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Hospital Tumor Board

 

An Organizational Primer

Reynaldo O. Joson, MD, MHA, MHPEd, MS Surg

2002

 

What is a Hospital Tumor Board in the Philippines?

 

It is envisioned to be a policy-making body on management of cancer patients and cancer program in a hospital.

 

It is requirement set by the Department of Health for licensure of the hospital;  the Philippine College of Surgeons for accreditation of training program in general surgery; and the Philippine Obstetrics and Gynecologic Society for accreditation of training program in OB-GYN.

 

What is the goal of a Hospital Tumor Board?

 

Goal

            To promote quality services to patients with cancers.

 

What are the objectives of a Hospital Tumor Board?

 

1.      To formulate integrated, coordinated, and comprehensive hospital-wide policies on the management of patients with cancer in the hospital.

2.      To monitor and continually improve the quality of care to patients with cancers.

3.      To conduct educational and training programs for concerned staff so as to facilitate implementation of hospital policies on management of cancer patients.

4.      To promote research on oncology that will continually improve the quality of care for cancer patients.

 

Considering the goal and objectives, who should be members of a Hospital Tumor Board?

 

All staff who are actively involved in the management of cancer patients and who are interested and committed to the goal and objectives of a Hospital Tumor Board can be members. 

 

Surgical oncologists

Medical oncologists

Pediatric oncologists

Gynecologic oncologists

Radiation oncologists

Pathology oncologists

Anesthesia oncologists

Psychiatry oncologists

Nurse oncologists

Pharmacy oncologists

 

Who should head a Hospital Tumor Board?

 

Any oncologist who has the following qualifications:

 

1.      Comprehensive knowledge in cancer management

2.      Objectivity and holistic approach in problem-solving and decision-making in cancer management

3.      Leadership to set up integrated, coordinated, and comprehensive hospital-wide policies on cancer management.

 

What are the general activities of a Hospital Tumor Board?

 

All activities that are needed to effectively and efficiently achieve the goal and objectives of a Hospital Tumor Board.

 

The Hospital Tumor Board formulates, directs, supervises, and evaluates the cancer care program of the hospital.

 

The Hospital Tumor Board may participate in cancer programs in the community.

 

What are the usual specific activities of a Hospital Tumor Board?

 

1.      Cancer registry

2.      Conferences

2.1             Administrative conferences

2.2             Education and training conferences

2.3             Research conferences

3.      Patient education

 

How should the performance of a Hospital Tumor Board be evaluated?

 

Whether the goal and objectives are effectively and efficiently achieved.

 

See table on performance parameters and standards below.

 

 

What are common problems of a Hospital Tumor Board?

1.      Hospital administrators, appointed chairs, and oncologists do not have a clear idea on the goal and objectives of a Hospital Tumor Board.

2.      Appointed chairs do not have sufficient leadership and managerial skills.

3.      Turfing and insecurity among oncologists.

4.      Inadequate logistic support.

 

 

What are some tips for hospital administrators on Hospital Tumor Board?

 

1.      Know clearly the goal and objectives of a Hospital Tumor Board and sincerely support it.

2.      Appoint a chairperson with the necessary qualifications.

 

What are some tips for appointed chairs on Hospital Tumor Board?

 

1.      Know clearly the goal and objectives and evaluation parameters of a Hospital Tumor Board.

2.      Make sure all members know the goal and objectives and evaluation parameters of a Hospital Tumor Board.

3.      Motivate and empower all the members to work towards common goal and objectives of a Hospital Tumor Board.

4.      Together with all the members and by consensus, formulate integrated, coordinated, and comprehensive hospital-wide policies in the management of cancer patients.

5.      Together with all the members and by consensus, formulate standardized protocols on the management of cancer patients.

6.      When formulating policies and procedures, have the greater good in mind rather on a few or individual patient.

7.      When conducting education and training program, focus on concept and principle learning and application rather than on individualistic problem-solving.

8.      Entice the oncologists to share their experiences with their cancer cases.

9.      Entice the oncologists to bring challenging cancer cases to the Hospital Tumor Board for multidisciplinary discussion.

10. Have a clearly written system of procedures in governing and evaluating the Hospital Tumor Board that will include a year-start management action plan and budget and a year-end performance review and report.

 

What are some issues where policies and procedures should be formulated as a priority?

 

Unified philosophy and concept in

            Cancer causes

            Cancer prevention

            Cancer cure

            Cancer palliation

 

Standardized management of a patient process

 

Policies and protocols for managing terminally-ill cancer patients

 

Protocols in cancer pain control

 

Cancer Registry

 

 

Performance Parameters and Standards

Hospital Tumor Board

 

 

Objectives

Parameters

Standards and Targets

To formulate integrated, coordinated, and comprehensive hospital-wide policies on the management of patients with cancer in the hospital.

Presence of written policies

Integrated, coordinated, and comprehensive hospital-wide

Continually updated

To monitor and continually improve the quality of care to patients with cancers.

Morbidity and mortality rates

Complaints of patients

Acceptable rates (<5%)

Acceptable no. of complaints (<5 / year)

To conduct educational and training programs for concerned staff so as to facilitate implementation of hospital policies on management of cancer patients.

Educational and training programs

Structured

Geared towards goal and objectives

To promote research on oncology that will continually improve the quality of care for cancer patients.

Research output

Number (4 a year)

Useful enough to be integrated into policies and procedures