Data provided by individual provincial cancer agencies.
Data source: National Research Corporation Canada’s Ambulatory Oncology Patient Satisfaction Survey results
Data provided by individual provincial cancer agencies.
Data source: National Research Corporation Canada’s Ambulatory Oncology Patient Satisfaction Survey results
Definition: NRC AOPSS Survey (self-reported data); see inclusion/exclusion criteria below – provincial % Negative rating, summary indicator for the dimensions surveyed: Access to Care, Coordination and Continuity of Care, Emotional Support Information, Communication & Education, Physical Comfort, Respect for Patient Preferences, Overall Quality of Care
Data source: Reported by provincial cancer agencies or equivalent to the Canadian Partnership Against Cancer
Patient satisfaction – emotional support dimension
Definition: NRC Picker AOPSS Survey (self-reported data) – provincial % negative rating for the 7 stratifications for emotional support:
By site (Breast, Cervix/Uterine/Ovarian, Colorectal/Bowel, Lung and Prostate/testicular)
Reason for Treatment (first time cancer diagnosis, repeat cancer diagnosis)
Time since Diagnosis (less than 6 months ago, between 6-12 months ago, between 1 and 2 years ago, between 2 to 5 years ago and more than 5 years ago)
Education (< Sec. School, Sec. School Grad and Post-Sec. Grad)
Health Status (Poor, Fair, Good, Very Good and Excellent)
Sex (Female and Male)
Age (<50, 50-74 and 75+)
Data source: Reported by provincial cancer agencies or equivalent to the Canadian Partnership Against Cancer Measurement timeframe: AB: Feb-Aug 2012 MB: Jun-Oct 2011 NS: Jun-Sept 2012 PE: Nov 2012-Jan 2013 SK: Apr-Jun 2011
National Research Corporation Canada
Ambulatory Oncology Patient Satisfaction Survey
Inclusion and Exclusion Criteria
Exclusion Criteria:
Deceased patients
Patients less than 18 years of age (based on date of birth at time of data extraction for surveying)
Patients with no known fixed address
Patients who do not have a confirmed cancer diagnosis (even if they have received treatment in the facility) including in-situ, benign haematology and/or non-malignant cancers (for example myeloproliferative diseases) or those going through a diagnostic assessment process
Patients who received only inpatient services
Patients who have notified the hospital that they wish to be excluded from mailing list.
Inclusion Criteria:
Patients who have received active treatment in an ambulatory setting in the past 3 months
Patients with a confirmed diagnosis of Cancer (include those patients with diseases identified as invasive, with a 3 in the 5th position of the ICD-O-3 histology code (malignant, primary site)
Have undergone active outpatient treatment in the past 3 months
Are 18 years or older (based on date of birth at time of data extraction for surveying)
The table below highlights where sampling criteria for jurisdictions varies from the criteria outlined above.
Jurisdiction
Deviations from the standard Inclusion/Exclusion criteria
Data elements in addition to those required as per NRC Implementation Manual
Alberta
Inclusion:
Those who have been on treatment for six months.
Can identify patients who received chemotherapy and radiation treatments however surgery is not captured until approximately a year after diagnosis so the vast majority of patients will not have surgical information.
Will identify patients who received IV and/or oral chemotherapy at the tertiary centres. However at the Associate and Community cancer centres, are unable to determine the type of systemic treatment received. This will result in the inclusion of patients who received hormones and immunotherapy as well as those who received chemotherapy.
Alberta will use the ICD code for invasive cancer as used by the other provinces.
Will use age at diagnosis as prescribed on the Implementation Manual.
Nova ScotiaSurveyed Point in TimeSummer 2012
Exclusion:
Exclude in-situ bladder.
There is a flag set on each case where ‘ambiguous' terms appear on the pathology report. The histology could still be classified as /3 (invasive), but if this flag were set, the patient would not be approached.
Oral Chemotherapy patients:
There is a problem in identifying these patients. They are not specifically included or excluded. Due to limitations in the IT system, an algorithm has been developed for selecting patients that are most likely to be receiving chemotherapy based on visits to medical oncologists so oral chemotherapy patients could be part of that algorithm. Certainly oral chemotherapy is increasing and they may have different issues or not identify themselves as chemotherapy patients in the survey.
SaskatchewanSample point in time every 1 – 2 years
Exclusions:
Patients who are on injections (determined by a comprehensive drug master list from Care Services)
Patients who have restrictions in Ceres/Eureka/CMS
Patients with specific chemo/radiation events
Inclusions:
Patients who have a specific COPS institution as a scheduled event
Haematology patients (as there is no way currently to exclude those patients)
Have undergone active outpatient treatment in the past six months.
Oral Chemotherapy patients:
Oral chemotherapy patients included in sample size. Patients not receiving IV chemotherapy are not excluded from the serious side effects and care that they should receive and expect during their cancer care service. Many cancer patients are on oral chemotherapy, such as the brain, GI, pancreatic cancer patients that require the same information, education, support, follow up and side effects management as do the IV chemotherapy patients.
Manitoba
As per criteria above.
Prince Edward Island
As per criteria above.
Data and measurement considerations
While the provincial surveys used to produce the patient satisfaction results are all based on the AOPSS tool, inclusion criteria for patients may vary among provinces. As well, the results presented in this report are based on the latest surveys conducted in each province, but the years the surveys were conducted vary among provinces (from 2011 to 2013). While progress has been made, work is still needed to ensure that inclusion and exclusion criteria are consistent across all hospitals and jurisdictions to allow results to be compared within and among jurisdictions. Any deviation from these criteria are identified above and should be considered when interpreting results.
In Nova Scotia, Manitoba and Prince Edward Island, surveyed patients had received disease-oriented treatment within three months of the survey period, whereas in Alberta and Saskatchewan, patients had had treatment within six months of the survey.
The survey consistently captures data on patients receiving radiation treatment, but chemotherapy treatment data collection may vary by province (e.g., whether patients receiving oral chemotherapy alone were included rather than only those receiving intravenous chemotherapy).
It is important to be cautious when interpreting results in this section given that individuals may not have recalled all facets of care that took place when they received disease-oriented treatment three to six months earlier.
Current state of Patient Reported Outcomes implementation, by province, as of April 2017
Province‡
Disease sites
Data capture method
Number of clinical sites using ESAS/number of sites providing cancer therapy
Frequency of screening
British Columbia
—
Paper (with electronic re-entry)
6/6
—
Alberta
All
Paper (with electronic re-entry)
17/17 sites on paper (15/17 sites have electronic re-entry)
New patient oncology visit
Follow-up visits
Once per cycle of chemotherapy
Beginning, middle and end of radiation therapy
Saskatchewan
All
Paper (with electronic re-entry)
18/18 (2 tertiary sites, 16 community oncology centres)
Once for every new patient at new patient consultation
Once for every patient referred to pain and symptom management clinic
Once for every radiation therapy patient while on radiation therapy
Manitoba
All but head & neck
Paper (with electronic re-entry)
22
At every physician visit
Ontario
All except in-situ melanoma (malignant skin and malignant melanoma)
Electronic (direct patient entry)
70/80
All visits
Quebec
All
Electronic (direct patient entry)
2/92
At every physician visit
New Brunswick
—
—
—
—
Nova Scotia
All
Paper
9/11
Newly diagnosed patients and at specific transition points in cancer care
Prince Edward Island
All
Paper
2/2
New patient oncology visits
Intravenous chemotherapy review appointments
End of treatment for all patients
Newfoundland & Labrador
All
Electronic (tertiary cancer treatment centre);
paper (with electronic re-entry for all other clinics)
13/17
New patient oncology visits
Some follow-up screening at identified points in treatment trajectory
“—” Data not available
‡ All provinces that have implemented Patient Reported Outcomes tools (except BC) were a part of the Patient Reported Outcomes Initiative, led by the Canadian Partnership Against Cancer
ESAS-r= Edmonton Symptom Assessment System – revised
Data source: BC Cancer; Patient-Reported Outcomes Initiative Partners