Delivering High-Quality Cancer Care

Abstract

Patient-Centered Communication and Shared Decision Making T he committee's conceptual framework for a high-quality cancer care delivery system highlights the critical importance of engaged patients. Patients are at the center of the framework (see Figure S-2), which conveys the most important goal of a high-quality cancer care delivery system: meeting the needs of patients with cancer and their families. Such a system should support all patients and families in making informed health care decisions that are consistent with their needs, values, and preferences. This will require a delivery system and workforce oriented to the provision of patient-centered care, defined as "providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions" (IOM, 2001, p. 40). Patient-centered care includes fostering good communication between patients and their cancer care team; developing and disseminating evidence-based information to inform patients, caregivers, and the cancer care team about treatment options; and practicing shared decision making. Although patient-centered communication and shared decision making were not a major focus of the Institute of Medicine's (IOM's) Ensuring Quality Cancer Care report (IOM and NRC, 1999), several concepts from that report are relevant to the committee's recommendations on both topics: the importance of developing a cancer care plan; managing pain, other symptoms, and side effects; as well as the timely referral to hospice care at the end of life. Currently, patient-centered communication and shared decision making in oncology are suboptimal (

Tools to facilitate communication during physician‐patient consultations in cancer care: An overview of systematic reviews

“…1 Effective communication increases people's satisfaction, reduces distress, promotes faster recovery, and improves pain control, adherence to treatment, and quality of life. [1][2][3] Physicians also benefit from positive communication, as breakdowns in communication increase stress, decrease job satisfaction, and contribute to burnout. 3 Unfortunately, from 30% to 50% of people living with cancer in the United States report less than satisfactory communication with their care providers, 1 and a recent report by the National Institute of Medicine described cancer care as a "system in crisis," 2 citing communication issues as barriers to quality care.…”

“…CA: A Cancer Journal for Clinicians and promote optimal symptom management and support. 2,4,5 In recognition of these issues, the Institute of Medicine has developed a conceptual framework placing the person at the center of a supportive health care system, underpinned by shared decision making.…”

When Primary Care Providers (PCPs) Help Patients Choose Prostate Cancer Treatment

“…1 This was motivated, in part, by recognizing the growing number of cancer patients with complex medical needs. The role of PCPs in cancer care has typically been limited to screening, diagnosis, and, more recently, survivorship.…”

Let the Individuals Directly Concerned Decide: A Solution to Tragic Choices in Genetic Risk Information

“…However, one should also observe that many patients would like a greater share in the process of making decisions about their health [15] and that, in the near future, practicing physicians are likely to more frequently encounter patients wishing to discuss genetic test results [8]. The shared decision-making assumption is that the individual is empowered by choice, and more empowered when more choices are offered [16]. Being allowed to make decisions will enable people to control their lives and act as autonomous individuals, being able to define their own needs, rather than their needs being defined for them by others [17,18].…”