Hux Cancer Center2018 ANNUAL REPORT

Union Hospital has been accredited by the Commission on Cancer of the American College of Surgeons for over 40 years. This accreditation serves to document the excellence of the Cancer Program at Union Hospital. Accreditation is a voluntary commitment by the Cancer Program and the Hospital that ensures our patients will have access to the full scope of services needed to diagnose, treat, rehabilitate and support patients with cancer and their families. Accredited programs complete critical self-assessment programs that lead to quality improvement and innovations in patient care.

We take great pride in everything we do and strive to provide the highest quality and most efficient cancer care in the community to our patients. People through Terre Haute and the Wabash Valley area can trust us to detect and treat cancer with skill and heart. We maintain an attitude of optimism and encouragement and foster hope in our patients and families as an important part of treatment.

We at Union Hospital are the premier provider of cancer care, clinical research and community education in the Wabash Valley. We bring together all of the community medical staff to accomplish our goal of providing total patient centered care.

Sue Jarvis, RN, BSNDirector Oncology Service LineUnion Hospital

Union Hospital Cancer ProgramAt Union Hospital, we take cancer personally.

Our mission is to serve our patients with compassionate healthcare of the highest quality.

Providing exceptional healthcare and service while leading Wabash Valley communities to their best health and wellness.

Patient FocusedIntegrityStewardshipTransparencyCollaboration

Mission, Vision, Values Map of Service Area

Cancer ConferencesGeneral Tumor ConferencesUnion Hospital’s general tumor conferences are presented eight times per year. A multidisciplinary approach brings together medical oncology, radiation oncology, surgeons, radiologists, pathologists, nurses, patient navigators and other specialists. During the conferences, medical professionals discuss treatment options for all types of cancer cases and review available clinical trials.

Breast Tumor ConferencesDedicated specifically to newly diagnosed breast cancer cases, our breast tumor conferences are led by Clara Fairbanks Center for Women, presented bi-weekly on Tuesday mornings. As with our general tumor conferences, our breast tumor conferences boast a multidisciplinary approach featuring medical oncology, radiation oncology, surgeons, radiologists, pathologists, nurses patient navigators and other specialists to discuss the best coarse of treatment for various cases based on best practices and evidence-based guidelines.

Thoracic Tumor ConferenceDedicated specifically to newly diagnosed lung cancer cases, our thoracic tumor conferences are presented weekly on Wednesday mornings. As with our breast and general tumor conferences, our thoracic conference takes a multidisciplinary approach to discuss the clinical pathways and best treatment options for the various cases based on national guidelines and best practices. The multidisciplinary team consists of medical oncology, radiation oncology, pathologist, radiology, pulmonologist, thoracic surgeon, navigators and other specialists.

Accountability Measures 4.4

• Radiation therapy is administered within 1 year (365 days) of diagnosis for women under the age of 70 receiving breast conservation surgery for breast cancer.

Comparison Performance Rate # Cases # Facilities

Union Hospital 97.4% 39 1

All CoC Performance Programs 93.4% 52,600 1315

• Tamoxifen or third generation aromatase inhibitor is considered or administered within 1 year (365 days) of diagnosis for women with AJCC T1c or stage IB-III hormone receptor positive breast cancer.

Comparison Performance Rate # Cases # Facilities

Union Hospital 96.2% 52 1

All CoC Performance Programs 92.9% 74,463 1315

• Radiation therapy is recommended or administered following any mastectomy within 1 year (365 days) of diagnosis of breast cancer for women with >= 4 positive regional lymph nodes.

Comparison Performance Rate # Cases # Facilities

Union Hospital 100% 6 1

All CoC Performance Programs 90.2% 7547 1315

CP3R Accountability Measures - Performance Rates - 2016 Data

Support ServicesS.P.O.H.N.C.Support for People with Oral, Head and Neck CancerSPOHNC is a patient-directed support group dedicated to meeting the needs of people who have been diagnosed with oral, head and neck cancer.SPOHNC offers:• monthly meetings• information on recovery and treatments• encouragement and support• friendly forum

Patient NavigatorThe Patient Navigator helps breast cancer patients and their families find and make use of various resources, treatment services and support services that they need to receive the best cancer treatment possible.Services provided by patient navigators vary by the needs of the patient, but often include:• facilitating communication among patients, family members & health care providers• coordinating care among providers• finding financial support and assisting with paperwork• scheduling transportation and child care• facilitating follow-up appointments• ensuring availability of medical records at appointments

Chaplain’s Program The Chaplain’s Program provides professional chaplaincy services for the spiritual and emotional needs of patients and their families.Spiritual assistance and support services available:• pastoral counseling• grief support• memorial services• celebration of life services• healing services• Camp Bluebird assistance• Faith Journey Group• Reflection Garden

Massage TherapyAt Union Health, we believe in caring for the health and well-being of the person, not just the symptoms of disease. Massage is a complimentary therapy available for Hux Cancer Center patients that, when used together with your medical treatment, helps to treat the whole person.Massage benefits for cancer patients may include:Improvements in:• sleep• quality of life• mental clarity and alertness• the range of movementReduction of:• pain• fatigue• nausea• anxiety and depression

Help for Healing WoundsFor some people with soft tissue injuries resulting from radiation, hyperbaric oxygen therapy can help. This therapy technique aids in recovery by increasing the amount of oxygen within the tissues.Depending on the location of the previous radiation therapy, symptoms of soft tissue radiation include:• presence of blood in urine• rectal bleeding• vaginal discharge• pain

Genetic TestingGenetic Testing uses laboratory methods to examine your DNA, the chemical database that carries instructions for your body’s functions. It can reveal changes or alterations in your genes that may cause illness or disease.Eligible individuals and/or families may have:• cancer diagnosed at an early age• multiple close biological relatives with cancer• biological relatives in two or more generations with cancer• more that one primary cancer• family members who have developed a rare or unusual cancer or combination of cancers.

Cancer Rehabilitation TherapyCancer Rehabilitation Therapy is for people who have undergone treatment for cancer. Our therapists work closely with your physicians by actively consulting and collaborating with them during the duration of your care.Cancer Rehabilitation Therapy provides several benefits, including:• improved quality of life• reduced fatigue and increased energy levels• increased strength and endurance• enhanced self-image and sense of control• strengthened immune system• increased bone strength

Union Hospital Cancer Committee2018

Scott Ackley, MDRadiation OncologyCancer Liaison Physician

Megan Adcock, MSWSocial Worker-Palliative Care

Cathy Atterson, RN, CNBNBreast Navigator

Kathy Bannon, RN, BSN, OCNOncology Patient Navigator

John Bolinger, MDVP of Medical Affairs CMO

Todd Carpenter, PsyDPsychosocial ServicesPsychosocial Coordinator

Dan Cleveland, PharmDManager of Pharmacy Services

Jill Dugan-Miller, MHSAMarketing and Public RelationsCommunity Outreach Coordinator

Megan Finch, RN, MHA, DNP, RN-BCDirector of Medical/Clinical Education

Polly Fullom, RN, MSN, OCNOncology Clinical Educator

Rafael Gallardo, MDMedical Oncologist

Raya Gowda, MDPulmonologist

Robert Haerr, MDRadiation OncologistCancer Committee ChairpersonCancer Conference Coordinator

Sang Huh, MDMedical Oncologist

Sue Jarvis, RN, BSNOncology Service Line DirectorProgram Administer

Betty Jeffers, RHIT, CTRCancer Registry

Guresh Kunapareddy, MDMedical Oncologist

Suresh Kunapareddy, MDMedical Oncologist

Christopher Lueking, MDGeneral Surgeon

Vanni Manyam, MDMedical Oncologist

Jenny Meyer, RN, BSNManager of Medical Oncology

Tom Nascimbene, RTTRadiation Oncology

Andrea Overpeck, CMACancer Registry

Trudy Rupska, RN, VP/COOHospice and VNA/Palliative Care

Barb Sinclair, RN, BSN, CCMCase Management

Tamidor Singh, DOAnesthesiologist

George Spencer, MDRadiologist

Stephanie Strohl, RNQuality ManagementQuality Improvement Coordinator

Karen Tisinai, MDGeneral Surgeon

Kimberly Villain, RN, OCNClinical TrialsClinical Trials Coordinator

Leslie Voils, RT (R) (M)Manager of Clara Fairbanks

Relay for Life and Race for the Cure

Cancer Committee Report

It has been said that it takes a village to raise a child but it also takes a whole village of active participants to take care of patients with cancer. Cancer treatment today involves a wide array of medical specialists including family doctors, radiologists and pathologist to diagnose cancer; surgeons, medical oncologists, and radiation oncologists to actively treat the tumor; psychologists, physical therapists, Chaplains, nurses and a host of support personnel like tumor registrars, hospice nurses, the palliative care team, nurse navigators, research specialists and geneticists to support the patient and their treating physicians. The goal of the Union Hospital Cancer Committee is trying to get all of these diverse individuals working together to care for our patients. What does the Cancer Committee do to ensure our patients get top notch care? We begin with trying to prevent cancer by participating in screenings and health fairs. This requires folks not only to do the screenings and instruct lay people but the hospital public relations staff helps get the word out for the screenings and health fairs. The Cancer Committee reviews pathology reports to confirm correct reporting of cancer diagnoses and Dr. Jora, head of pathology, reviews the pathology reports to confirm that the correct biopsy and analyzation has been done. The Committee works with the surgeons and oncologists to keep abreast of new treatments and procedures. Our oncologists have a variety of clinical trials available to our patients who want or are a candidate for these cutting edge trials. The Committee has Dr. Carpenter available to give input on psychological assistance for patients. Tara Naylor is available to help guide recommendations for improvements in physical therapy for cancer patients. Trudy Rupska from Hospice of the Wabash Valley attends all of the meetings to offer advice on palliative care. The Committee has a pharmacist, inpatient and outpatient nurse managers, and at least once a year the American Cancer Society representative from Indianapolis to give valuable advice on how to improve support services. The tumor registrars actively catalogue patient treatment and response data and four times per year Dr. Scott Ackley, the American College of Surgeons liaison, reviews our treatment results and compares them with national results. His studies confirm that we are doing as well as or better than other hospitals in our area and nationally. A member of the hospital administrative staff is available on the Committee so that recommendations from the Committee can be put into action. For example, we are working with Mr. Jack Hill and Indiana State University representatives to hire a full-

time genetics counselor and have them working here on the Union Hospital campus. The Committee works with the Oncology nurse navigator, Mrs. Kathy Bannon, to ensure that survivorship care plans are available for all patients with curable cancer so they can better participate in their follow-up care. The Committee has weekly tumor conferences to facilitate discussion of cancer cases and implementation of treatment plans for individual patient care. With the help of the American Cancer Society, we are updating the Cancer Center library. The Cancer Committee has projects underway to help integrate the Radiation Oncology computer system with the hospital computer network and projects to improve and monitor the use of expensive drugs like Erythropoietin and expensive tests like PET scans. In summary, the Cancer Committee is involved in all aspects of cancer care at Union Hospital trying to ensure that the entire hospital is on the same page to provide the best care that we can for cancer patients. The American College of Surgeons established the commission on cancer in 1922 to ensure quality, multi-disciplinary and comprehensive cancer delivery in health care settings. They assist the Cancer Committee by providing guidelines to accomplish the goals that the Cancer Committee develops and to provide a framework to ensure that the Committee covers all of the appropriate areas of care that our patients require. By working with the commission on cancer through the Cancer Committee, I believe that the hospital has demonstrated its commitment to provide the best cancer care that we can for all of the residents of the Wabash Valley. By diligently working to maintain a quality program, we have developed a system that forms the “village” that the Committee believes provides equivalent or better care than Wabash Valley residents can obtain anywhere in the country.

Robert Haerr, MDRadiation OncologyCancer Committee Chairperson

Tomosynthesis

myunionhospital.org

Advanced imaging at the Clara Fairbanks Center.

Peace of mind,from us to

At Union Health, we understand that early detection of breast cancer saves lives. That’s why the Clara Fairbanks Center for Women offers the most advanced breast cancer detection available: tomosynthesis 3D breast imaging. This state-of-the-art technology pinpoints breast cancer at its earliest stages — before it can even be felt in a self-exam and when it’s most curable. For you, that means earlier detection. For us, that means being able to give you peace of mind in your healthcare. It’s just one more way we’re healthier together.

To schedule your mammogram, call (812) 238-7766.

Hux Cancer Center

www.myunionhealth.org