title: Patient-centered, evidence-based, and cost-conscious cancer care across the continuum: Translating the Institute of Medicine report into clinical practice.
abstract: In 2013, the Institute of Medicine (IOM) concluded that cancer care in the United States is in crisis. Patients and their families are not receiving the information that they need to make informed decisions about their cancer care. Many patients do not have access to palliative care and too few are referred to hospice at the appropriate point in their disease trajectory. Simultaneously, there is a growing demand for cancer care with increases in new cancer diagnoses and the number of patients surviving cancer. Furthermore, there is a workforce shortage to care for this growing and elderly population. The IOM's report, Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis, outlined recommendations to improve the quality of cancer care. This article provides an overview of the IOM report and highlights the recommendations that are most relevant to practicing clinicians who care for patients with cancer across the continuum. The implementation of the recommendations in clinical practice will require better patient-clinician communication, improved care coordination, targeted clinician training, effective dissemination of evidence-based guidelines and strategies for eliminating waste, and continuous quality assessment and improvement efforts.
authors.affiliation: Department of Population Medicine, Harvard Medical School, and Department of Medicine, Harvard Vanguard Medical Associates, Boston, MA.
authors.forename: Larissa
authors.initials: L
authors.lastname: Nekhlyudov
authors.forename: Laura
authors.initials: L
authors.lastname: Levit
authors.forename: Arti
authors.initials: A
authors.lastname: Hurria
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Ganz
mesh_terms: D003142:Communication; D003657:Decision Making; D055317:Evidence-Based Practice; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care
keywords: cancer; communication; decision-making; evidence-based health care; patient-centered care; quality of health care