How Did YOU Deal With Hurricane Sandy??

I'm sitting here early Tuesday morning in my bathrobe with poached eggs, English muffins with cherry-apple butter, and coffee with the fireplace burning brightly -- feeling like I made a great decision to stay home today and wait out Hurricane Sandy's  foul weather!  Despite dire warnings from PEPCO, I haven't lost electrical power  here in  Silver Spring, Maryland.

On the other hand, we just bought a waterside beach house in Delaware a few weeks ago.  I hope its still there.  What a time to decide to buy a beach house  :(

How did YOU deal with Hurricane Sandy?  Post your reply as a comment, below.

JC Leahy
October 30, 2012

The Milton J. Dance, Jr. Head and Neck Center's 15th Annual Conference on Head and Neck Rehabilitation

The Milton J. Dance, Jr. Head and Neck Center will hold its 15th Annual Conference on Head and Neck Rehabilitation on Friday, October 26, 2012, in Baltimore, Maryland

This one day program is designed to educate Head and Neck Surgeons, Otolaryngologists, Radiation and Medical Oncologists, General Dentists, Oral Maxillofacial Surgeons and Prosthodontists, Speech-Language Pathologists, Nurses, Social Workers, registered dietitians and other healthcare professionals and cancer survivors on head and neck cancer treatments and rehabilitation. Topics include research updates, new trends in the treatment of head and neck cancers, as well as early and late symptom management.

The venue will be the Milton J. Dance Head and Neck Rehabilitation Center, at The Johns Hopkins Voice Center at the Greater Baltimore Medical Center.

 BROCHURE

ONLINE REGISTRATION

How to Pick the Right Yoga Routine

If you are thinking of getting into yoga, here a link worth checking out:

How to Pick the Right Yoga Routine

JC Leahy

Cancer Care Navigation Training - Smith Center for Healing and the Arts

By JC Leahy

I'm excited that I have completed a training certificate in Cancer Patient Care Navigation with the Smith Center for Healing and the Arts in Washington, This year’s training program was limited to 20 trainees – a diverse group of physicians, nutrition experts, therapists, patient care advocates, nonprofit professionals, and nurses.  The training program was crafted to prepare attendees to guide cancer patients from screening through recovery.

By 2015, the American College of Surgeons will require EVERY cancer center to have a patient care navigation program as a condition of accreditation.

 

With a unique focus on integrative health and holistic wellness, Smith Center’s Patient Navigation model and training program have grown to attract participants from across the country. This year’s group of 20 participants joined together from New York, Illinois, Texas, Georgia, South Carolina, California, and as far away as Hawaii.  The program lasted for 5 days, with most days training lasting a solid 13 hours. During the training, highly-regarded experts in oncology care, psychosocial support, complementary therapies, cancer survivorship, palliative care, nutrition, and stress reduction offered information and tools to navigators in an immersive retreat setting. The retreat environment is modeled after Smith Center's Weeklong Cancer Retreat Program, which has been at the core of the organization’s work since 1996. The training is also made up of a unique blend of didactic and experiential sessions that provides a comprehensive yet deep learning experience in the practice of integrative cancer care navigation. 

Footnote: cool quote from the Smith Center's Laura Pole's nutrition education: "You can't eat dogma."  

Free!! Cancer Care Advocacy Forum, Washington, DC, October 24, 2012

Cancer Care Advocacy Forum

October 24, 2012

Embassy Suites Hotel @ the Chevy Chase Pavilion4300 Military Road, NWWashington, DC  20015

Community Oncology Alliance and Vital Options International, Inc., are hosting a Cancer Care Advocacy Forum, in Washington, DC on October 24, 2012. This will be the first in a series of forums bringing to light, not only the challenges faced by cancer patients undergoing care, but also potential solutions to those very roadblocks to high quality, affordable cancer care.
REGISTRATION:  To register for this event, CLICK HERE!

What is the Cancer Care Advocacy Forum(s)?

With over 80% of cancer patients being treated in the community/private practice setting, special attention must be paid to the care issues that confront this vast patient population. These individuals are often unaware of current advocacy and public policy initiatives that may affect them, positively or negatively.

As should be, there is a great deal of focus on finding and advocating for the “cure” for cancer. What often gets lost in the process is the importance of advocating for the “care,” especially as the nation’s health care delivery is under increasing economic pressure. Current and future cancer patients are faced with financial, treatment access, and related issues that often increase the burden of simply fighting the disease. The Cancer Care Advocacy Forum will focus on issues linked to cancer “care”   with an emphasis on the care that is received in the community and private practice setting.  The day will bring together national cancer-related advocacy organizations to learn more about the pressing issues and concerns that these cancer patients face, as well as their physicians and nurses, through their treatment process and survivorship journey.  

The goals for the Cancer Care Advocacy Forum are:

• Increase awareness of the issues surrounding community-based cancer “care” among the national cancer advocacy community, including disease-specific and general cancer advocacy groups
• Provide national cancer advocacy organizations with great exposure to the entire cancer care delivery team housed within community oncology practices nationwide.
• Educate attendees about community cancer “care” issues and advocacy
• Raise awareness of cancer care advocacy opportunities and possibilities amongst individuals being treated in the community setting
• Launch an ongoing dialogue by employing social media and other methods surrounding “Advocating for the Care”

Cancer “Care” Issues to be discussed:

• Advocating for the “care” in the context of the “cure”
• Implications of the changing landscape of cancer care for patients
• How health care reform (following the Supreme Court decision) will affect cancer care
• Exchanges, essential benefits design, and over-all cancer care
• Patient cost sharing and co-payment obligations
• New therapy advances on the horizon
• Oncology provider work force forecasts and the future of cancer care
• What’s ahead on the public policy horizon
• Drug shortages and impact on treatment
• Impact to state Medicaid beneficiaries

• When

• Wednesday, October 24, 2012
  9:00 AM - 5:00 PM

• Where

• Embassy Suites Hotel at the Chevy Chase Pavilion
  4300 Military Road NW
  Washington, District of Columbia 20015

Scouting the Smith Center Vicinity for Parking

By JC Leahy

Smith Center for Healing and the Arts Cancer Care Navigation Training Is This Week!!

The Smith Center for Healing and the Arts is holding an educational seminar that lasts from this Wednesday through Sunday: September 19 through 23.  The topic is cancer patient care navigation.  I'm planning to attend.  I went to their site today to scope out the parking situation.  At first inspection, parking looks abysmal, but (as with most things in Life) having information in advance should make all the difference.

The Smith Center is located at 1623 U Street, NW, Washington, DC  20009.  This is essentially the southeastern corner of 17th and U Streets. Across the street, the block is occupied by Fire Department and Police facilities.  To the the west on U Street, it is residential.  To the east are small shops and eateries.  There is street parking only.  It costs $2.00 per hour if you can find a metered spot on a weekday, which I doubt. 

It looks like motorcycles are customarily parked on the sidewalks in this neighborhood, if you can find a spot that doesn't block pedestrian flow.  I happen to have a motorcycle, which I hesitate to ride in DC city traffic.  I used Garmin Mapsource to plot a motorcycle route from my home in Colesville, Maryland to the Smith Center. As I approached the Smith Center, I would be coming south on 16th Street.  If I broke left on Florida Avenue, then left on 17th Street, I would come into the 17th and U intersection at the right angle to veer onto the wheelchair ramp of the southeast corner, onto the sidewalk and into a little alcove right at the door of the Smith Center.  That's one possibility.

Another possibility for me would be to park at the 17th Street Army and Navy Club.  That would give me valet service for my car at $16 per day.  I would have to walk 1.1 miles north the the Smith Center.  Mapquest.com says this would take 26 minutes.  That's another possibility. (I hate riding a motorcycle in the city.)

The next alternative is public parking.  These are the nearest public parking locations, in ascending order of distance:

1. Camden Roosevelt Parking Garage, 2101 16th Street, NW, Wash., DC  20009, tel 866-797-5410 0.20 mi. $15 per day. Garage locked at all times. To gain access, call 202-265-4612 and an attendant will let you in.
2. Colonial Parking #700, 1711 Fla. Ave., NW, Washington, DC  20009, tel 202-295-8100 0.28 mi. $13 per day. Monday through Thursday 6:30 am till midnight. Friday 6:30 am till 4 am. Saturday noon until 4 am.  Closed Sundays.
3. Star Parking, 1900 CT Avenue, NW, Washington, DC  20009, tel 202-387-0448 0.55 mi.
4. 14th Street LLC, 1736 14th Street, NW, Washington, DC  20009, tel 202-745-0185 0.57 mi.
5.  Las Parking Mid-Atlantic, Inc., 2001 S Street NW, Washington, DC 20009, tel 202-667-3030 0.63 mi
6. GPSI, 1914 14th Street, NW, Washington, DC  20009, tel 202-332-5406,  0.71 mi.

Another way to get to the Smith Center cancer care training would be by Metro.  In my case, I would probably park at the Red Line's Glenmont Station 5 miles from my home.  The nearest stations to 17th and U Streets NW are the U Street Station half a mile (5 blocks) to the east, or Dupont Circle 0.7 miles to the southwest of the Smith Center.  Metro has a pretty nice Metro Trip Planner for finding out how to get from point A to point B by Metro at any particular date at time.

Good luck!

CareNav1 Web Surf Report: Cancer Patient Navigation Toolkit by C-Change

This website was created by an organization called C-Change at 1776 Eye Street, NW, 9^th Floor, Washington, DC 20006 Tel. 202-756-1600, FAX 202-756-1512 . It gives an overview of the concept of and need for cancer care navigation, and offers some tools and advice about setting up a cancer care navigatioin prgoram.  Check it out by clicking here.

CareNav1 Surf Report: The Role of Patient Care Navigators in Eliminating Health Disparities

These authors have some other axe to grind than just how to perform patient care navigation.  It's an interesting read.  Check it out and let me know what you think.

CareNav1 Web Surf Report: Patient Care Navigation Literature Review

Paskett, Harrop, and Wells published a literature review focused on the developmental status of patient care navigation, especially cancer care navigation.  This article appeared in the July/August 2011 edition of CA Cancer Journal for Clinicians.  Click here. It's informative reading.

CareNav1 Web Surf Report: History and Principles of Patient Navigation

Harold Freeman and Ryan Rodriguez provide a 4-page overview of the history and development of cancer care navigation .

Informative and Funny CPR Educational Video -- 2010 AHA Guidelines

Check out this CPR/Basic Life Support for Health Care Providers training video.

CPR EDUCATIONAL VIDEO

CareNav1 Web Surf Report: American Cancer Society on What Causes Cancer

This American Cancer Society web page deals with the causes of cancer. Note the navigation tab on the right to read about specific types of cancers.

AMERICAN CANCER SOCIETY ON THE CAUSES OF CANCER

CareNav1 Web Surf Report: Basic Info About Cancer from the American Cancer Society

This American Cancer Society webpage provides a basic understanding of what cancer is, how it starts, how it spreads, and how common it is:

LEARN ABOUT CANCER - THE AMERICAN CANCER SOCIETY

JC Leahy

JC Leahy is a seasoned registered nurse currently managing a 4,000-patient-per-year outpatient otolaryngology (ENT) clinic in a major Washington, DC medical center.  He aspires to make a unique contribution to health care by combining his nursing experience with his business experience.  Mr. Leahy has degrees in Business Administration and advanced Accounting as well as Nursing.  He also has corporate and small-business experience in budgeting, financial planning, financial management, project management, proposal writing, and administrative management.   Mr. Leahy’s  16 years' nursing experience includes 10 years in intensive care. 

While managing his 4,000-patient-per-year, Mr. Leahy also served as Cancer Treatment Coordinator for the Otolaryngology (ENT) service at the medical center from Feb., 2009 through May, 2012.  Mr. Leahy’s results were so dramatic that the Medical Center made a public display about his work in its Inspiration Hallway section from August 2010 until early 2012.  By creating and managing a 7-element cancer care navigation system, he helped reduce the time from initial ENT consultation to the start of treatment from an average 100 days to less than 30 days.  This is important because cancer treatments are most effective when performed early.

Mr. Leahy designed the Plan of Care Exceptions Report (POC) as one element of this 7-element care navigation and management system. The Plan of Care Exception Report (POC) went live in May 2011. It’s purpose is to quickly identify patient non-compliance and similar deviations from cancer treatment plans.  For ENT cancer patients, the report identifies all missed appointment throughout medical center.  It also gives an indicator of why the appointment was missed – patient cancelled, clinic cancelled, no-show, etc.  It calculates a reliability factor to measure how often their appointments are kept, and it also lists when the patient was last seen In the ENT Clinic and when he is scheduled to be seen next.  Deceased patients can be included or excluded, or you can print a report for only deceased patients.  The medical center is now preparing to roll out the program to other services besides ENT and  other medical centers in the region.

The Plan of Care Exceptions Report was not developed in a vacuum.  In February, 2009, the ENT Chief was grappling with serious delays in the treatment of ENT cancer.   She tasked Mr. Leahy to expedite treatment of Head and Neck cancer patients.  In response to this assignment, he created a 7-element care navigation and management system.   It’s purpose is to track, coordinate, instigate, facilitate, and educate.  The graph below shows success in reducing the average time from initial ENT consult (or other “start” event) until commencement of treatment (or negative diagnosis).   This “days-to-begin-ENT-cancer-treatment” has fallen from 100 days at the beginning of 2009 to around 30 days  as of May 31, 2012.  The improvement from 100 days to less than 30 days was dramatic enough that the Medical Center displayed a poster and graph about it in the “Inspiration Hallway” public area for nearly a year and a half, until early this year.

JC Leahy's Seven Elements of Expediting Cancer Treatment Employed by John Leahy for Head and Neck Cancer, February 2009 – May, 2012.

ONE: Early identification of potential cancer patients by frequent review of new consults. Here’s an example of how this benefits veterans:  While reviewing consults in early June, 2012, Mr. Leahy realized that 2 consults sounded like probable head-and neck cancer, and they both had initial ENT Clinic appointments scheduled for June 27.  He phoned both veterans and changed their appointments to June 7.  On June 7, both came to clinic and both were bona-fide ENT cancer cases.  End result: By simply looking at their consults and acting early, Mr. Leahy advanced their cancer treatments by 20 days each before they had even seen an ENT physician!

TWO:  Setting aside a block of appointments every week specifically for patients who should not wait for a “next-available” appointment, but instead should be seen on an expedited basis.

THREE: Establishing an Excel-based work breakdown structure, or plan, for each cancer patient’s prospective diagnosis and care.  Each patient’s treatment is treated as an individual project to be managed and expedited.  Each patient’s WBS-sheet also serves as a place for memos about plans, problems, and face-sheet data.  This is where Mr. Leahy tracks  what is planned and what has happend for each patient.

FOUR: Maintenance of an Outlook based task list to make sure planned elements of cancer treatment do not fall through the cracks.  A perfect example this benefits veterans happened this week.    Mr. B had been diagnosed in September 2011 with buccal SCCA, easily cured if treated early.  Mr. B had had stubbornly refused to come to the hospital for treatment.  ENT physicians had declared that no further effort was needed because the patient had refused care.  But the Mr. Leahy made an entry onto his task list to try again later .  When the “try again” task came due, he crafted and mailed to Mr. B  a special letter designed to be opened,  read carefully, and not thrown in the trash without due consideration.  Two weeks later, Mr. B phoned Mr. Leahy.  Mr. Leahy outlined the long-term danger of the cancer and  encouraged Mr. B to talk about why he was refusing care.  He confided that he was afraid.  He and  Mr. Leahy talked together about fear.  At the end of the conversation, Mr. B accepted an appointment for June 12, and agreed to not miss that appointment no matter WHAT might happen.  On June 12, he came to clinic as promised -- even though he only had one leg and needed to take a taxi with his wheelchair.  His cancer was excised then-and-there in ENT Clinic.  Days-to-Treatment: 303 – which is why that third-quarter-2011 spike in the above graph represents an accomplishment, not a setback.

FIVE: Establishment of a calendar so that we can see important elements of what is happening with all ENT cancer patients on any particular day

SIX:  Identification of non-compliant patients and other deviations from the treatment-plan using the Plan of Care Exceptions Report

SEVEN: Establishment of a repeating list of cancer patients needing post-treatment or during-treatment follow-up, with frequencies that vary from q-month to q-year.  This ensures that post-treatment Clinic follow-up visits do not fall through the cracks.

*************

Expediting patient's medical care is only one aspect of care navigation.

 

Mr. Leahy lives in an old farmhouse in the Washington, DC suburbs.  He and his wife have four daughters.  He enjoys reading, hiking, photography, and trap shooting.