Cancer Quality & Innovation Program (CQI)

Ari Meguerditchian, MD CQI Program Lead

CQI Program and RCN strategic priorities

CQI is linked to strategic priority 5: research & education

Projects supported by CQI aim towards the achievement of all RCN strategic priorities

Funding mechanisms available

• RCN Research Fund

• Quality Improvement Initiatives Fund (QI2)

• “Investing in the Future” Skills Enhancement Fund

• Kuok Fellowship

• GOALS:

• Position McGill as a recognized leader in the field of cancer care quality by investing in scientific development

• Allow health professionals at the point of care to drive innovations pertaining to the science of quality and improve patient care directly

• Develop networks of collaborative research and care within the McGill oncology community

• Strengthen the culture of evidence-based planning and objective assessment based on validated metrics

• TARGET AUDIENCE: health care professionals involved in the delivery of cancer care within the network

• REVIEW PROCESS:

• External scientific review committee of nationally recognized leaders in the field of cancer health services research / planning

• assessment using a standardized, published grid

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Research Fund

• Requirements:

• unanswered question in the field of cancer care quality

• collaborative effort of at least 2 RCN-partner institutions

• cannot supplement / replace operating budgets or support clinical trials of investigational drugs.

• Contain a knowledge transfer component

• Documents: (on-line application)

• Proposal (5 pages)

• Budget (1 page)

• Lay term summary

• RCN perspective

• Next launch: spring 2017

Indexed in Canadian Common CV catalogue (spring 2016)

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Research Grant - overview

http://www.mcgill.ca/rcr-rcn/rcn-

grants/research-grants/instructions

External peer review – Assessment Grid

PRE-DX ACTIVE PHASE CHRONIC PHASE

NETWORKS OF COMMUNICATION

SUPPORTIVE CARE

SCREENING SURVIVORSHIP

Work up

Px-cation

Modalities

Risks

Target

populations

Response

assessment

Adverse

events

Treatment

optimization

Re-entry

challenges

Follow up

Managing

recurrence

TREATMENT

DELIVERY

TREATMENT

PLANNING DIAGNOSTIC

WORK UP

Symptom

control

End of

life

Research Grant – 2014

Project Investigator

Improving the Quality of Care to Kidney Cancer Patients

Undergoing Nephrectomy

Franck Bladou

Castration-Resistant Prostate Cancer: Evaluation of the Quality of

Care, Disease Management, and Associated Costs

Alice Dragomir

A Supportive Re-entry Program Tailored by and for Patients

Completing Cancer Treatment

Rosana Faria

Streamlining the Trajectory for Oesophago-gastric Patients with

Cancer

Lorenzo Ferri

Effect of Early Compression Therapy on Incidence of Lymphedema

in Gynecological Cancer Patients

Shirin Shallwani

and Anna Towers

Women’s Experience with Breast Cancer

Donna Stern

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Total investment: $536,629

Research Grant – 2015

Project Investigator

“Using multimodal prehabilitation to improve outcomes for frail

patients undergoing resection of colorectal cancer”

Franco Carli

Marching Ahead: Imaging Biomarkers, a new revolution in patient

management and care for Human Papilloma Virus (HPV) Positive

Oropharyngeal Cancer

Jeffrey

Chankowsky

“Ultra-low dose methadone as coadjuvant opioid therapy for cancer

pain”

Jordi Perez

Spectral dual energy CT and textural radiogenomic analysis for

optimal tumor delineation, patient staging, and biomarker for head

and neck squamous cell carcinoma”

Reza Forghani

Adherence to guidelines in the management of chronic myeloid

leukemia in Quebec

Sarit Assouline

Texture Imaging: A novel technique to guide treatment and improve

quality of life in patients with Non-Small Cell lung Carcinoma

(NSCLC)

Jana Taylor

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Total investment: $ 342,866

RCN Research Fund: allocations to date

• 2014: – 6 projects

– RCN investment: $ 536,629

– Leveraged for CIHR funding

• 2015: – 6 projects

– RCN investment: $ 342,866

– External matching investment: $ 24,000

• 2016: – 5 projects

– RCN investment: $ 437,173

– External matching investment: $40,000

• GOAL:

• Support quality improvement projects with a focus on the operational aspect of quality improvement, when there is an opportunity to directly impact quality of care.

• Achieve optimal care and service organization, at the highest quality and safety levels, in a manner that is seamless from the patients’ perspective.

• AVAILABLE RESOURCES:

• Project management

• Clerical / administrative support

• Cancer registry support

• Data analysis

• Up to $20,000/project

• Budget & resource management

• Definition of deliverables and timelines

• Identification of risks and mitigation

strategies

• Communication plan

• Project reporting to RCN leadership

• Project performance and quality

evaluation

• Scope management

Quality Improvement Initiatives (QI2)

www.mcgill.ca/rcr-rcn/rcn-grants/qi2-fund

Quality Improvement Initiatives (QI2)

• Proposal:

• Background: what is the problem you wish to address?

• Proposed intervention: what do you plan on doing?

• Rationale: how will your intervention address the problem and impact patient care across the RCN?

• Evaluation: how will you assess success of your intervention?

• Sustainability Plan: how will this be sustained once the project ends?

• Key elements:

• reinforce, strengthen excellence and improve access / quality

Targeted, interventions and not core program development

• Available to all RCN health professionals involved in cancer care delivery

• Must reflect a collaborative effort from at least 2 RCN-partner institutions

• Key resource: RCN project management support

• Systematic reporting and assessment of progress

QI2- Assessment Grid

Criteria Score

Quality of the proposal - The project targets cancer care quality improvement

- The project includes an objective assessment/evaluation component

- The project is innovative

4

Feasibility of the proposal - The project proposal is realistic within the proposed health care environment

and timeline

- The team composition covers all relevant skills

4

Impact/Relevance to RCN Goals and Objectives - The project improves an important aspect of cancer care delivery

- The project involves more than one site as proportionally equal partners

- The project results in the development of cross-site collaborative teams

- Experience or knowledge gained from the deployment of this project has the

potential for application at other partner hospitals or across other disease sites

8

Budget relevance - The proposed budget is realistic

4

Current QI2 projects

Projects Principal Applicant

Urgent Care Clinic: Feasibility study Erin Cook

Male Fertility Preservation Maria Belen Herrero

Adolescent & Young Adult Service planning

according to needs

Petr Kavan

Start The Talk: Parlons-en Andrea Laizner

Next Launch: winter 2017

• GOAL:

• Strategic investments in acquiring / increasing the know-how and specific skills within the RCN oncology workforce

• PRIORITIES:

• Moving from individual skill acquisition to group expertise development

• Larger groups of professionals for more impact and more equity of access to skills development / acquisition opportunities

• Current focus: oncology nursing personnel

• Future goal: Aiming for more meaningful impact by training health care professionals in leadership and management roles on quality interventions (IAC recommendation)

“Investing in the Future” Education Fund

• GOAL: Endowment to support graduate fellowships as part of the objectives

of the Rossy Cancer Network

• TARGET AUDIENCE: Trainees enrolled in gradate training at McGill

University and involved in cancer care quality-relevant research

• AMOUNT: $30,000 to $32,000 / year

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Kuok Fellowship

Current Kuok Fellow

• AWARDEE: Jonathan Di Tomasso, dietitian

• LAB: Cancer Nutrition Performance Laboratory (McGill & Concordia)

• PROJECT SUMMARY: examining the relationship between changes in nutritional status as measured by the abridged Patient General Subjective Global Assessment and changes in the quality of life of people with cancer

• OUTPUT:

– 3 posters

– 2 oral presentations

– 2 accepted manuscripts

– 2manuscripts submitted

• KEY FINDINGS:

• aPGSGA can detect differences in physical performance and QOL in adult patients

• Repeated measures of aPGSGA can predict shifts in nutritional status and QOL by patients before, during and after treatment

• aPGSGA can be used as a nutritional assessment tool in oncology to identify patients rapidly patients with malnutrition and optimize access to dietitians

• aPGSGA can be used to measure the effectiveness of their interventions

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Congratulations 2016 Research Grant Awardees

Quality of end-of-life of patients with prostate cancer Alice Dragomir

Project Investigator

Nunavimmi puvakkut kaggutimik aanniaqarniq -

qanuilirqitaa? (Lung cancer in Nunavik: how are we

doing?)

Faiz Ahmad Khan

The Breast Cancer Healthy Aging Program (BCHAP) -

Developing an e-Health Program to Increase Daily

Exercise and Reduce the Fatigue Associated with Breast

Cancer Therapy.

Steven Grover

Rectal toxicity prediction using accumulated-DVHs

determined from daily CBCT imaging for hypo-fractionated

radiotherapy of the prostate

John Kildea

Establishing Quality Care for patients with Malignant

Pleural Mesothelioma (EQUAL CARE MPM)

Jonathan Spicer

Thank you!

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