BC launches pilot program for colorectal cancer screening

The BC Cancer Agency launched a three-year, $3.8-million pilot colorectal cancer screening program to test the effectiveness of a new screening test in the early detection of colorectal cancer in Penticton this January.

Screening test kits will be available through a Colon Check hotline to individuals in Penticton who are between the ages of 50 to 74. Once the pilot is complete and results are analyzed, the province will examine the feasibility of expanding the program province-wide.

Family physicians will play a key role in encouraging eligible patients to participate.

Participants will be screened using an immunochemical fecal occult blood test [iFOBT], which is able to detect blood in the stool that is not visible to the naked eye. iFOBT is easily performed at home and, unlike other colorectal cancer screening tests, does not require any dietary restrictions. After using the test kit, patients will return it to a designated drop-off point.

All tests will be analyzed in the Provincial Health Services Authority’s Central Processing and Receiving Laboratory in Vancouver. Patients who test positive, as well as those individuals identified as having a higher than average risk of developing colorectal cancer, will be referred for follow-up.

Negotiations are currently underway to select a second community for participation in the BC Cancer Agency's Colon Check program, and it is anticipated that screening will begin in this location later in the year.

British Columbians with a high risk factor currently have access to colorectal cancer screening through their physicians' offices and this screening is paid for by the Medical Services Plan.

For a full copy of the press release, please visit: http://www.bccancer.bc.ca/ ABCCA/NewsCentre/2009/coloncheck.htm  

Advancing Strategic Direction #1
Sustain and advance the BC Cancer Agency's system of cancer control.

Accreditation 2009: Demonstrate Excellence

The BC Cancer Agency’s last formal Accreditation survey was held in 2005. Since that time Accreditation Canada’s process has changed significantly to include more input from staff, volunteers, patients and their families.

In the past, surveyors spent more time meeting with senior leadership and committees, and reviewing records and documents to ensure policies and standards are in place. This May 31 to June 4, six Canadian healthcare professionals will travel to the regional centres and will be on the front-lines asking questions and observing how we work, so staff need to be knowledgeable about the key standards and Required Organizational Practices and demonstrate how they are being employed.

“That doesn’t mean you need to know the answers to all the questions that are asked of you,” says Sue Fuller-Blamey, director of Quality & Safety, BC Cancer Agency, who is helping staff prepare for Accreditation. “But you need to know where you could go to get the answers, or who would be best person to respond, if you don’t know."

While it may sound intimidating to be approached by a surveyor, they are quite friendly. “They will engage staff in a conversation about their role and departmental practices to determine if we are compliant with the required quality and safety practices while they are touring through an area,” continues Sue. But rather than feeling anxious about the possibility of being singled out, Sue feels staff can use it as an opportunity to showcase our commitment to continuous quality improvement and patient safety.

Surveyors will also observe our processes. They may sit in a corner with patients and observe staff doing their jobs.

All of their findings will be recorded and presented in a final report to the Agency.

So, just what are surveyors looking for? Accreditation Canada is a governing body that certifies Canadian Hospitals and Agencies demonstrate a certain level of quality and safety standard. This year, surveyors will be focusing on the high risk areas of service delivery. Accreditation Canada has identified 28 standards which demonstrate a high level of patient safety. For the Agency, we have bundled these 28 standards into six key areas which are meaningful to the work we do.

Population Oncology (Sandra Broughton, Leader)
Deliver a population based cancer control program across the continuum of care, from prevention to end-of-life care.

Infection Prevention and Control (Fiona Bees, Leader)
Reduce the risk of site-acquired infections and their impact across the continuum of care/service.

Communication (Dr. Ivo Olivotto, Leader)
Improve the effectiveness and coordination of communication among care/service providers and recipients across the continuum.

Medication Management (Dr. Charles Blanke)
Ensure the safe use of high risk medications.

Culture of Safety (Anne Burgess, Leader)
Create a culture of safety through the BC Cancer Agency.

Work life/Workforce (John French, Leader)
Create a work life and physical environment that supports the safe delivery of care/service.

The expectation is that the BC Cancer Agency will receive Accreditation with no recommendations or conditions. If you have any questions about Accreditation, please ask your manager or leader, or contact Sue at Sue.fuller-blamey@bccancer.bc.ca

Take our  Accreditation Quiz and enter to win a gift certificate to Cactus Club Cafe! Click on link below:
http://www.surveymonkey.com/s.aspx?sm=DOP6Up0NxjfOxWU0XV9mXw_3d_3d  

Six interconnecting areas
There’s a lot of information for staff to digest. So, rather than overwhelm you by providing details on all of the six key Quality and Safety areas at once, the information will be staggered over the next few months.

Every few weeks your manager will be receiving information packages about each of the six areas, which they will review with you. The information will also be posted on the h drive at h:\EVERYONE\Accreditation 2009. The first two areas to be rolled out are Population Oncology and Work life/WorkForce.

However, each of the six areas are interdependent. “You can’t have good infection prevention and control, and a culture of safety, without having a well-trained workforce,” says John French, leader of the Work Life/Workforce area. “And, you can’t deliver a high-quality population oncology program without addressing the other five key areas.”

John’s team will be reviewing safety and education training across the Agency for staff to ensure Accreditation requirements are being met. In the upcoming months, programs will be implemented to ensure all nurses receive annual pump certification and general safety training and education are provided annually for all staff and volunteers.

Sandra Broughton, the team lead for the Population Oncology area, will review the components of how we deliver a population-based cancer control program across the continuum of care from prevention to end of life.

Population Oncology topics include:
• are community partnerships developed to ensure services are in place for patients when they return home?
• are operational agreements in place to ensure cancer patients receive the tests they require (if contracted with other hospitals)?
• are teams using an interdisciplinary approach and encouraging the development of new skills?
• are best practice guidelines employed?
• is information technology best used to meet current and future needs?

The Population Oncology area looks at whether we have a strong foundation as a cancer care organization, whether we’re engaged with the communities we serve, and if we continue to evolve and innovate as a result of new knowledge.

Watch for details about the other key areas in future issues. 

Advancing Strategic Direction #1
Sustain and advance the BC Cancer Agency's system of cancer control.

Interim President brings impressive Accreditation credentials to job

Accreditation is a major organizational focus over the coming months as you may have gleaned from the newsletter, and if you’ve attended one of the kick-off events held recently.

Supporting Agency staff as they prepare for this critical event in June is Brian Schmidt, the Agency’s interim President. Brian, a member of Accreditation Canada’s national advisory committee which revamped the standards in 2007, and himself a surveyor for 15 years, is looking forward to supporting the process and sharing his experience with staff.

“I hope I can provide some assurance by saying healthcare staff across the country prefer the new process more than the past one. Previously, the focus was on surveyors reviewing policies and standards and meeting managers and leaders, and they didn’t move around as much to talk to front-line staff about their work. The new process is far more interactive and relevant for staff,” says Brian.

Brian has conducted dozens of accreditation site visits over the years, and he says the BC Cancer Agency is seen as a national leader. “There are many cancer treatment organizations that provide excellent care, but the BC Cancer Agency was the first in Canada to demonstrate a comprehensive cancer control program, so it is the standard by which many others are compared. The excellent outcomes in B.C. continue to speak to the quality of work being done here.”

But, that’s not to say, the Agency can rest on its laurels, because there’s lots of work to be done before the Accreditation visit in June, he adds.

In addition to preparing for Accreditation, the Agency will benefit from Brian’s continuing executive role as senior vice-president for Provincial Services, Public and Population Health, at the PHSA. 

As a member of the PHSA Budget Committee, he will be able to offer up to date information on government funding plans, and also help the Agency move forward once budget decisions are made. “There’s no doubt this is a challenging year given the provincial economic climate and the looming election.”

He also understands the impact the economic climate is having on fundraising for research. As a BC Cancer Foundation board member until a permanent Agency president is selected, he is committed to working with the Agency and Foundation to support the important cancer research underway across the province.

Brian has been able to hit the ground running because he is no stranger to the BC Cancer Agency. Chief Operating Officer for the BC Cancer Agency from 1988 to 2002, Brian served with three Agency leaders: Drs. David Klaassen, Don Carlow and Simon Sutcliffe. He’s also continued to work with Agency staff in his role as PHSA senior vice-president, specifically to support the mammography and colorectal cancer screening programs for B.C.

“It’s been a real treat to get reacquainted with staff I knew from my earlier days, and it’s a testament to the Agency being such a wonderful place to work that there are so many familiar faces. It’s also been wonderful to meet new staff, and to learn out about their work.

But what’s it like being back on a daily basis? “It’s been a real treat to get reacquainted with staff I knew from my earlier days, and it’s a testament to the Agency being such a wonderful place to work that there are so many familiar faces. It’s also been wonderful to meet new staff and to learn out about their work.

“The Agency is a busier and more complex organization, than when I was here last. It has kept up with increasing patient demand, through the building of an additional regional cancer centre in Abbotsford, and significantly broadened the scope of its research activities, supported by the new research centre. The growth and development that has occurred since 2002 has been phenomenal. I really congratulate the staff of the BCCA for all they have done to continue the tradition of excellence in care and research.”

Editor’s note: Brian is a resident of West Vancouver, where he lives with wife Lauren (a social worker) and their two sons. 

Brian’s office is located on the 14th floor of the BC Cancer Agency’s Research Centre. He can be reached by e-mail at bschmidt@phsa.ca

Surgical oncology imPROVES scheduling of prostate brachytherapy procedures

Beginning this February, the Surgical Oncology’s Prostate Brachytherapy program is introducing changes fine-tuned during the most recent imPROVE workshop. The proposed changes promise about a 10 percent increase of efficiency within the existing resources.

“Prostate brachytherapy is a very successful procedure,” explains John French, director of Surgical Oncology, and co-lead of the team. “We anticipate patient demand will increase in the future. So it is critical that we maximize the resources available to us.” 

Since the end of last year, an 11-member team was put together to review the surgical prostate procedures. The team includes radiation oncologists, booking staff and PHSA facilitators.

“We wanted to develop a scheduling system that is more efficient and responsive to the actual time each physician takes to perform a procedure, rather than arbitrarily setting operating room time for each physician. By minimizing the time the OR sits empty, we hope to be able to add in one more procedure each week,” says John.

To achieve this, the team analyzed historical data and developed a new scheduling model based on the actual average time physicians took to perform the procedure. This new model projects a potential gain of 45 hours per year, which is about 30 cases. “Our goal is to maximize OR capacity by increasing efficiency, which translates into more operations and shorter wait time for patients,” says John.

“It is quite complex to change a process in one area, because it has spill-over effects into other areas, such as RT, OR booking, pre-anesthetic clinics, post-anesthetic recovery (PAR), and patient decision-making. We built a computer simulation model to assess PAR capacity. We also worked on optimizing the booking process to reduce paperwork,” John adds.

February 6 was the first day the new scheduling model was launched with great success. OR conducted five prostate brachytherapy procedures – one more than usual. The team will continue to monitor and evaluate the outcomes as implementation progresses to make further adjustments as required.

“Our commitment to imPROVE is long term. There are more than 18 procedures performed in OR. We are very optimistic that we can expand this model to other procedures as well,” says Richard Simson, team leader and facilitator.

Advancing Strategic Direction #4
Ensure we have the resources to achieve maximal organizational effectiveness.

Stop!: Have you completed our Accreditation Quiz? If you do, you could enter to win a gift certificate to Cactus Club Cafe! Click on link below:

http://www.surveymonkey.com/s.aspx?sm=DOP6Up0NxjfOxWU0XV9mXw_3d_3d  

Centre for the North: noteworthy milestones

Three qualified firms have been short listed to supply a request for proposal to design, build, finance and maintain the BC Cancer Agency’s Centre for the North. It’s a significant milestone towards providing cancer patients with care, closer to home. The three teams are Northern Gateway Health, Plenary Health, and Sequence Health.

Hal Collier, who was recently appointed chief project officer, Northern Cancer Control Strategy, is busy working with the Ministry, the BC Cancer Agency, PHSA, Partnerships BC and Northern Health to put the final touches on the request for proposal (RFP) document which will be distributed to the short-listed firms. It is the main reference document firms will use to create their proposed plans for the new centre.

“The RFP document has all the clinical, technical and financial specs on which the firms will provide their proposals for designing, building and upkeeping the new centre,” says Hal. “The detailed designs will include everything from where the vaults will be situated, to how open and garden areas are integrated for patients and families.”

Once the RFP is distributed, the three firms will have several months to put together their detailed plans. An evaluation committee with representatives from the Agency, the Ministry, PHSA, Northern Health and Partnerships BC will evaluate the proposals and make a recommendation for the successful proponent. Overseeing the entire process to ensure it is fair, open, transparent and conducted with integrity is a fairness advisor, ADR Chambers Inc.

The centre, to be completed in 2012, will be designed to achieve Leadership in Energy and Environmental Design (LEED) Gold certification. “The building will be designed to be as energy efficient as possible in order to reduce its carbon footprint on the local environment,” says Hal. “The proponents will be scored on how they use natural light, recycled, and energy-efficient materials. But, they’ll also be scored on how they integrate elements of the indigenous culture into the design of the building.”

In his new capacity, Hal will also be working in close partnership with Dr. Ronald Chapman, executive director, Northern Cancer Control Strategy, to oversee the development and implementation of a comprehensive cancer strategy for the North.

Dr. Chapman who has been shepherding the strategy in the North for the past 19 months has seen a “remarkable amount accomplished in a short period of time, thanks to the funding from government and the MOH and the collaboration between Northern Health and the BC Cancer Agency,” he says.

The proponents will be scored on how they use natural light, recycled, and energy-efficient materials. But, they’ll also be scored on how they integrate elements of the indigenous culture into the design of the building.

“A strategy has been developed – which includes improving prevention and access to screening, diagnostic, palliative, and support services – and we’re seeing the implementation of that in the community. This past November, the project leads for each component of the strategy presented their implementation plans to their colleagues."
 
“The implementation of the Northern Cancer Control Strategy will lead to the provision of quality services for patients and families closer to home,” says Ronald. “The building of the new cancer centre is a critical part of that strategy.”

Advancing Strategic Direction #3
Support regional centres, regions and communities with the implementation of provincial cancer control programs and the integration of knowledge.

Prostate brachytherapy study reports excellent results

The first long-term results from the largest prostate brachytherapy program in Canada were published on-line in the journal Urology, showing brachytherapy is a very effective treatment for early stage prostate cancer.

The population-based study tracks the disease outcomes of the first 1,006 consecutive patients treated through the BC Cancer Agency’s Prostate Brachytherapy Therapy Program since its inception in July 1998.

The study found that 95 percent of men in the cohort did not experience a biochemical recurrence – a rise in the blood level of PSA (prostate-specific antigen) after treatment with brachytherapy, which points to excellent outcomes. Men in the cohort also experienced extremely low rates of metastasis (spread of cancer) and death from cancer.

All patients in the cohort received follow-up care (initially at six weeks, then every six months for two to three years, and then annually), allowing the BC Cancer Agency to maintain a large database that includes information on patients and disease characteristics, toxicities and treatment outcomes.

“Our program is the largest in Canada. Over 2,400 men have been implanted so far. It’s very unusual to have such a large program involving so many physicians. Other cancer centres with excellent outcomes typically only have a few physicians performing brachytherapy,” explains Dr. Mira Keyes.

“With our population-based program, we have 13 radiation oncologists in five regional cancer centres using fixed criteria for patient selection, treatment planning and implantation. The results from the study speak to the strength and quality of the program.” 

Advancing Strategic Direction #2
Establish the knowledge generation and application model within the provincial cancer control platform.

Vancouver Island Centre pilots innovative survivorship program

On January 29, the BC Cancer Agency’s Vancouver Island Centre (VIC) launched a new pilot program, Cancer Transitions, to help cancer survivors cope with the challenges of post-treatment life. The VIC is one of just four sites, along with Prince George, Toronto and Montreal, to offer this survivorship program in Canada. This pan-Canadian pilot is funded by the Canadian Partnership Against Cancer – the Cancer Journey Action Group.

“Patients tell us they are very well supported by health professionals and their family and friends while undergoing treatment. But when treatment ends, many of them feel overwhelmed with new challenges and many feel as though they have been abandoned,” says Nancy Payeur, Regional Practice Leader, Patient and Family Counselling at the VIC. “They struggle with side effects of treatment, fear of recurrence, fatigue, and making sense of the recovery phase.”

“Undergoing six months of chemotherapy was difficult, but I felt a sense of reassurance from seeing my oncologist and other staff regularly,” says Janice McLean, a participant in the program, who was treated for colorectal cancer. “When I completed the treatment, all of these feelings started flooding in. With every ache, I was quick to suspect my body; I had so many questions; and I felt there was an expectation from some people in my life to be my ‘old self’ again, both physically and emotionally.”

The six-week program is offered to both men and women survivors. Participants will learn from different experts at each session about a variety of topics, including exercise techniques, strategies for managing stress, nutrition and managing health concerns.

“The pilot program reflects what survivors tell us will be helpful to them,” adds Nancy. “The program offers an opportunity for survivors to get professional support, but equally important, it allows them to learn from each other and to know they aren’t alone with their fears.”

Participants will be asked to complete a series of questionnaires to assess changes in their mental and physical health, physical activity, dietary habits and overall quality of life.

“We want to determine if the program has a significant impact on participants. The information gathered from this initiative will be used to make recommendations regarding future program development, including potentially offering the program in other regional cancer centres,” says Nancy.

Cancer Transitions was developed by the Wellness Community and the Lance Armstrong Foundation, and offered in 15 U.S. locations. Feedback from U.S. participants has been highly positive. 

Advancing Strategic Direction #2
Establish the knowledge generation and application model within the provincial cancer control system. 

Ruth Grantham: reflecting on 25-year career

After 25 years of supporting the Agency executive, including Dr. Simon Sutcliffe for the past 12 years, Ruth Grantham retired this month.

Dr. David Klaassen, former Vancouver Centre Executive Director, put it best, when he said, “During the past two decades, behind every successful leader at the Agency was Ruth.

“It’s a testament to Ruth’s adaptability that she has been able to support such disparate leaders.”

Staff gathered on February 5 at a special tea to celebrate the career of this unpretentious woman, whose infectious laughter and goodwill has been appreciated by all.

“Ruth is extremely loyal and committed to both the Agency and people who work here. Regardless of the task ahead, once she agreed to participate in a project, we just knew she'd always follow through,” says Barb McDermott, a retired colleague and friend who has worked with Ruth for 25 years.

“I’m sad to see her leave, but I’m also excited because I have another buddy I can do things with,” says Barb. “We can have a drink at lunch now and not worry about going back to work.”

For Sharon Kennedy, senior director for the BC Cancer Foundation, Ruth was a wonderful ambassador for the Agency. "She's always professional, but not stuffy; gracious to patients and donors, and always discreet. She always knew how important it was to represent the Agency at BCCF events."

It was a difficult decision to leave, says Ruth, but she took the recent spate of bad weather as an omen that it was time to call it quits. “It seems all the momentous events in my life correlate with bad weather. I was born during one of the worst winters in England. I got married during another momentous winter. And, we’ve just had one of the worst winters in Canadian history, so it seems appropriate that I leave on that note.” 

BC Cancer Foundation Update – a message from interim CEO Pat Jacobsen

As reported in the October issue of the Link, Pat Jacobsen assumed the role of interim CEO of the BC Cancer Foundation after serving for nearly six years as a volunteer on the Board of Directors. Once a new CEO is hired, Pat is looking forward to rejoining the Board.

BC Business Magazine interviewed Pat at the end of last year, as one of B.C.'s ‘leading lights’, asking her to reflect on 2008 and look forward to 2009.

Excerpts of the interview and the accompanying photo are reprinted here, with permission from BC Business Magazine.

What was 2008 “the year of”?
Heightened interest in targeting donations. There is no doubt that in 2008 more and more donors were interested in investing in specific areas of cancer research – either a tumour group or a part of the province where they wanted their dollars to stay.

What keeps you up at night?
Making sure that we have the CEO who can lead the Foundation to the next level.

If you could wave a magic wand, what would appear – or disappear – on January 1?
I’d make cancer disappear. I’d make my job disappear.

What’s your top goal for 2009?
Funding research that has the greatest impact on people’s lives. Focusing on cancers that affect the most people – lung, breast and colon – or those cancers that respond best to research.

In your world, what needs to happen to make 2009 a success?
We need to continue to raise significant funds in this province.

Contact the BC Cancer Foundation

Provincial Office:
604.877.6040
infobccf@bccancer.bc.ca  

Abbotsford:
Liz Harris
604.851.4736
lharris3@bccancer.bc.ca  

Fraser Valley:
Kate Ludlam
604.707.5900 ext. 4960
kludlam@bccancer.bc.ca  

Southern Interior:
Cynthia Waldek-Peters
250.712.3910
cwaldekpeters@bccancer.bc.ca  

Vancouver Island:
Laura Walsh
250.519.5554
lwalsh@bccancer.bc.ca  

Vancouver:
Sharon Kennedy
604.877.6040
skennedy@bccancer.bc.ca 

Advancing Strategic Direction #4
Ensure we have the resources to achieve maximal organizational effectiveness.

Newsmakers

First brachytherapy patient treated at the BC Cancer Agency’s Abbotsford Centre