Complementary medicine research program launched at BC Cancer Agency
This month, the BC Cancer Agency, in collaboration with the University of British Columbia School of Nursing, launched a research program to support cancer patients and healthcare professionals in making informed decisions about complementary medicine (CAM).
Recent surveys report that between 50 to 80 percent of patients use CAM along with conventional cancer care. CAM includes a range of therapies such as vitamins and herbal supplements, acupuncture, and meditation.
Despite widespread use, patients and healthcare professionals often feel uncomfortable talking about CAM. However, according to a B.C. Ministry of Health 2006 survey of more than 6,900 cancer patients, patients ranked receiving information and decision support from the conventional cancer community about CAM among the top three areas for improvement.
“We’re really playing catch-up at this point,” says Tracy Truant, a BC Cancer Agency co-investigator and Regional Professional Practice Leader in Nursing. “We know patients are using CAM in huge numbers, but we don’t have the clinical decision support tools or understand the best practices to support their decision-making.”
CAMEO will receive direction from an interprofessional CAM Steering Group to ensure research questions posed and knowledge generated within CAMEO will be relevant to practice. A provincial BC Cancer Agency CAM Advisory Group is also being formed, including Agency health professionals and community partners, to give direction for policy setting.
“Healthcare professionals also receive very little, if any, education about CAM in their undergraduate and graduate education so they often don’t feel equipped to have those discussions with patients.”
So, the time for CAMEO – the Complementary Medicine Education and Outcomes Research Program – the first such program situated within a conventional cancer centre in Canada was long overdue.
Tracy and Dr. Lynda Balneaves, CAMEO’s principal investigator, and Dr. Marja Verhoef, another co-investigator with the University of Calgary, emphasize that CAMEO is foremost a research program.
“CAMEO will explore how best to provide CAM information and decision support to patients and families so that they are able to make safe and informed decisions within the context of conventional care,” says Lynda. “CAMEO will not provide recommendations about particular CAM therapies, instead the goal of CAMEO is to empower patients to make evidence-informed decisions that fit with their values and goals.”
The first research projects will explore how to best prepare healthcare professionals to provide CAM information and decision support to patients, and group education for patients on how to make evidence-based decisions. Researchers will follow-up with patients to determine how the group education impacted their CAM decisions. Healthcare professionals will be followed over time to examine how the education impacts their attitudes, readiness to engage in CAM discussions, and actual practice changes related to CAM decision support.
Future research plans include exploring how best to provide one-on-one decision support for patients and families with complex needs, and development of a decision aid specific to CAM and cancer decisions.
“At the end of the four year project, we envision a practice environment at the BCCA where cancer patients can talk about CAM in an open, unbiased and supportive way with health professionals, who are able to effectively meet patients’ CAM information and decision support needs,” says Tracy.
The CAMEO research program is funded for four years and supported through a $1 million grant from the Lotte and John Hecht Memorial Foundation. For more information about CAMEO, please visit
www.bccancer.bc.ca/cameo, or contact Tracy at
ttruant@bccancer.bc.ca , or Lynda at
lynda.balneaves@nursing.ubc.ca Advancing Strategic Direction #2
Establish the knowledge generation and application model within the provincial cancer control platform.
Accreditation: focus on patient safety
Accreditation Canada (formerly the Canadian Council on Health Services Accreditation) now has 31 Required Organizational Practices (ROPs) within seven Patient Safety Goals. Fully implemented ROPs are mandatory for an unconditional accreditation. The patient safety goals include: culture, communication, medication use, worklife/workforce, infection control, falls prevention, and risk assessment. Here's a complete list of the
ROPs.
There are five ROPs under the goal of "creating a culture of safety" within the organization. “Essentially, the ROPs focus on whether a culture of safety is embedded within an organization, reporting of adverse events, policies and procedures and if there’s organizational support for continually improving patient safety,” says Rosmin Esmail, director, Quality, Safety and Risk Management, BC Cancer Agency.
Last year, the PHSA Board conducted a Survey on Patient Safety Culture of all agencies, including the BC Cancer Agency. In total, more than 1,000 responses were received from Agency employees. That survey will be the starting point for discussions around the ROPs on culture, and the change that needs to take place to improve patient safety at the Agency, says Rosmin.
“We’re not unlike any other organization,” says Rosmin. “The survey identified areas for improvement, which are not surprisingly different from our colleagues in other healthcare organizations, and areas where we have great strengths.”
The PHSA Board Survey on Patient Safety Culture found that the Agency’s main strengths were: teamwork within and across units; management support for patient safety; and supervisor/manager expectations and actions promoting patient safety. Staffing, handovers and transitions, and response to reporting of critical incidents were identified as areas for improvement.
In the next few months, detailed results from the Patient Safety Culture Survey will be shared with staff, with an eye to improving overall patient safety, and preparing for Accreditation. “We are a step ahead by having the results of this comprehensive survey to spark a meaningful conversation about our patient safety culture and identifying key changes that need to be made,” says
Rosmin.
Editor's Note: Rosmin will be leaving the Agency on June 20, and heading back to Alberta. Recruitment of her position is a priority for the Agency. In the meantime, if you have a question about accreditation, please contact Fiona Bees, senior director, Cancer Care, at
fbees@bccancer.bc.ca
Advancing Strategic Direction #1
Sustain and advance the BC Cancer Agency's system of cancer control.
BC Cancer Agency's Abbotsford Centre: countdown to opening
The BC Cancer Agency's Fraser Valley and Abbotsford Centres staff are moving closer to the official opening date of Monday, August 25, when the centre will be ready to treat patients. Commissioning of new equipment has been underway for several months, and now support staff are beginning to move into the new centre. About three-quarters of the hiring has been done to fill positions at the centre, with more hiring anticipated for August and into the fall.
There's been a great deal of anticipation and activity this spring and summer as the community and staff have looked forward to the opening of the new centre. The BC Cancer Agency held a public open forum in April for the community to provide information on the cancer centre and answer questions from the audience.
On May 6, there was a special event to mark the 100 day count-down to the opening of the Abbotsford Regional Hospital and Cancer Centre, attended by the Minister of Health, the Honourable George Abbott, and the Fraser Health and Provincial Health Services Authority board. This was followed by a sneak peek of the new facility for BC Cancer Agency and Fraser Health Authority staff. A public open house will be held on June 14 at the ARHCC. Staff are welcome to attend.
Advancing Strategic Direction #1
Sustain and advance the BC Cancer Agency's system of cancer control.
Radiation therapy program going paperless in Fraser Valley and Abbotsford
This April, the Fraser Valley Centre’s radiation therapy program launched a paperless record and documentation process in anticipation of the opening of the Abbotsford Centre (opening August 25).
Now, the two centres' radiation therapy staff will be able to seamlessly share information electronically rather than relying on the transfer of paper records between the two sites.
Radiation therapy staff traveling between both centres can access and update patient files regardless of whether they are in Abbotsford or Surrey, and depending on workload, patients can routinely be treated at either centre, thereby ensuring that patients are treated as quickly as possible.
“The two radiation therapy departments will be integrated and run as closely together as possible to provide the best possible patient care and to realize efficiencies,” says Anand Karvat, head of Radiation Therapy at the Abbotsford and Fraser Valley Centres.
Benefits of the paperless system include:
- treatment booking occurs much quicker
- reduces time retrieving paper records
- improves access and flow of clinical information between health care professionals
- information is easy to read (reduces time clarifying illegible notes)
- easier to gather data for year end statistics
- resources can be allocated to treat patients as quickly as possible
- a task manager, which records and tracks requests. For example, a patient may require a dressing change. Nurses can view requests on-line, and report back electronically after care has been provided, thereby eliminating follow-up time
“For example, the Abbotsford Centre will have two CT scanners, so as the new centre ramps up, a patient living in Surrey may go to Abbotsford for a CT and treatment planning if the capacity is there, but ultimately be treated at the Fraser Valley Centre. Or an Abbotsford patient may initially be seen by a radiation oncologist at the Fraser Valley Centre, but receive treatment and follow-up at the Abbotsford Centre.”
“It’s really the way of the future,” says Tammy Currie, chief radiation therapist for the Abbotsford Centre, of the electronic patient record keeping system. Tammy along with a core team, has spent the last six months pilot testing the program.
“We had a unique opportunity with the opening of the Abbotsford Centre to standardize processes between both centres, and weed out inefficiencies. We pulled together a multidisciplinary team – nurses, oncologists, physicists – to look at our processes, and eliminate as many of the redundant processes as possible.”
“Everybody worked and is still working extremely hard to make the new system work. The success of this very important advancement is due to the knowledge, commitment and hard work of the entire radiation therapy process,” says Tammy.
Advancing Strategic Direction #1
Sustain and advance the BC Cancer Agency's system of cancer control.
Cross-Cultural Considerations in promoting advance care planning
Advance care planning (ACP) is a process in which an individual creates instructions and guidelines about their medical care in the event that they become too seriously ill or injured to make decisions.
A new study, Cross-Cultural Considerations in Promoting Advance Care Planning in Canada, by Dr. Andrea Con of the CIHR Cross-Cultural Palliative NET, looks at the beliefs, values and traditions of diverse cultural groups in Canada towards including ACP as part of the health care system.
Report information was gathered from published research materials, telephone interviews with individuals representing minority groups, health care professionals and organizations, and through focus groups. Culturally specific themes were identified regarding palliative and end of life care, including how best to break the news, importance of discussing ACP, how to discuss ACP and the advantages and disadvantages of ACP.
The goal of the study was to ensure ACP practices are respectful and conducted in a culturally competent manner.
“Our study found that ACP was viewed as important, however, few Canadians have participated in the process, or have an advanced directive,” says Andrea. “The report provides valuable insight for health care practitioners about how ACP can improve palliative and end of life care for all cancer patients and their families.”
Andrea is a research investigator with the BC Cancer Agency and a clinical assistant professor, UBC School of Population and Public Health.
To read the full report please visit: www.bccancer.bc.ca/RES/ResearchPrograms/SBR
If you would like more information please contact Andrea at
acon@bccancer.bc.ca Advancing Strategic Direction #3
Support regional centres, regions and communities with the implementation of provincial cancer control programs and the integration of knowledge.
Foundation grant boosts research activity at Fraser Valley Centre
The Agency’s Fraser Valley Centre is well known for its high quality patient care, more so than for its research activity. When the centre’s Professional Practice Leaders asked the BC Cancer Foundation to help remedy the problem, the Foundation responded.
First, six years ago, the Foundation created the Interdisciplinary Research Grant or IDRG to encourage the Agency’s Fraser Valley Centre clinicians to conduct interdisciplinary research. The $10,000 grant is awarded annually, and overseen and judged by the centre’s Academic Advisory Committee.
The Foundation has also funded a Research Development Officer position, held since January of 2007 by Dr. Rich Sobel. He has been raising awareness of research at the centre, helping individuals and teams develop research projects and actively promoting and encouraging research activities among centre staff.
“The BC Cancer Foundation’s IDRG
BC Cancer Foundation contacts:
Abbotsford: Liz Harris, toll free 1-877-751-0111
Fraser Valley: Kate Ludlam, 707-5900, x 4960
Vancouver: Sharon Kennedy, 604-877-6160
Vancouver Island: Laura Walsh, 250-519-5554 provides vital seed money for pilot studies that have the potential to become full scale, multidisciplinary research endeavors, but lack the funds necessary to generate the preliminary data necessary for external funding competitions,” Rich explains.
Previous recipients of IDRG awards include Dr. Lee Ann Martin, Elena Serrano and Dr. Paddy Rodney for their pilot study examining moral distress and moral climate within the interdisciplinary ambulatory cancer care team environment.
The 2007 IDRG went to the team headed up by Maureen Parkinson, Dr. Hannah Carolan, Dr. Lee Ann Martin and Dr. Gina Mackenzie, for a pilot study comparing two assessment tests used to detect cognitive impairment in patients with brain tumours.
The 2008 Interdisciplinary Research Grant process is underway now, with the deadline for submissions to Dr. Rich Sobel on or before 12 noon, September 30.
Advancing Strategic Direction #4
To ensure we have the resources to achieve maximal organizational effectiveness
Newsmakers
Abraxis BioScience fund breast cancer fellowship
Representatives of Abraxis BioScience came to the BC Cancer Agency in May to present Dr. Stephen Chia with the first installment of a donation for a two-year breast cancer fellowship.
Abraxis BioScience is a global biotechnology company concentrating on treatments for cancer and other critical illnesses. Abraxis BioScience, Canada Inc., is located in Mississauga, Ontario.
Prestigious honours for two Agency staffDr. Charles Ludgate (Radiation Oncologist, Vancouver Island Centre) will receive the Order of BC for being a leader in the fight against prostate cancer and for improving the quality of life for men diagnosed with prostate cancer. Charles is a founding member of the Vancouver Island Prostate Cancer Research Foundation and the Prostate Centre in Victoria. The award is given to British Columbians who have made extraordinary contributions to the province. The award will be given at a ceremony on June 26.
Ann Syme (Program and Network Leader, Pain & Symptom Management/Palliative Care) was awarded the BC Hospice Palliative Care Association’s (BCHPCA) 2008 Award of Excellence. The BCHPCA gave the award to Ann for her exemplary commitment to improve end of life care for people in B.C., across Canada and around the world. Ann has been instrumental in the development of interdisciplinary pain and symptom outpatient clinics in all cancer centres around the province. Among her many accomplishments, Ann supported the development of the Vancouver Island Palliative Network (VIPN) in 2000. The VIPN brings together physicians and nurses working in community and hospital care settings from 14 different communities on the Island to share their challenges and successes, advance their knowledge in palliative care and assist them to train others in their own communities.
BC Cancer Agency researchers awarded $4.3 million by Canadian Cancer Society
In May, the Canadian Cancer Society awarded 76 new grants across the country. Of the $36.2 million awarded, more than $5.6 million was earmarked for projects at the BC Cancer Agency. Congratulations to the following recipients:
Researcher: Angela Brooks-Wilson
Grant: $601,275 over five years
Project: Population-based genetics of non-Hodgkin lymphoma
Researcher: Dr. Mary McBridge
Grant: $2,975,000 over five years
Project: Childhood adolescent young adult cancer survivor research program
Researcher: Dr. Annette McWilliams
Grant: $347,185 over three years
Project: Detection of lung cancer using an electronic nose
Researcher: Dr. Donald Yapp
Grant: $378,000 over three years
Project: IrinophoreC – a nano-scale drug formulation that targets tumour vasculature
Researcher: Dr. Shoukat Dedhar
Grant: $682,500 over five years
Project: Cell-extracellular matrix interactions in differentiation and oncogenesis.
Researcher: Fumio Takei
Grant: $682,500 over five years
Project: Generation and regulation of natural killer cell diversity
Furthermore, Dr. Joseph Connors, Dr. Randy Gascoyne, Dr. Doug Horsman, and Dr. Marco Marra, were awarded a $6.2 million Terry Fox Foundation program project grant renewal over five years to continue and expand their research on genomic studies of B-cell lymphomas. The grant will continue the work that began in 2005, investigating the biology and genomic alterations present in the cells of follicular lymphoma.