Systems to Promote Patient-Centric Care in Oncology & Beyond

Cancer care must be patient-centric. 

Not only does patient-centric care drive better health outcomes, but it also promotes more effective and ethical healthcare. Implementing intentional systems that prioritize an individual’s needs and well-being is essential to fostering patient-centric care in oncology, and the following strategies can be considered and applied to other service lines as well:  

Empowerment in Decision-Making: Cancer centers empower their patients to take an active role in participating in healthcare decisions through the implementation of personalized treatment plans, which allows the patient’s lifestyle factors and individual preferences to be considered. This ultimately impacts patient compliance positively during treatment. Patients should also be encouraged to use patient-reported outcome (PRO) assessments to allow their care teams to provide ongoing monitoring of health metrics and make necessary changes to interventions. 

In addition to these tools, centers should ensure there is an underlying culture of dignity and respect for autonomy in decision-making for the patient. A tactic introduced in one of our medical oncology clinics was for the last team member leaving the patient’s room to pause and ask, “Before I leave, are you comfortable with today’s plan?” This small gesture helped create intentional space to uncover and address residual concerns that could then be followed up with by the appropriate care team member in the most effective medium: face-to-face. 

Patient-Centric Support Programs: Integrative health has grown in its prominence of offering patients a personalized holistic approach to wellness. 

It represents a range of effective ways of combining complementary therapies with conventional treatments to treat a patient's psychosocial needs. Cancer centers may offer their patients services like massage therapy and art therapy or mind-body instruction like meditation and yoga. Facilities should look for ways to provide unique community benefits and promote patient dignity. 

For example, one of the centers I oversee that serves a high breast cancer patient population has a full-time bra fitter who sits in an in-house boutique with many garments tailored specifically toward mastectomy patients. Other types of wellness support might include nutritional guidance, such as working with a dietitian on a plan modified to address a patient’s certain dietary needs or manage specific treatment-related side effects. It is impossible to separate social determinants of health factors like housing and food insecurity that patients may face from their ability to adhere to treatment plans. Social workers have been vital in identifying community partners who can provide some support to patients facing socioeconomic challenges along with their diagnosis. An example is a dietary support program recently deployed at one of my cancer centers. 

A contracted chef is mailing out a full week of frozen nutritional meals to patients identified by our social workers to be facing food insecurity, who have just started chemotherapy. 

Support groups are often part of the Integrative Health program offerings, providing a space for social and emotional support to individuals (and their families and caregivers) who are dealing with cancer. It is important to offer support to patients across their cancer journey continuum. After ending treatment, patients may consider joining a cancer survivorship program, which is aimed to provide support with post-treatment side effects and help with the transition from treatment to post-treatment.  

Patient-Centric Operations: The “day of” experience being positive is critical to maintaining a strong relationship between the patient and the oncology care team. This is especially important in a cancer center where a patient may come multiple times a week for their ongoing treatment. Having efficient appointment scheduling processes is a must, and easy appointment coordination and follow-up lessens the burden on both patients and their caregivers. 

An important role to highlight on the oncology care team is the nurse navigator. These incredible advocates and educators facilitate coordination among various disciplines involved in a patient’s care. Navigators are key to linking the patient’s visit with their medical or surgical oncologists to labs, imaging, chemotherapy and other infusion treatments, radiation oncology treatments, and patient education. A consideration especially relevant to oncology operations is the same-day coupling of multiple appointments. Patients often get their labs drawn, see their oncologist in the clinic, and then go over to infusion to start chemotherapy–all on the same day. The initial clinic visit is important to give the provider time to review the medication based on the patient’s lab results, for the provider to assess the patient’s readiness for the subsequent treatment, and for the informed consent process to take place. To minimize the patient’s overall time in the cancer center, our amazing pharmacy, nursing, and support teams work through a carefully orchestrated handoff between running labs and obtaining their results with timely turnaround, getting the patient through the clinic to see their provider, preparing the drug itself, and the patient receiving their infusion. A cancer center that runs smoothly will intrinsically be a more positive environment for our patients, their caretakers, our clinicians, and our staff.