hardin memorial health · • hardin memorial health is a member of both the research and...

Annual Report 2018

Hardin Memorial Health

Oncology Service Line

Hardin Memorial Health | Oncology Service Line 2018 Annual Report | Page: 1

TABLE OF CONTENTS:

Mission, Vision, Uniqueness 2

Comments from Cancer Committee Chair 3

Comments from Cancer Liaison Physician 4

Meet Our Cancer Care Providers 5

2017 Data 6 - 7

Multidisciplinary Breast Cancer Care 8 - 10

Multidisciplinary Lung Cancer Care 11 - 12

Clinical Trials 13

Supportive Care Clinic 14 - 15

Surviving Your Cancer Diagnosis 15

Survivorship Clinic 16

Psychosocial Services 16

Financial Counseling Services 17

Community Needs Assessment 18 - 20

Community Outreach 21 - 27

Hardin Memorial Health Oncology Service Line


HMH Cancer Program

Hardin Memorial Health is pleased to present its 2018 Cancer Program Annual Report This report outlines the activities of the Cancer Program and newly diagnosed analytic cancer cases for 2017 Analytic cases are those that were either diagnosed and/or treated at our facility

MissionTo exceed the physical, emotional and spiritual needs of our patients and their families by providing comprehensive, state-of-the art cancer treatments and therapies

VisionTo provide hope and healing as the premier community cancer center in Kentucky

Our UniquenessOur medical, surgical and radiation oncology specialists incorporate multidisciplinary treatments to provide advanced, cutting edge cancer expertise close to home

Through our affiliation with the University of Kentucky Markey Cancer Center, the only National Cancer Institute (NCI) designated cancer program in Kentucky, we offer patients access to clinical trials and advanced cancer care expertise

We are Commission on Cancer (CoC) accredited which recognizes our integrated continuum of care Our comprehensive resources include prevention and screening, genetic counseling, nurse navigation, social work, financial counseling, an onsite dedicated pharmacy, survivorship and palliative care

We value our caring relationships with our patients and families


Comments from Donald E. Goodin, M.D. Incoming Cancer Committee Chair

At Hardin Memorial Health (HMH), cancer care is top priority We have access to the most current treatment regimens available and supportive services through the continuum of care

The HMH cancer program is Commission on Cancer accredited demonstrating evidence-based high quality criteria for cancer care The HMH cancer team is in the process of obtaining American College of Radiology (ACR) Accreditation for Radiation Oncology and National Accreditation Program for Breast Centers (NAPBC) We believe quality programming is demonstrated through accreditation

The HMH cancer program provides patients access to multidisciplinary lung and breast clinics allowing physicians from multiple specialties an opportunity to discuss and coordinate complex cancer treatment in one visit In addition, our patients also have access to the UK Markey Cancer Center Affiliate Hospital and Research Networks which brings us access to clinical trials and other resources This affliation is a benefit to our 10-county service area providing high quality cancer care closer to home

Donald E. Goodin, M.D.


Richard Seither, M.D.

Comments from Richard Seither, M.D. Cancer Liaison Physician

At Hardin Memorial Health (HMH), the cancer committee drives program development and is responsible for the metrics supporting the mission of high quality cancer care The Cancer Liaison Physician (CLP) reports quality metrics and drills down on data measurements for further analysis The CLP has access to data through the National Cancer Data Base (NCDB), Cancer Patient Data Management System (CPDMS) and hospital Cancer Registry data housed in the Kentucky Cancer Registry

The NCDB provides access to cancer data and survival outcomes and compares our program with other cancer programs Accountability and quality improvement measures are reported to the cancer committee and action plans are developed when our metrics are outside of expected benchmarks

CPDMS provides cancer incidence and mortality data by disease site and counties/regions in Kentucky This comparative data supports programmatic development and planning

The Cancer Registry data provides a breakdown of diagnoses at HMH The detail is used to manage stage at diagnosis, where treatment is provided, etc , allowing analysis of programs to support patients in our service area


Kathryn Francescon, APRN-OCN, AANPSpecialty: Medical OncologyGraduate School: Spalding University, MSN

Cora Veza, M.D.Specialty: Hematology/OncologyMedical School: University of Santo Tomas, Manila, Philippines Practicing since 1985

Donald E. Goodin, M.D.Specialty: Hematology/OncologyBoard Certified in Internal Medicine/Medical Oncology/HematologyMedical School: University of KentuckyPracticing since 2004

Meet Our Cancer Care Providers

Chandler Park, M.D.Specialty: Hematology/OncologyBoard Certified in Internal Medicine/Medical Oncology/Hematology Medical School: University of LouisvillePracticing since 2016

Richard Seither, M.D.Specialty: Radiation Therapy Board Certified in Radiation Oncology Medical School: Louisiana State University Practicing since 1992

Stephen Toothaker, M.D.Specialty: Hematology/OncologyBoard Certified in Medical Oncology/HematologyMedical School: Dartmouth Practicing since 2008

Victoria Jones, APRN-OCN

Specialty: Medical OncologyGraduate School: Walden University

Kelly White, APRN-OCNSpecialty: Medical OncologyGraduate School: Spalding University, MSN


2017 Top 5 Diagnoses180

160

140

120

100

80

60

40

20

0

Lung Breast Prostate Colon Bladder 175 158 100 58 51

2017 Stage Breakdown: All Diagnoses

300

250

200

150

100

50

0

2017 Data

Stage 0 Stage 1 Stage 2 Stage 3 Stage 4 NA Unknown 72 289 164 122 167 69 12


2017 Case Diagnosis Location and Treatment

700

600

500

400

300

200

100

0

Diagnosed at HMH & Diagnosed & treated Diagnosed elsewhere treated elsewhere at HMH & treated at HMH 96 672 127

K E N T U C K Y

Hardin

Breckenridge

Grayson

Hart

Larue

MeadeBullitt

Nelson

Taylor

Green

AdairMedcalfeBarren

EdmonsonButler

Warren

Muhlenburg

OhioMcClean

Daviess

Hancock

Jefferson

Spencer

Shelby

Anderson

Washington

Marion

Casey

Pulaski

Lincoln

Boyle

Mercer

Woodford

Franklin

HarrisonPerry

SpencerWarrick

I N D I A N A

56

73

441

98

1312

9

67

69

21

Primary Secondary Tertiary

2017 Cases by Service Area


HMH provides statewide access to the Paxman® Cooling Cap

Hardin Memorial Health was the first

in Kentucky to offer the Paxman®

Scalp Cooling System, reducing the

likelihood of chemotherapy induced

alopecia (CIA) in cancer patients with

solid tumors The FDA has approved

expanded use of the cooling system

for ovarian, breast, colorectal, bowel

and prostate cancer patients

Since its inception in July 2017, we

have provided access to the Paxman®

Scalp Cooling System to 14 women

with breast cancer From the Hardin Memorial Health Foundation’s generous

support, 7 patients have received full or partial funding for use of the system

“When I first heard my diagnosis, I was flooded with painful memories of losing my hair when I was treated for cancer as a child Being able to have the opportunity to save my hair means more than you can ever know, and this is why I choose to come to HMH for my care I am just so thankful ”

Nancy Mazzoni, Lexington, Kentucky HMH Cancer Care Patient

Multidisciplinary Breast Cancer Care


National Accreditation Program for Breast Centers (NAPBC)

Hardin Memorial Health supports a breast center of

excellence methodology The multidisciplinary breast team

is dedicated to the improvement of quality outcomes for

patients with diseases of the breast through evidence-

based standards The Breast Program Leadership Committee

under the direction of Dr Karen Johnson Brunkhorst, Breast

Program Director, is in the process of applying for NAPBC

accreditation

We value the importance of:

• A multidisciplinary team approach to coordinate the best care and treatment options available

• Access to breast-specific information, education and support

• Breast center data collection on quality indicators for subspecialties involved in breast cancer diagnosis and treatment

• Ongoing monitoring and improvement of care

• Information about participation in clinical trials and new treatment options

“At HMH, we strive for high quality breast care and continuously benchmark our outcomes against national standards We want to achieve the highest quality standards available Patients will receive the same high quality care close to home ”

Dr. Johnson Brunkhorst

Breast Cancer Cases 2013 - 2017

200

150

100

50

0 2013 2014 2015 2016 2017 135 139 158 133 158

Karen Johnson Brunkhorst, M.D. General Surgery, Breast Program Director

Multidisciplinary Breast Cancer Care


Multidisciplinary Breast Cancer Care Team

Audrey Cleaver, MSN, OCN, RN Nurse Navigator

Jessica Clevenger, M.D. Pathology

Ashley Kerekes, M.D.Plastic & ReconstructiveSurgery

Laura Barkley, M.D.Radiology, Co-Medical Director Women’s Diagnostic Services

Chandler Park, M.D. Hematology/Oncology

Stephen Toothaker, M.D.Hematology/Oncology

Richard Seither, M.D.Radiation Therapy

Srikala, Ramasamy, M.D.Radiology, Co-Medical Director Women’s Diagnostic Services

Gwen Godfrey, D.O.Pathology

Karen Johnson Brunkhorst, M.D. General Surgery, Breast Program Director

Donald Goodin, M.D. Hematology/Oncology

Cora Veza, M.D.Hematology/Oncology


Multidisciplinary Lung Cancer Care

The HMH multidisciplinary lung program began in

November 2016 minimizing the number of patient

visits while providing comprehensive multidisciplinary

cancer care close to home Patients with lung nodules,

suspicious diagnostic findings or a newly diagnosed lung

cancer are seen in clinic on Tuesday afternoon following

a lung tumor board The multidisciplinary team is

featured on the next page

Since 2013, there has been a significant increase in the

number of lung cancer cases diagnosed and or treated

at HMH (see Exhibit A) In addition, since 2015, there

has been a significant increase in the number of stage

1 cancers diagnosed and or treated at HMH (see Exhibit

B) This increase is the result of a robust LDCT screening

program, nurse navigation and evidence-based high

quality care

Connie Barnes, Lung Nurse Navigator states, “The

biggest impact I bring to the weekly multidisciplinary

lung program is scheduling suspicious findings before

diagnosis We average two to five incidental findings

a week Not all cases seen are malignant; but a large

percent move forward for diagnosis and staging ”

Lung cancer nodule

EXHIBIT ALung Cancer Cases 2013 - 2017

200

150

100

50

0 2013 2014 2015 2016 2017 113 126 136 168 175

EXHIBIT BLung Cancer Stage 1 2015 - 2017

50

40

30

20

10

0 2015 2016 2017 27 33 48


Multidisciplinary Lung Cancer Care Team

Navin Kaini, M.D.Pulmonary/Critical Care

Kelli Mathew, D.O.Pulmonary/Critical Care

Aaron Mulhall, M.D. Pulmonary/Critical Care

Chandler Park, M.D. Hematology/Oncology

Jordan Miller, D.O.Cardiothoracic SurgeryUK HealthCare

Richard Seither, M.D.Radiation Therapy

Connie Barnes, MSN, OCN, RNNurse Navigator

Gwen Godfrey, D.O.Pathology

Ronald Wurth, M.D. Radiology

Jesse Bryant, M.D. Radiology

William Cundiff, D.O. Pulmonary/Critical Care

Jessica Clevenger, M.D. Pathology

Donald Goodin, M.D. Hematology/Oncology

Stewart Couch, M.D. Radiology

Cora Veza, M.D.Hematology/Oncology

Stephen Toothaker, M.D.Hematology/Oncology


HMH Clinical Trial ParticipationThe mission of the clinical research program is to reduce the impact of cancer by increasing awareness of new evidence, trends and practice standards It is our goal to increase the involvement of those in the community to participate in cancer research activities creating more opportunities for community based

research services

University of Kentucky Clinical Trial Opportunities• Hardin Memorial Health is a member of both the research and affilitate networks of the UK Markey

Cancer Center, the state’s only National Cancer Institute (NCI)-designated cancer center We offer patients access to national clinical trials and advanced cancer expertise HMH participates in the NCI‘s National Cancer Trails Network through the University of Kentucky

• The Molecular Tumor Board is a forum of expert clinicians and scientists that analyzes tumor genotypes and molecular abnormalities from next generation sequencing test results in order to recommend patient-specific targeted therapies The Molecular Tumor Board provides a gateway for Markey researchers to learn more about which genetic mutations cause certain cancers in patients throughout the Commonwealth Knowing which genetic mutations are found in Kentucky’s cancer population can help with developing or recruiting targeted clinical trials for patients Through the observational study conducted, Markey has been able to create a rich molecular database connected to the Kentucky Cancer Registry, providing researchers with a wealth of information for drug development as well as population-based studies

Clinical Trial Volumes

In 2017, clinical trial accrual exceeded accreditation requirements of 4% for a comprehensive community cancer program See the chart below Our goal was 36 clinical trial accruals

2017 Clinical Trial Accrual #

Kentucky Lung Education Awareness Detection and Survivorship (LEADS) 25

Optimization of Smoking Cessation Strategies (MOST) 3

NCI Trials 1

Referrals to other programs 10

Total 39

In addition, HMH participates in the National Radiology Data Registry (NRDR) dedicated for low dose CT screenings This is a second generation research project building on the ongoing screening of patients age 55-77 with a 30-pack year smoking history, who either currently smoke or quit within the past 15 years This rich data will be used to learn more about lung cancer Our participation in the NRDR during 2018 supports an increased clinical trial accrual of over 300 patients

Picture of Diane Drobny

Clinical Trial Accrual by Year 2015 - 2017

50

25

0

2105 2016 2017 16 21 39


Supportive Care Clinic

In December of 2017, HMH Cancer Care, in partnership with Hosparus of Louisville, implemented a provider

driven Supportive Care Clinic Dr Cory Lucas (Palliative/Hosparus Provider), DeAnna Werle (RN), and Kristina Kopp

(Oncology Social Worker), see patients every Friday

The purpose of the clinic is to discuss goals of care, symptom management, advanced care planning and

spiritual counseling for patients with late stage cancers Patients being treated with palliative intent in radiation

oncology and medical oncology are offered a referral to the Supportive Care Clinic The goal is to establish a

patient in the Supportive Care clinic early in the journey to support and complement the prescribed treatment

plan

Below is a graph of referrals to the Supportive Care Clinic through September 2018 In August 2018, a referral

notification was built in the medical record to support ease of referrals These efforts are increasing the

consistency of earlier patient referrals

January - September 2018 Supportive Care Referrals

12

8

4

0

JAN FEB MAR APR MAY JUN JUL AUG SEP 4 0 10 5 0 4 5 11 7

DeAnna Werle, RN, BSN, OCNSurvivorship Nurse Navigator

Cory Lucas, MDPalliative Care/Hosparus Provider

Kristina Kopp, MSW, CSW Oncology Social Worker


January - September 2018 Supportive Care Clinic

12

8

4

0

JAN FEB MAR APR MAY JUN JUL AUG SEP 4 -2 0-0 10-7 5-2 0-0 4-2 5-3 11-7 7-6

# of Patient Referrals # of Patients Seen

In the next graph, a comparison is shown between referrals and patients seen through September 2018 The

goal is to close the gap between referrals and patients seen through earlier referrals to the Supportive Care Clinic

Often patients are not referred until end of life when a Hosparus admission or death occurs prior to the visit

DeAnna Werle, RN, BSN, OCNSurvivorship Nurse Navigator 2015 - 2017 Survivorship Care Plan Distribution

400

300

200

100

0 2015 2016 2017 13 28 324

Plan

s G

iven

Surviving Your Cancer Diagnosis

At HMH, patients completing curative treatment receive a survivorship care plan

and treatment summary This information provides the patient with detail about

their treatment, information on follow up recommendations, and ongoing

screening

“As the survivorship nurse navigator, it is my responsibility to connect with

patients, providing a contact for ongoing support Patients appreciate the

personal conversation and often reach out afterwards with questions,” says

DeAnna Werle, Survivorship Nurse Navigator


Survivorship ClinicIn 2018, a Survivorship Clinic was established A nurse practitioner evaluates the

patient’s current versus pre-treatment status and develops strategies to improve

conditioning and healthy lifestyles (e g Physical Therapy, Nutrition, Alternative

Therapies), and assists in scheduling screening for other cancers Patients

are scheduled in the clinic after the last curative treatment appointment A

survivorship care plan is also presented at this time The next appointment is with

the physician for specific diagnosis follow up

HMH is excited to provide this best practice as a high-quality service for our

patients Kelly White, APRN Medical Oncology

Psychosocial ServicesTo address psychosocial issues experienced by patients with cancer, the HMH

Cancer Program performs distress screening for all new cancer patients, as

needed during treatment, and at survivorship appointments Our oncology social

worker, Kristina Kopp, assesses psychological, social, financial and behavioral

issues that may interfere with a patient’s treatment plan and adversely affect

treatment outcomes

Kristina meets with cancer patients in radiation oncology, the infusion center

and multidisciplinary clinics to address barriers to care that arise after the new

patient appointment “At the first appointment, my time is spent on emotions

dealing with the diagnosis Often, it is when

treatment is in process that barriers to care with

transportation and cost arise,” states Kristina

This year, the top interventions requiring

actions were emotional support, financial

assistance, transportation assistance, and

referrals to Friend for Life Through September

2018, 779 distress screenings have been

completed, and 663 interventions have been

initiated

Kristina Kopp, MSW, CSW Oncology Social Worker


Financial Counseling ServicesThe HMH Cancer Program offers all cancer patients access to financial counseling services The cost of

treatment can be prohibitive due to expensive co-pays and out-of-pocket expenses for services

Through a recent assessment of cancer patients in active treatment, most have limited income with

32% of our patients at or below poverty level Patients indicated cost of medication as the reason for not

refilling prescriptions and cost of treatment as a reason to not seek care in the future

Hanna Price provides financial counseling services at any time during a patient’s treatment Most patients

are identified at the new patient appointment by the oncology social worker through the distress

screening tool The oncology social worker refers the patient to Hanna to collect information to support

drug assistance, charitable options, and other services that support patient adherence to the prescribed

treatment regimen This team oriented approach to patient care closes the gap on missed appointments

and decisions not to go forward with treatment

In 2018, 19 applications were approved for co-pay assistance, 41 applications were approved for free

medication, and 101 Financial Assistance Program applications were completed

“The majority of my time is spent processing applications If there is a program available, I want to

make sure our patients are enrolled Often the thought of the financial obligation weighs as heavy as

the diagnosis The last thing I want to hear is a patient does not move forward with treatment or stops

treatment due to cost That’s where the oncology social worker and I step in, and work together to find a

program or solution to ensure our patients receive the care they deserve,” states Hanna

Hanna PriceOncology Financial Navigator


2018 Community Needs Assessment Update

Purpose:

To supplement information provided in the 2017 Community Needs Assessment (CNA) with

information available in the 2018 County Health Rankings Report, Kentucky 2017 Minority

Report, and articles in Oncology journals These sources provided more current data to

evaluate health outcomes, socio-economic factors and specific information on minority

health status pertinent in addressing healthcare disparities and barriers to cancer care for

patients in our service area

Health Risks – HMH Primary and Secondary Service Area

A review of County Health Rankings provided comparisons of health outcomes and factors

by county, state and US Health factors represent the following focus areas: health behaviors

(tobacco use, diet and exercise, alcohol & drug use, sexual activity), clinical care (access to

care, quality of care), social and economic factors (education, employment, income and

family/social support) and physical environment

The 2017 Kentucky Minority Health Status Report highlights the need of continued work to

close the gaps in health outcomes between between African Americans (AA) and Whites,

as well as disparities based on geography and physical or intellectual disability in order to

improve the health of all Kentuckians


Invasive Cancer Incidence and Mortality Rates in KY, by Race 2011-2015

INCIDENCE RATES MORTALITY RATES

Cancer Sites KY AA White KY AA White

All sites 521 1 512 2 520 6 200 3 214 0 199 8

Prostate 113 0 165 2 105 6 19 7 36 7 18 9

Breast 66 2 70 0 66 1 12 2 16 2 11 8

Lung & Bronchus 95 3 84 5 96 0 69 3 67 8 69 7

Colorectal 50 0 55 2 49 7 17 1 20 2 16 9

Source: KY Cancer Registry. Rates are per 100,000.

Transportation is often a barrier that is not identified until treatment starts There are

transportation resources in service area counties available to support rides to appointments

and therapies; however, there is a lack of knowledge of available resources and the cost is

outside the patient’s discretionary income to utilize these resources The average drive time

for oncology care in our service area is 30 to 45 minutes

To assess patients’ thoughts about transportation, financial and access to care barriers during

treatment, we administered a patient needs assessment from August 6 – 20, 2018

146 assessments were completed in medical and radiation oncology

From the patient needs assessment we learned:

• 32% have a household income at or below the poverty guideline

• 46% drive more than 26 miles round trip for their visit

• 63% are 65 or over

• 51% live outside Hardin County

• 75% have their own car to get to appointments

• 24% have access to someone else’s car to get to appointments

Since most of our patients have access to a car, our strategies will focus on consistent

processes to support transportation as needed:

• An algorithm and transportation calculator was developed to identify round trip costs – this provides a consistent approach to determining gas card support for our patients

• Expanded funding to support gas cards

• Develop tools to direct patients to ask for supportive services


Underserved Population – Current cancer statistics demonstrate the African American

population initial diagnosis is Stage 3 or higher 55% of the time In comparison, the

White population initial diagnosis is Stage 3 or higher 45% of the time

Health disparities emerge when some groups of people have more access to opportunities

and resources over their lifetime and across generations These differences are often a

result of policies and practices at many levels that create deep rooted barriers to good

health

Several studies point to race and ethnicity as a significant predictor for medication

underuse Patients are underusing their medication in order to prolong supply due to

cost This is attributed to lower incomes and higher out-of-pocket drug costs even when

insurance is present

When it comes to cancer survival, the United States is sharply divided by race According to

the Centers for Disease Control and Prevention, the cancer death rate for African American

patients is 25% higher than White paitents and are more likely to be diagnosed with cancer

at a later, more dangerous stage

From the patient needs assessment we learned:

• 13 of 146 or 9% of the responses were from the African American patients

• 4 of 13 indicated having a ride was a barrier to care

• 1 of 13 mentioned an appointment was missed because they were unable to travel

• 3 of 13 noted their drug prescriptions cost too much

• 4 of 13 preferred not to answer the income question

Our primary strategy to address the Hardin County underserved population access

to care and later stage diagnosis is to bring prevention and screening to community

settings through initiatives at Wednesday night services in African American churches and

expanded community health fairs/festivals


Community Outreach

Public Reporting Outcomes

Quality Study: Delay from Radiation Oncology Consult to Treatment

Dr Seither, Radiation Oncologist, asked that we study the timeliness from radiation consult

to start of treatment, stating his expectation was patients should start treatment within

7 – 10 calendars days of consult This expectation was in line with area radiation oncology

practices The perception was patients are taking more than 10 calendar days to start

treatment

March 2018 patients on treatment were reviewed for date of consult, date of simulation

(SIM), and date treatment began to determine the length of time for the total process and

each handoff The average number of days from date of consult to start of treatment

was 19 5

The table below exhibits the number of patients in the study, mean, median, range and

spread of data Breast, lung, rectum, brain and prostate patients represented over 70% of

the patients treated with radiation

PATIENTS N MEAN MEDIAN RANGE SPREAD

Consult to SIM 61 4 87 3 0 – 28 28 days

SIM to Start 61 14 67 15 2 – 28 26 days

Consult to Start 61 19 54 18 3 – 38 35 days

Three primary root causes were identified 1) Consult and SIM are often not performed

the same day due to age of our CT scanner, scheduling left sided breast cancer patients in

Radiology for required breath hold and 10 day wait time for improved swelling after fiducial

marker placement 2) Pre-authorization of insurance is delayed until plan adjustments are

completed – (1 to 5 day delay) 3) 30% of breast patients need to see a physical therapist

for arm mobility and/or site healing needing more time before scheduling a SIM

Three resolutions were implemented in June/July 2018 to impact timelines of consult to

treatment: 1) A new CT scanner was installed 2) Implemented Radformation Clear Check

software 3) Reduced wait times after fiducial placement


To verify the resolutions reduced delays from consult to start of treatment, September

2018 patients on treatment were reviewed There was a 4 5 day improvement from

consult to treatment

IMRT PATIENTS N MEAN MEDIAN RANGE SPREAD

CONSULT TO SIM 62 3.43 3 0 – 18 18 DAYS

SIM TO START 62 11.71 11 0 – 21 21 DAYS

CONSULT TO START 62 15.15 15.5 1 – 28 27 DAYS

To further improve timeliness in start of treatment, a scheduled hold for prostate patients

getting fiducial markers was implemented Periodic spot checks will be performed to

evaluate ongoing timeliness

PreventionIn 2018, our goal was to increase the number of service area residents reached for

FIT (Fecal Immunochemical Test) testing through business and industry clients and

underserved populations participating in health fairs, WOW van visits and/or church

events

From March through September, 134 FIT OC Light kits were distributed reaching 128

clients in 14 counties The American Cancer Society guidelines for screening protocol

were followed Various venues were utilized to reach our community: 9 health fairs, 1

church, 8 business/industry locations, and 1 school wellness family health fair

Partnering with Kentucky CancerLink, follow up by phone calls and letters were placed

to find the following:

• Results: 13 positive, 73 negative, 2 kits in progress, 38 noncompliant and 1 invalid kit with 7 no show/cancelled

• Colonoscopies from 13 positive results: 5 completed with clear results, 2 with polyps, 3 cancelled/no show, 2 in progress, and 1 noncompliant


From 2017 to 2018, we noted an increase in FIT kit distribution by 82% supporting effective

outreach

• The campaign expanded from 4 counties to 14 counties offering the kits during wellness coaching at business/industry worksites, with the addition of community festivals

• FIT kits were offered in conjunction with flu immunizations at business/industries in conjunction with ACS FLUFIT

• Kentucky CancerLink is an effective partnership for FIT Kit compliance and to ensure follow up procedures take place in a timely manner

We encountered several barriers reaching the underserved and African American populations

This impacted our effectiveness in successfully offering FIT kits to these populations

Overall, the initiative was successful in expanding targeted service areas However, it was not

as effective in reaching those populations with later stage cancer at initial diagnosis To be

more effective in 2019, we are exploring:

• Expanded distribution of FIT kits through flu immunizations

• Partnering with HMH African American cancer patients to be advocates in their communities/churches for prevention and screening


Other Prevention And Screening Initiatives

National Cervical Health Awareness Month January 2018

Understanding the important role of early detection of

cervical cancer, HMH provided wellness cancer coaching

to a local business/industry in which 121 women met the

screening guidelines and were encouraged to schedule their

appointment for PAP testing with their healthcare provider

National Colorectal Cancer Awareness MonthThe Incredible ColonMarch 24, 2018

Partnering with the Kentucky Cancer Program, HMH offered the community the

opportunity to explore the Incredible Colon, a 20 foot inflatable interactive medical

model to learn about colorectal cancer and the importance of early detection

screenings Registered nurses with HMH Cancer Care Center and Endoscopy services

were present to engage participants in a discussion regarding risk factors, prevention

tips and screening guidelines for colorectal cancer 436 community members visited the

display in the Towne Mall center court and completed a colon cancer screening survey


National Cancer Control MonthPurses, Pumps and Prevention: A Cancer Awareness Social April 26, 2018

Recognizing April is National Cancer Control Month, Hardin Memorial Health, in

conjunction with Hardin Memorial Health Foundation, held a community cancer

prevention awareness program featuring a fashion show, dinner and educational

program for participants to learn about breast, colorectal, cervical, skin and lung

cancer prevention Cancer prevention educational handouts were provided in

addition to local support and resources


Screening Programs

Skin Cancer Screening June 11, 2018

In recognition of National Skin Cancer Detection and Prevention Month, a free skin

cancer screening was provided: 62 community members were screened following the

American Academy of Dermatology (AAD) screening guidelines with the assistance of

two local dermatologists and two physician assistants Educational materials from the

American Academy of Dermatology and National Cancer Institute were distributed to

promote skin cancer prevention Demographics below:

Average Age: 44.8

Participants completed a screening evaluation noting: 86% of the participants stated

they regularly use sunscreen, 54% perform monthly self-preventive skin check

examinations and 67% indicated they will start checking their skin monthly for changes

Follow up phone calls were conducted by a registered nurse to the 20 referring

participants reaching 17 clients

18 44

20 referred for follow-up

(6 males and 14 females)

• 4 Rule Out Basal Cell Carcinoma

• 1 Melanoma

Social Media

Various venues of social media, including Facebook, Internet hmh net, and YouTube,

were implemented The goal was to help the regional community learn more about

cancer prevention, education and various cancer support group opportunities


Skin Cancer Prevention Education and Awareness:

Utilizing the EPA (Environmental Protection Agency) Sun Safety program “SunWise,”

we reached over 1,500 community members at community festivals from May-July

Sunscreen and education regarding UV radiation was shared and distributed through-

out our regional service area

Additionally, 122 community clients who visited the WOW mobile health unit during

regional visits were counseled regarding skin cancer prevention based upon their risk

factor 94 of the 122 received educational information and 8 clients received follow up

with 1 client making a skin cancer screening appointment with a dermatologist

Submitted by: Karen G Blaiklock, MS, RN Communications and Community Relations Director, HMHCommunity Outreach Coordinator, Cancer Committee


521 Robinbrooke BlvdElizabethtown, Kentucky 42701

www.hmh.net

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