Becker's Clinical Quality & Infection Control

33 QUALITY IMPROVEMENT & MEASUREMENT RWJBarnabas to screen all patients for social determinants of health By Mackenzie Bean W est Orange, N.J.-based RWJBarnabas Health has launched a universal social determinants of health program to regularly screen patients for factors that may contribute to chronic disease. The health system is piloting the Health Beyond the Hospital program at several of its locations, it said Oct. 13. The initia- tive entails screening patients for such social determinants of health as food security, housing access and transportation in the same way healthcare providers regularly screen for temperature, weight or blood pressure. After a screening, clinicians can create tailored resources for the patient and "e-prescribe" services or support programs such as the federal Supplemental Nutrition Assistance Program. RWJBarnabas Health is using NowPow, a personalized digital community referral platform, and ConsejoSano, a patient engagement platform that specializes in linguistically and culturally tailored outreach, to support the new program. The health system said it is planning a phased adoption of the program across its entire system, and the program will be fully integrated into its EHR. n Insurance type may affect quality of surgical care By Erica Carbajal P atients with private insurance were more likely to receive surgical care at high-volume hospitals than those who were underinsured or insured by Medicare or Medicaid, according to a study published in the American Cancer Society's peer-reviewed journal, Cancer. The study included 1,279,738 patients who had a confirmed diagnosis of breast, prostate, lung or col- orectal cancer between 2004 and 2016. Researchers concluded that those who were underinsured or in- sured through Medicare or Medicaid were less likely to receive surgical care at a high-volume hospital. The odds of receiving surgical care at high-volume hospitals has improved for colorectal cancer patients since the implementation of the Affordable Care Act in 2010, according to the study. "Ultimately, if patients with private insurance get care at better hospitals, then they will have better outcomes," Quoc-Dien Trinh, MD, senior author of the study and surgeon at Brigham and Women's Hospital in Boston, told EurekAlert. "Policy needs to address these issues urgently, otherwise insur- ance-based disparities will persist or get worse." n Cancer death risk rises about 10% for every month of delayed care, study finds By Erica Carbajal T he COVID-19 pandemic has had a profound impact on cancer screenings and treatments, and researchers are now warning that delaying cancer treatment by just one month can lead to a 6 percent to 13 percent higher death risk, according to a study published Nov. 4 in The BMJ. Researchers from Queen's University in Kingston, Canada, analyzed 34 studies with data on surgical interventions, systemic therapy and radiotherapy for bladder, breast, colon, rectum, lung, cervix and head and neck cancer, which were meant to represent 44 percent of all global incident cancers. e 34 studies included 17 types of conditions that needed treatment and involved over 1.2 million patients between January 2000 and April 2020. Delays were measured from time of diagnosis to first treatment, or the first treatment completion to the start of the next. Delays in treatment led to increased mortality rates in 13 out of the 17 conditions analyzed, and led to worse outcomes across all three treatment approaches — surgical, systemic therapy and radiotherapy. One result indicated that the death risk increased by 17 percent for an eight-week delay in breast cancer surgery, rising to 26 percent for a 12-week delay. Researchers also found a 12-week delay in surgery for all breast cancer patients for a year would lead to 6,100 excess deaths in the U.S., 1,400 in the U.K., 700 in Canada and 500 in Australia. These results assume surgery is the first treatment in 83 percent of patients and a 12 percent mortality without delay. "In light of these results, policies focused on minimising sys- tem level delays in cancer treatment initiation could improve population level survival outcomes," Timothy Hanna, MD, PhD, lead researcher and professor at Queen's University on- cology department, said in a news release. n

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