more than 10,000 tions with referring physicians new cases of lung Cancer in In Affordable.

6 Low out-of-pocket cost for Franklin County, the largest county in the patients 42 November/December 2015 radiology management With the help of the AHRA & Toshiba Putting Creating a standard radiology low dose protocol and new OhioHealth Lung Patients First grant we were able to advance Cancer Screening Program Startup hos- pital check list assisted with the expan- our Program this past year. sion of the Program into new OhioHealth hospital locations in the northern region of Ohio (see Figure 2). The standardized The Program follows the United appropriateness for Screening .

7 The navi- protocol allows the technologist(s) to set States Preventative Services Task Force gators then meet the patients to provide up the CT scanners properly and safely and National Comprehensive Cancer education about risk reduction, assess since a low dose amount of radiation is Network guidelines, which defines those initial patient's readiness to quit smoking, delivered to patients during their chest at higher risk for lung Cancer as3,4: initiate smoking cessation referrals, and CTs. to show the educational video created to The Startup hospital check list was Men and women age 55 80 who have explain a possible CT Following the created to identify team members, map at least a 30 pack-year smoking history, scan, the navigator contacts the patient's scheduling process for retail billing, and/or are ex-smokers who quit within primary care physician to communicate implement the radiology protocol and the last 15 years.

8 Results and coordinate the recommenda- processes, and map out patients' flow Men and women age 50 or older who tions for follow-up and track all find- through the Program . This new check list have smoked at least one pack of cig- ings and future appointments through was successfully utilized to implement arettes or more for 20 years or more Midas, a navigational focused data base. the Program at two additional hospital and have one additional risk factor See Figure 1 for workflow. locations. (eg, COPD, pulmonary fibrosis, radon With the initiation of the Program exposure, occupational exposures, per- in 2013, a patient educational video sonal history of lung Cancer , or family Advancements was This OhioHealth Lung history of lung Cancer ).

9 The OhioHealth Lung Cancer Screen- Cancer Screening Program video was ing Program had already established the created to increase patients' awareness ground work for a successful lung Cancer of the risks and benefits of the Program Nurse Navigators Screening Program , and with the help of and to include smoking cessation edu- At the center of the OhioHealth Lung the AHRA & Toshiba Putting Patients cation. This video was overwhelmingly Cancer Screening Program is a dedi- First grant we were able to advance our received by our patients with a 90%.

10 Cated team of oncology lung nurse Program this past year. The main goals acceptance rate. The OhioHealth Lung navigators. The navigators perform pre- focused on patient safety, education, and Cancer Screening Taskforce group deter- enrollment risk assessments to ensure overall patient experience. mined that a second video for patients Pending NN will NN meets w/ results, NN. Referral to Dedicated contact the NN contacts patient prior will contact NN from Radiologists PCP with patient NN contacts NN arranges to test to patient &.