Leading the Way in Evidence Based Cancer Rehabilitation & Survivorship Care

Julie K. Silver, MD

Last year at this conference the STAR Program Advisory Team shared several goals to move the entire field of cancer rehabilitation forward. This lecture will review those goals and the tremendous progress STAR Programs have made. Several of the goals had to do with addressing the significant gap in care for survivors who would benefit from cancer rehabilitation services. This lecture will demonstrate how STAR Programs are improving access to cancer rehabilitation care by focusing on two key and highly effective strategies. The two key strategies and exciting results from these two initiatives will be presented. Other goals had to do with improving occupational therapy utilization and piloting new cancer prehabilitation protocols. The results of these initiatives will also be presented. Cancer rehabilitation is a dynamic and growing field in medicine, and STAR Programs are leading the way—learning about the evolving science and the translation of the evidence-base into clinical care. This lecture will also highlight key aspects of new research in evidence-based cancer rehabilitation with the goal of understanding how these services are incorporated into high-quality oncology care.

Delivering and Demonstrating Value Based Cancer Rehabilitation in a Dynamic Healthcare Environment

Lori McKitrick MA, MBA, CCC-SLP

There is no doubt that the healthcare environment is dynamic and requires constant adaptations from clinicians and administrators to provide value based care. STAR Programs are leading the way in valued based cancer rehabilitation care, and this lecture focuses on the specific characteristics that define the most successful programs in this dynamic environment. All healthcare facilities are charged with not only providing value based care but also demonstrating that value to patients, physicians, senior level administrators and payers. Therefore, this lecture takes a two prong approach with explaining how to deliver the value and then how to demonstrate to key stakeholders that the value was delivered.  Throughout the lecture there is a focus on patient-centered care and how to show value with not only increased referrals and improved patient function but also patient satisfaction.

Business Case Strategies for Oncology Rehabilitation

Sally Luehring, MSL, RHIA & Jarod Husmann, MA, PT, MSHA, FACHE

Hospital Sisters Health System which is a multi-institutional health care system comprised of 14 hospitals and an integrated physician network across Illinois and Wisconsin. In the Eastern Wisconsin Division, there are several strategic partnerships with One Family of Care that includes St. Vincent, St. Mary’s and St. Nicholas Hospitals as well as Prevea Health. As with many complicated hospital systems, initial attempts to develop and expand cancer rehabilitation services lacked cohesiveness and the care was fragmented. Leadership recognized the need to strategically develop high quality cancer care that included rehabilitation and opted to adopt the STAR Program in 2014. This presentation focuses on the overall strategy to differentiate their oncology service line, develop a business plan with short and long term components, establish a Steering Committee and write a Charter. Overcoming barriers from their initial efforts was an important objective and required educating the physicians, strategic marketing and the establishment of a new oncology rehabilitation navigator role.

Learning from Past Experience in Cancer Rehabilitation Service Line Development: 5 Key Barriers and Effective Strategies to Overcome Them

Amy DeRamus, BS, LPTA

Centra is a comprehensive, regional nonprofit healthcare system that consists of 4 community hospitals, a specialty hospital, a regional cancer center, 4 long term care facilities, and 38 regional outpatient locations.  Centra provides inpatient, outpatient, home health and hospice care in Central and Southwest Virginia. Centra also participates in Medicare’s Program of All-inclusive Care for the Elderly (PACE). Centra became STAR Program Certified in late 2009 and continues to focus on building a comprehensive cancer rehabilitation service line throughout its care continuum. This talk provides a look back at what Centra has accomplished in the past 5 years as a pioneer in the service line model of cancer rehabilitation delivery with an aim to help others to accomplish their goals more efficiently and effectively. Centra has been working on implementing dual screening and presented their initial data at the American Congress of Rehabilitation Medicine in Toronto in 2014. This lecture will focus on 5 key strategies used to facilitate multi-year growth and decrease the gap in care and 5 important barriers to overcome that will help other health systems with their cancer rehabilitation implementation across the care continuum.

Integration of Oncology and Rehabilitation Services Lines: Strategies to Establish Collaboration and Alignment

Vishwa S. Raj, MD

As the growth of oncological knowledge and clinical services continues to expand, a multidisciplinary approach is necessary to optimize medical care for cancer survivors. Understanding this need, the Commission on Cancer of the American College of Surgeons has placed significant emphasis on survivorship care plans to address the functional and cognitive needs of individuals throughout the trajectory of care.  This has provided a unique opportunity to integrate both oncology and rehabilitation service lines to a previously underserved population. Critical to integration however is the understanding of needs and values for each institution. The purpose of this presentation is to describe approaches for integration and alignment between oncology and rehabilitation service lines.

Building a Pulmonary Prehabilitation Program

Andrea McKee, MD

Lahey Hospital and Medical Center is a 317 bed hospital with more than 2600 new analytic cancer cases annually. Lahey established an active CT lung screening program in 2011 and became STAR Program certified in 2014.  The lung screening program screens an average of 60 high risk patients per week diagnosing one lung cancer every 2 weeks. Three quarters of the cases diagnosed through screening are stage I and treated primarily with definitive surgical resection. In 2014 the oncology and rehabilitation teams set out to develop a pulmonary prehabilitation pilot program offered to patients diagnosed with lung cancer through its CT lung screening program. The goals of the pilot study were threefold. 1) To develop a process for patient identification and tracking of patient outcomes through the program. 2) To identify barriers to implementation within the existing CT lung screening program. 3) To identify challenges to expansion of the program to the larger population of lung cancer cases diagnosed throughout the health system. This lecture focuses on the challenges associated with pulmonary prehabilitation program development and how integration with existing CT lung program infrastructure can help overcome existing barriers. The team worked in collaboration with its affiliates, Lahey Medical Center Peabody and Lahey Winchester Hospital to co-develop the pulmonary prehabilitation programs at multiple sites across the Lahey Health system.

Value Based Oncology Care and the Role of Cancer Rehabilitation in 2015 and Beyond

Diana K. Verrilli

This session will focus on the continued changes that are emerging as a result of the Affordable Care Act, the changing healthcare landscape and the implications for reimbursement.  The Affordable Care Act has led to substantial reductions in the uninsured rate and is driving changes in the delivery of and reimbursement for both oncology and rehabilitation services. This lecture will provide an up-to-date overview of these dynamics and explain how to navigate these changes—to improve service delivery and reimbursement.

How to Create Your Value Based Story Board

Diana K. Verrilli & Lori McKitrick MA, MBA, CCC-SLP

As hospitals and medical practices take on more risk and become increasingly accountable for the care they deliver, demonstrating value through clinical outcomes, patient satisfaction and reduced per capita cost is imperative. All healthcare professionals need to learn to the best ways to present value based care results to their leadership. When hospitals negotiate with payers, they often present a story board. Presenting information as a story board is a very effective method, and this lecture will teach participants how to do this. The story board generally includes narrative content, specific outcomes with graphs and charts and other key information. The concept of using a story board works really well for any presentation—whether it’s a lecture to colleagues, a presentation to the cancer committee or a surveyor, or demonstrating success to administrators. All healthcare professionals should be familiar with how to prepare a story board – it is the key to demonstrating value based care and your own professional value. This lecture describes how to create your value based story board.

Improving Quality of Life for Oncology Rehabilitation Inpatients

Maegan Caldrone, PT, C/NDT & Melissa Martin, PT

Desert Canyon Rehabilitation Hospital opened in Nevada in 2007 and was acquired by HealthSouth in 2010. As a new inpatient rehabilitation facility (IRF), HealthSouth Desert Canyon has overcome many challenges. This IRF has made cancer rehabilitation a strategic initiative since 2013 and became not only STAR Program Certified but also the first hospital in the United States to become accredited in oncology rehabilitation by The Joint Commission. They are currently concentrating on increasing access to care as well as improving functional outcomes in the cancer population. Initially, the team identified numerous barriers to care including community awareness, need for integrative services, variability of patients’ diagnoses and acuity, program logistics, palliative care transition and hospice care transition. This talk focuses on how the HealthSouth Desert Canyon team has identified barriers and developed specific strategies to overcome them—leading to improved quality of life for oncology patients.

Applying Rehabilitation Principles to Individuals Living with Head and Neck Cancer: The Importance of Therapeutic Intervention in Survivorship

Vishwa S. Raj, MD

As mortality rates continue to improve for individuals diagnosed with head and neck cancers, functional deficits have become a significant focus of survivorship care. Head and neck cancer accounts for 3% to 5% of all cancers within the United States. Over 280,000 individuals are currently living with oral cavity and pharyngeal cancer. Although morbidity associated with intervention has improved, survives are still left with significant anatomical changes that affect the oral cavity, larynx, pharynx, and surrounding structures. These changes result in physical impairments and many symptoms that cause decreased function and disability. Dysphagia is the most common consequence of treatment, but there are numerous other impairments that are a result of acute oncological interventions and may benefit from rehabilitation services. This presentation focuses on the diagnosis and treatment of head and neck cancer and highlights the need for rehabilitation interventions through case studies and new research.

High Quality Cancer Prehabilitation with Head and Neck Cancer Patients Prior to G-Tube Placement:  A Pilot Study

Kelly Berry, MPH, PT, Cert. MDT

St. John Health System is a fully-integrated healthcare system that encompasses eight hospitals in northeastern Oklahoma and southern Kansas: St. John Medical Center (Tulsa), St. John Owasso, St. John Broken Arrow, St. John Sapulpa, Jane Phillips Medical Center (Bartlesville), Pawhuska City Hospital, Sedan City Hospital and Nowata Hospital. St. John Health System is a non-profit Catholic healthcare system, and is sponsored by Ascension Health, the nation’s largest Catholic and nonprofit health system. St. John Medical Center in Tulsa, Oklahoma, received STAR Certification in June of 2013 and, in 2014, became the first and only certified member of MD Anderson Cancer Network in Oklahoma. The pilot study began as a joint effort between radiology, special procedures, dietary and speech therapy to provide comprehensive patient education prior to G-tube placement with the goal of promoting optimal function of tube, prolonged swallow function, and enhanced nutrition with reduced weight loss. The pilot started with a vision statement and utilized “change acceleration” strategies to get it fast-tracked. This presentation describes the pilot study and results and will highlight the initial strategy, barriers encountered, efforts to overcome these barriers, lessons learned and future strategic initiatives.

12 Key Strategies to Improve Clinical Communication and Competency

Laura D. Kenda, BA, BSN, RN, OCN

Lahey Hospital and Medical Center is a 317 bed hospital with more than 2600 new analytic cancer cases annually. Lahey became STAR Program certified in 2014 and recognized early on that communication, including developing clinical competencies with their nursing staff, across departments and diagnosis specific cancer programs would be critical to their success. This lecture focuses on the communication and clinical competency strategies that Lahey has utilized. The lecture has three components: staff communication, referral source communication and patient communication. This lecture will also demonstrate how developing communication and competency strategies supports two important objectives in STAR Programs—supporting nurse navigators and developing evidence-based multimodal and interdisciplinary prehabilitation services. One of Lahey’s STAR Program Coordinators, Laura Kenda, is a nurse who recently published an article on the STAR Program for Nurse.com. Her team is also working with SPARK (STAR Program Alliance Research Kickstart) to submit their lung cancer prehabilitation research.

Training Your Team to Have Difficult but Productive Conversations when the Prognosis is Poor

Rebecca Kirch, JD

Both oncology and rehabilitation professionals need to develop the necessary skills to conduct difficult conversations with patients and their loved ones. Although it is often assumed that clinicians who are empathic will simply find the right words to say at the right time, this is simply not true. Clinicians need to be trained to have difficult conversations with patients that may have a poor or uncertain prognosis. This type of training often begins at the administrative level with a needs assessment or the identification of a gap in clinical education. Patients, survivors and caregivers confronting cancer and its aftermath place strong value on personal choice, communication, and control as priorities of their care so they can survive and have the best quality of life possible. Integrating palliative care early in cancer treatment – including providing the person-centered communication that is its foundation – is essential to achieve these quality care and quality of life objectives.  But most oncology clinicians are not trained in the communication skills that are critical for helping cancer patients and their families make the right decisions for difficult care situations. This lack of training results in suffering that could be avoided and wasted resources.  From the pain and cost of unnecessary care to degraded relationships with patients and families to physician burnout and staff turnover, the price of poor communication is extraordinarily steep. This session will highlight key action steps and resources available for prioritizing and improving communication skills that will help your team to have difficult but productive conversations regardless of the prognosis.

Understanding and Demonstrating the Palliative Care Value Proposition

Rebecca Kirch, JD

Palliative care has increasingly become a topic of interest among practitioners, payers and policymakers. Research has demonstrated that providing early palliative care with cancer therapy helps mitigate the burden of disease and treatment regimens—thereby improving the quality of care while simultaneously improving the patient and family experience with care. Palliative care may also reduce per capita healthcare costs. Interest has intensified particularly in oncology with the emergence of palliative care practice guidance and standards from the Commission on Cancer, American Society of Clinical Oncology and National Comprehensive Cancer Network. This session will highlight the current state of palliative care and discuss specific strategies that institutions may take to develop better integration of these services in a value based model of care.

Rules of Engagement: The 10 Best Ways to Integrate Cancer Rehabilitation and Increase Referrals

Barry Brooks, MD

High-quality cancer care involves the integration of many service lines, and oncologists are dedicated to ensuring that their patients have the best possible care. Cancer rehabilitation is a critical component of this high-quality care, but there is a well-documented gap between the evidence-based need for cancer rehabilitation and the delivery of these services. There are numerous barriers to the delivery of rehabilitation care that must be overcome. This lecture focuses specifically on how to decrease the gap in care by improving integration with other services and engagement with oncologists. The talk will cover 10 key strategies that can be easily implemented in your cancer rehabilitation service line.

Screening for Physical Impairments: Fast Tracking Referrals and Access to Cancer Rehabilitation Care

Katie Narvarte, LMSW & Angela Brown, PT

Medical City Dallas Hospital is one of 15 hospitals that make up the Hospital Corporation of America’s  (HCA) North Texas Division. It is a 660 bed comprehensive healthcare system serving the Dallas-Fort Worth Area providing both inpatient and outpatient services.  Medical City offers breadth and depth of medical care in North Texas with its ability to treat 95 specialties within its facility including an annual cancer caseload of approximately 1500 survivors. Medical City Dallas is currently undergoing STAR Program Certification and has focused on the new implementation pilots that are required for certification. This talk describes how Medical City Dallas fast-tracked their cancer rehabilitation service line beginning with improving access to care through physical impairment screening.

Improving Access to Oncology Rehabilitation Care through Strategic Collaboration Across a Large Health System

Joan Jeanetta, MA, CCC/SLP

Essentia Health is a large, integrated health system serving patients in Minnesota, Wisconsin, North Dakota and Idaho. Essentia began fully integrating operations in the summer of 2010, by bringing together the resources of its member organizations – St. Mary’s/Duluth Clinic Health System, Innovis Health, Brainerd Lakes Health and the Essentia Institute of Rural Health. Essentia Health combines the strengths and talents of nearly 14,000 employees, including 1500 physicians and credentialed practitioners that encompass 17 hospitals, 66 clinics, eight long-term care facilities, two assisted living facilities, four independent living facilities and a research institute. The facilities are divided into three primary regions: Central, East and West.

Essentia Health received STAR Program certification in June 2013 through the collaborative efforts of their STAR leadership team and members, including representatives from each of its three regions. This presentation describes the implementation of a cancer rehabilitation service line across a large health system—identifying barriers and strategies to overcome them. Strategic planning and creative input from team members has been central to the early success of this service line. Essentia continues to expand the services and access to care and will share future challenges and initiatives. This lecture will also focus on how excellent cancer rehabilitation services have positively affected the communities Essentia serves, and how they are continuing their efforts beyond cancer rehabilitation to include prehabilitation and research initiatives that keep this health system on the cutting-edge of high-quality oncology care.

How to Pilot and Implement a Multidisciplinary Survivorship Clinic

Kathleen Y. Michie, MT, PT, CLT, Kerri S. Applegate, MPT & Shawna M. Street, BS

Poudre Valley Hospital is a 241 bed hospital that is part of University of Colorado Health System. UC Health has several member hospitals.  One is University of Colorado Hospital which provides clinical services for University of Colorado Cancer Center—an NCI designated cancer center. In anticipation of a new cancer center that opened in June 2014, Poudre Valley Hospital focused on a four phase rollout to implement cancer rehabilitation and prehabilitation as well as Commission on Cancer standard 3.2—treatment summaries and survivorship care plans. The first phase was to establish a pilot Multidisciplinary Survivorship Clinic, including a nurse practitioner, physical therapist, an oncology social worker, and a massage therapist. The pilot began in November 2013 and focused on the subset of survivors with various types of cancer who were treated with curative intent and had completed active therapy.  Phase 2 expanded this successful pilot regionally to our 2 other medical oncology treatment centers. Phase 3 will begin the STAR Program Prehab pilot and Phase 4 will expand the prehabilitation services. This lecture focuses on the strategy and implementation of survivorship care plans and rehabilitation/prehabilitation services through a four phase process utilizing pilot experience and data to improve the implementation process.

Safety in Cancer Rehabilitation: Exercise Prescriptions, Fracture Risk and Modalities

Nancy A. Hutchison, MD

Safety is an important concern in the rehabilitation of cancer patients—particularly vulnerable populations such as those with advanced cancer involving the bones. Other vulnerable populations include those who are frail, elderly and/or have co-morbidities. This lecture focuses on presenting cases that highlight how to appropriately prescribe therapeutic exercise and use physical modalities. The discussion will cover precautions in patients with bone metastasis as well as other vulnerable populations. Whether prescribing therapeutic exercise or physical modalities, safety is always a priority. Where there is a lack of evidence, the lecture will present best practices. Finally, this presentation will address myths that are not helpful but may be found on the internet or other venues that survivors access.

Implementing and Expanding High Quality Cancer Prehabilitation Services
Kathy Duval, MS, CCC-SLP & Messina Corder, BSN, MBA, RN
Mary Washington Healthcare is a fully integrated, regional medical system in Virginia that provides inpatient and outpatient care through Mary Washington Hospital, a 437-bed regional medical center, and Stafford Hospital, a 100-bed community hospital that became STAR Program Certified in 2013. In a short period of time, they have demonstrated excellence in cancer prehabilitation care by implementing STAR Program Prehab in their prostate, lung and breast cancer populations. Utilizing SPARK (STAR Program Alliance Research Kickstart), they have published abstracts and presented posters at the Academy of Oncology Nurse and Patient Navigators (2014) and the American Occupational Therapy Association (2015). They are continuing their research efforts and helping to advance the field of cancer prehabilitation. This lecture focuses on how the rehabilitation team collaborated with the nurse navigators and oncology surgeons to drive the implementation and expansion of these services in their institution. Using their lung cancer prehab program as a model, they will discuss the barriers they faced and how these were overcome. They will share key insights and share their outcomes with other STAR Programs to help them better implement their own prehabilitation services. This team’s efforts have been rewarded through internal system recognition with their system’s President’s Award. They have received regional recognition and were featured in the Fredericksburg Business Journal and B101.5 radio. National recognition includes being highlighted in major oncology publications including Value Based Cancer Care, Oncology Issues and The Oncology Nurse.

Identifying and Implementing the Most Important Strategies to Improve Cancer Rehabilitation Care in the next 12 Months

Julie K. Silver, MD

STAR Programs are leading the way in improving access to cancer rehabilitation care. This year the conference begins with revealing the results of the two key strategies that the STAR Program Advisory Team helped the programs implement to improve access to cancer rehabilitation care over the past 12 months. This is the final lecture for the conference and will unveil what the STAR Program Advisory Teams suggests focusing on over the next 12 months to have the biggest impact possible in improving access to and the delivery of high quality cancer rehabilitation care. The strategies are designed to improve patient functional outcomes, satisfaction with care and to increase revenue to hospitals and reduce costs to payers. In this dynamic healthcare environment, it is challenging to simultaneously provide better care at a lower cost, but there are opportunities to do this. This lecture explains how to identify the most important strategies for the coming year, the barriers that may be encountered and ways to overcome these barriers.

Managing Advanced Breast Cancer as a Chronic Illness: How Cancer Rehabilitation and Palliative Care Can Collaborate to Improve the Quality of Life

Barry Brooks, MD

The prognosis for women with advanced breast cancer has significantly improved over the past decade and is now handled as a chronic illness more like diabetes or heart disease. Living for years with metastatic breast cancer is often accompanied by significant physical, emotional and financial toxicity that can impair quality of life if not managed appropriately. This talk focuses on the recent advances in breast cancer treatment that have transformed metastatic breast cancer from a death sentence into a chronic illness and discusses how to decrease the impairments and disabilities caused by both the treatment and the disease that can allow women with advanced breast cancer to live full, rich lives. To achieve this goal, the talk will address how both palliative care and cancer rehabilitation teams can collaborate to improve symptoms and function in this setting.

Diagnosing and Treating Edema and Lymphedema: A Case Study Approach for All Clinicians

Nancy A. Hutchison, MD

The differential diagnoses of edema and lymphedema are important for all oncology clinicians, since edema is a common physical finding in cancer patients and treatment depends on the cause. Subtle signs and symptoms of lymphedema are crucial to early diagnosis and effective treatment. It is also important to recognize alternate or co-existing diagnoses such as medical edemas associated with chemotherapy, post-surgical and post-radiation soft tissue swelling, rotator cuff impingement, carpal tunnel syndrome, lumbar radiculopathy, venous thromboembolism, venous incompetence and so on. Treatment for lymphedema may be restricted by third party payer compensation and caps in therapy visits. This lecture presents an update in the diagnosis and treatment of cancer related edema and lymphedema through clinical case studies that highlight how to deliver high quality rehabilitation care in this population.

Strategies to Improve Access to Cancer Rehabilitation Services

Karen Martin, MA, CCC-SLP & Kimberly Willford, BSN, RN, OCN

ProMedica is an integrated healthcare system comprised of 13 hospitals with locations across northwest Ohio and southeast Michigan. ProMedica sees more than 3,100 new analytic cancer cases per year. The STAR Program began as a pilot at ProMedica Bixby Hospital in May 2013. Within a year, it rolled out across the system to rehab locations in Sylvania, Fostoria, Tecumseh, Adrian, Maumee, Bedford, Onstead, Perrysburg and Brooklyn. This presentation focuses on improving access to cancer rehabilitation care through strategic referral growth that includes dual screening. This is a case study from the ProMedica integrated healthcare system that has utilized multiple strategies to accomplish and increase in cancer rehabilitation referrals by approximately 200% from 2013 to 2014. The discussion will explain the specific strategies that worked best to support the significant improvement in access to cancer rehabilitation care.  The strategies included, but were not limited to, dual screening, physician education, imbedding clinicians in the cancer center, patient advocacy and optimizing occupational therapy utilization.

Oncology Rehabilitation Navigator Position: A Pilot Study

Megan Pfarr DPT, CLT

This lecture describes a pilot study that was designed to test an oncology rehabilitation navigator position at St. Vincent Regional Cancer Center which is part of One Family of Care. One Family of Care has partnerships with Prevea Health, St. Vincent, St. Mary’s and St. Nicholas Hospitals. St. Mary’s, St. Vincent and St. Nicholas Hospitals are affiliates of Hospital Sisters Health System which is a multi-institutional health care system comprised of 14 hospitals and an integrated physician network across Illinois and Wisconsin. There are many challenges associated with a implementing a decentralized cancer rehabilitation service line that includes three hospital cancer center locations and nine outpatient facilities. A pilot study was undertaken in an effort to determine whether an outpatient rehabilitation navigator position would be beneficial in a liaison role. The role and responsibilities of the oncology rehabilitation navigator were defined and included, but were not limited to providing assessments and recommendations for referrals to rehabilitation services. An important goal of the study was also to assess whether patient/family/clinician communication could be improved. This study was funded through a grant from American Cancer Society and the Wisconsin Cancer Coalition. This presentation describes the pilot study and results and will highlight the initial strategy, barriers encountered, efforts to overcome these barriers, lessons learned and future strategic initiatives.

Integrating Rehabilitation into the Cancer Center: A Systems Engineering Approach to Physical Space

Susan Stevens, MS, CCC-SLP & Brian Jindra

As STAR Programs expand their cancer rehabilitation service lines, many of them are integrating these services into the cancer center. Not surprisingly, a frequent question they ask is “How much space do we need in the cancer center?” Of course, the answer depends on numerous factors such as the number of new analytic oncology cases, layout of the physical space, additional rehabilitation space elsewhere, and so on. Utilizing a systems engineering approach, this talk demonstrates several examples of physical rehabilitation space in the cancer center and includes workflow, equipment needed and potential revenue generation.  St. Vincent Cancer and Wellness Center is located in Worcester, Massachusetts. It is an outpatient facility located across the street from St. Vincent Hospital, which is part of the Tenet Healthcare. The rehabilitation department in the cancer center is one of several examples that will be highlighted in this talk. The treatment space is less than 700 square feet and features unique treatment and gym areas as well as equipment to maximize patient flow and revenue while simultaneously providing a nurturing patient-centered care experience.

The Right Place and Right Time: Delivering High Quality Cancer Rehabilitation Throughout the Care Continuum

Charles H. Nash, MD, F.A.C.P, Kim Snider, PT, CLT, Heather Wilsey DPT, PT, NCS, cert. SMT, cert. DN, BIG Clinician & Greg Higginbotham, DPT, PT, COS-C

Northeast Georgia Health System (NGHS) is a not-for-profit, community health system that provides inpatient and outpatient care through two hospitals – Northeast Georgia Medical Center (NGMC) Gainesville and NGMC Braselton – and multiple satellite offices. NGHS has a total of 657 inpatient beds (including 24 inpatient rehab unit beds), and an additional 261 skilled nursing facility beds.  Palliative care and hospice services are also available within the health system.  Rehabilitation services are offered in all settings, including six outpatient locations. NGMC became Georgia’s first STAR Program certified hospital in July of 2012 with a team predominantly focused on outpatient care of the cancer survivor. Over the next 2 years, the clinical resources grew to provide the capacity to focus on inpatient care as well. Despite the growth, barriers were identified to access and continuity of care. For example, there weren’t any home care agencies serving the NGMC area that had any special training related to rehabilitation of the cancer patient.  One homecare agency expressed an interest in the STAR Program certification.  Guardian Home Care located in Gainesville Georgia is an Accentcare Company that provides skilled services to patients in their homes.  NGMC has collaborated with this home care company to provide oncology rehabilitation to patients in their homes.  This talk focuses on the gap in the care continuum that identified the need for home care services and the collaborative efforts of NGMC and Guardian Home Care to provide this care.