Evaluation of Cancer Care Coordination in the National Cancer Institutes Community Cancer Center Programs

There is little evidence regarding the effect of multidisciplinary care (MDC) on health outcomes across various cancer sites, including colon, rectal, and lung cancer. The current study addresses this gap by providing preliminary data regarding the relationship between MDC and selected processes and outcomes of care in NCCCP pilot sites. The long-term goal of this preliminary study is to generate effect sizes, establish feasibility, and build infrastructure to support the development of a larger more definitive study of MDC outcomes. The key aim of this pilot study is to determine the relationship between specific MDC assessment areas identified by a pre-existing MDC assessment tool (http://ncccp .cancer.gov /NCCCPMDC- Matrix- Tool. pdf ): case planning, physician engagement, coordination of care, infrastructure, financial, clinical trials and medical records, and each of the following outcomes [0] and processes [P]: 1) time to receipt of initial therapy[P]; 2) receipt of multi-modality therapy[O]; 3) evaluation for enrollment in a clinical trial[P]; 4) patient experience[O]; 5) adherence to NCCN treatment guidelines[P]; and 6) all-cause survival[O]. The study focuses on adult patients with an incident diagnosis of Stage III colon cancer, Stage II or III rectal cancer, or Stage III non-small cell lung cancer.

We will quantify the relationship between MDC, various care processes and outcomes across 16 participating NCCCP sites, testing the hypothesis that increasing levels of MDC identified by the MDC tool are associated with improvement in care quality and a survival advantage.

Significant progress has been achieved in the past year establishing the necessary

processes for conducting the research study and the deliverables associated with the study. In terms of process outcomes, we can report the following:

1. Institutional Review Board approval for the multidisciplinary care study at all 16

   sites;

2. The development of a Standard Operating Procedures manual for use by the 16 sites;

3. The development of a data collection form (Site Data Collection Tool) to be used for

   collecting information that is not available via the pre-existing web-based data

   collection system that is in place at the 16 sites;

4. The development of a data collection form to be used for documenting the facility s

   annual scores using the Multidisciplinary Care Assessment tool.

5. The development of a flowchart for use in operationalizing the measurement of

   NCCN guideline adherence for patients with Stage III non small cell lung cancer;

6. The development of a Frequently Asked Questions document to assist with

   addressing questions in real time;

7. Multiple training sessions/webinars have been held for the participating sites.
8. Monthly conference call with the research team and representatives from all

participating sites.