1. Priorities C O M M M I T T E D T O D E L I V E R I N G T H E H I G H E S T
Q U A L I T Y C A N C E R C A R E T O T H E P A T I E N T S
& F A M I L I E S O F T H E E R I E S T . C L A I R R E G I O N

2. A message from our regional vice president
It’s been a year of hard work rewarded by significant
accomplishments. I am pleased to be able to briefly touch
upon the following key developments:
SUCCESSES:
Diagnostic Assessment Programs (DAPs) – Breast
DAPs have opened at Bluewater Health and Hôtel-Dieu
Grace Hospital, making coordinated and high-quality
breast assessment accessible to everyone in Erie St.
Clair (ESC). Bluewater Health is in the planning stages
for colorectal, prostate and lung cancer DAPs. A pilot
project, under the umbrella of the Regional Cancer
Program, is also underway for patients diagnosed
with colorectal cancer that will coordinate surgery and
oncology treatment. The pilot project will link with
hospital based colorectal DAPs in Essex and Kent
Counties. Within DAPs, Nurse Navigators work closely
with patients as they progress through diagnosis, helping
them understand and prepare for the various tests and
procedures they may experience and generally helping
them navigate the sometimes complex cancer care
system.
Colonoscopy Wait Times – Higher-risk colorectal cancer
patients are seeing shorter wait times for colonoscopies.
ESC exceeded regional targets with 71% of higher-risk
patients accessing colonoscopies within provincial targets.
Cancer Surgery Wait Times – ESC still has one of the
shortest wait times to cancer surgery within the province.
Eighty percent of surgeries are completed within priority
targets. Put another way, the majority of cancer surgeries
are completed within 4 weeks.
Patient Experience – By establishing an ESC Regional
Cancer Program (ESC RCP) Community Advisory
Committee (see Art’s story under Goal 13) we have
improved our access to a wider range of perspectives on
the quality of care our patients receive. The Committee
brings together patients and caregivers, from across
ESC, to learn from their stories and experiences. The
more patients we reach, the greater the opportunity for
understanding and improvement. To that end, the ESC
RCP engages patients and caregivers in a variety of ways
through surveys, focus groups, comment cards, internet
resources, formal groups and informal discussions.
Improvements where work is still
underway:
Cancer Screening – Our region’s participation in
mammography screening is among the highest in the
province. Screening for colorectal cancer has increased;
30 percent of our 50-74 year old population has had a
Fecal Occult Blood test in the last two years. That’s good;
90 percent of colorectal cancers can be cured if found
early enough. Unfortunately, the remaining 70 percent of
this high-risk group is not taking advantage of this easy
at-home test.
Our region’s participation in Pap tests is the lowest in the
province. Like colorectal cancer, cervical cancer can also
be cured if detected through regular screening.
Palliative Care – Community Palliative Care Teams
(CPCTs) in Kent and Essex counties now join the well-
established team in Lambton county to provide region-
wide access to timely, coordinated and expert palliative
services to patients and families in the community.
A successful new consultative Palliative Medicine
Program has also been established at Windsor Regional
Hospital which improves coordination of care between
the Cancer Centre, Windsor Regional Hospital’s in-patient
care programs and services delivered by our community
partners across the region – all with a primary focus on
managing pain and other symptoms.
Challenges:
Radiation Wait Times – Our wait times for Radiation
Treatment are still among the longest in the province. We
expect significant improvements by year end thanks to a “lean
process” that identified efficiency opportunities, the addition
of a fifth Radiation Oncologist, and replacement of a third
radiation treatment machine with state-of-the-art technology.
Healthy Behaviour Scores – Our region’s scores are among
Ontario’s worst. Our smoking rates are high, we drink too
much alcohol, we do not eat enough fruits and vegetables and
we are physically inactive. Given that 50 percent of cancers
are preventable, the need to promote healthier lifestyles
becomes more and more urgent.
Continuing our Commitment:
While we celebrate these successes and continue to tackle
these ongoing challenges, one overarching fact remains:
our total commitment to improving the cancer journey
experience for patients and families throughout Erie St.
Clair. The cancer care partners within the ESC RCP remain
united in a single-minded pursuit of excellence that results in
outstanding patient-centred cancer care.
– Claudia den Boer Grima
Regional Vice President

3. a prioritized plan
SIX STRATEGIC PRIORITIES TO IMPROVE CANCER SERVICES EVERY STEP OF THE WAY

4. Anat Ravid is the Erie St. Clair Surgical Oncology Program
Clinical Lead. As an active cancer surgeon, she knows that
smokers are at greater risk than non-smokers for complications
following surgery. Smoking rates in Erie St. Clair (ESC) –
among the highest in the province – match our higher rates
of respiratory illness and lung cancer. That’s what makes an
in-patient smoking cessation program a priority area for the
ESC Regional Cancer Program.
Dr. Ravid would like more
smokers to say “I quit.”
Interventions that help people stop smoking
have led to a 15 per cent improvement in the
long-term success for tobacco users
admitted to hospital. They also help reduce
readmissions to hospital.
Priority #1: C A N C E R R I S K
R E D U C T I O N
Goals 1 2:
Implement hospital in-patient
smoking cessation strategies
across Erie St. Clair
Design and implement an
out-patient smoking cessation
strategy. Pilot the strategy
within two to three health care
settings
What
Health care settings are uniquely positioned
to identify patients who smoke and to help
those who want to quit. Our program uses
bedside education and counselling (when
requested) in addition to recommendations
for nicotine replacement or pharmacotherapy.
When necessary, we’ll also refer patients to
community programs for additional support.
Hospital-based interventions have been widely
recognized as “best practices.” Their proven
success provides the opportunity to adapt the
program to an out-patient setting.
Why
Smoking rates in Erie St. Clair (ESC) are
among the highest in the province. Not
surprisingly, we also have higher rates of
respiratory illness and lung cancer.
Hospital-based interventions have led to a
15 per cent improvement in the long term
“quit rate.”
Daily smokers are 80 per cent more likely to
be hospitalized than those who never have
smoked. They’re at greater risk of post-
operative complications requiring Intensive
Care. Smokers are also at greater risk of
post-operative wound-healing complications,
including infections and impaired bone healing.
Tobacco users represent 19 per cent of all
hospital patients.
Encouraging and helping those who want to
quit changes the picture dramatically. Benefits
include:
• improved quality and longer length of life
regardless of the age at which one quits
• improved pulmonary function by
approximately five per cent within months of
quitting smoking
• reduced risk of coronary heart disease by half
within one year of quitting
• decreased the risk of oral and esophageal
cancer by half within five years of smoking
cessation
• reduced hospital readmissions and a 77 per
cent relative risk reduction in mortality

5. How
Work with cancer care partners to:
• implement in-patient smoking cessation
programs within ESC hospitals
• develop an ambulatory care smoking
cessation strategy
• create pilot programs in two care settings
i.e. Surgery, Cancer Centre
Goal 3: Extend Your Health
Matters™
to two workplace
settings within each
tri-county region
What
Your Health Matters™ is a cancer risk-
reduction program that focuses on “modifiable
risk factors” – the kinds of behaviours people
can control and change. The program, which
operates in workplaces, helps people identify
behaviours that elevate their risk of cancer.
It provides education and information about
these risks, helps people plan behaviour
change and provides tracking tools to monitor
progress over time. The program also
provides cancer screening services and, when
necessary, referrals to helpful community-
based programs and resources.
Why
Half of all cancers can either be prevented or
detected early, before they become serious
health concerns. Prevention is, of course, the
best solution and risk reduction remains the
best prevention strategy. In many cases, the
preventative lifestyle changes are fairly easy
to make.
Despite all that, Erie St. Clair residents
lag far behind the province, with “healthy
behaviour scores” among the worst in Ontario.
Compared to provincial averages, our smoking
and alcohol consumption rates are higher and
our physical activity and fruit and vegetable
intakes are lower. We can do better and
programs like Your Health Matters™ help.
How
Work with cancer care partners to extend Your
Health Matters™ to tri-county workplace
settings.
“Lung Cancer is the most frequently
diagnosed cancer in Ontario. It is directly
correlated to tobacco use. Almost half of
daily smokers say they’ve recently tried to
quit and we’re working hard to help them
succeed.” Dr. Allen Heimann, Medical
Officer of Health, Windsor-Essex County
Health Unit.
Priority #1:
C A N C E R R I S K R E D U C T I O N
( conti N ued )

6. Dianne George is a Nurse Manager of Community
Health at the Kettle and Stony Point Health Centre.
She’s seen the improvement in cancer statistics within
aboriginal communities as more and more First
Nations people have embraced the area’s improved
screening, education and prevention programs.
Because these successes have demonstrated the value
of greater outreach and education, ESC RCP, in
partnership with Cancer Care Ontario, will develop
and implement an Integrated Cancer Screening
program to increase screening rates for breast, cervical
and colorectal cancers in First Nations and Métis
communities, on and off reserves.
Dianne sees the benefits
of better screening
Priority #2: I N T E G R AT E D
C A N C E R S C R E E N I N G
Goal 4: Work in partnership
with Primary Care Providers
to increase screening
participation rates
What
We’re creating a more integrated approach to
cancer screening by linking the three provincial
screening programs for breast, cervical and
colorectal cancer. Program elements include:
• a common information technology system
• consistent messaging
• Primary Care Provider support for patient
screening, ensuring follow up of screening
abnormalities
• combined screening promotion and
performance measures
Why
Better screening programs lead to earlier
detection. As a result, treatments are less
invasive and more effective and, importantly,
death rates decrease
Colorectal cancer is 90 per cent curable with
early detection and cervical cancer, after early
detection of cervical cell abnormalities, can be
prevented with HPV vaccine.
Our area’s residents do very well in
mammography screening, with participation
rates among the highest in the province. But
the percentage of females 50 to 69 years who
are up to date for all cancer screening is very
low at just eight per cent.
How
Recognizing that Primary Care Providers are
key influencers for their patients’ participation
in screening, our program includes the
following strategies:
• strengthen Primary Care Network
• provide education and follow-up to provider
participation reports
• develop distribute integrated screening
tools to assist providers
Goal 5: In partnership with
CCO, develop and implement
a ‘Never Screened/ Under
Screened’ Integrated Cancer
Screening initiative within
First Nations and Métis
communities across Erie St Clair
What
The First Nations Métis Cancer Screening
Project is a successful proposal, funded by
Cancer Care Ontario (CCO), to increase
screening for breast, cervical and colorectal
cancers in First Nations Métis communities,
on and off reserves. The program will
provide health education and a strong referral
component that will link participants to easily

7. accessible cancer screening services. When
necessary, this will include on-site screening
and referral to community-support programs
that can help people adopt healthy lifestyle
changes.
The project builds on the success of the Your
Health Matters™ program (see goals #1 and
#2) by adopting practices that are proven to
work well with under-screened populations.
Why
Hard-to-reach populations like First Nations
and Métis communities face unique barriers to
participation in screening programs. Culturally
sensitive strategies have proven effective in
breaking down these barriers and increasing
participation.
The project, which will roll out over two
years, will provide education and improved
access to screening for First Nations and Métis
communities.
How
• establish a regional Steering Committee to
oversee proposal development
• develop and submit a proposal to CCO for
approval and funding
• key activities to be identified within the
approved proposal
Priority #2:
I N T E G R AT E D C A N C E R S C R E E N I N G
( conti N ued )
Hard-to-reach populations like First Nations
and Métis communities face unique
barriers to screening and participation.
Culturally sensitive strategies have
proven effective in breaking down these
barriers and increasing participation.

8. Priority #3: I M P R O V E PAT I E N T
O U T C O M E S
When doctors discovered a suspicious mass in Carol’s
lung, her family physician recommended the Lung
Diagnostic Assessment Program. Thanks to the
work of her DAP Nurse, the necessary appointments
followed within days and she was able to meet with
a surgeon within two weeks. Having the support
of a knowledgeable “system navigator” helped her
understand the diagnostic process and contributed to
a more streamlined diagnosis.
Breast, colorectal, lung and prostate cancer are the
four major cancers in our area. Expanding DAPs and
ensuring access to quality diagnostic programs is a
priority.
Carol knows why
our focus on DAPs
is so important
Goal 6: Implement
coordinate standards-based
regional Multidisciplinary
Cancer Conferences (MCC)
for cancer surgery disease sites
with a volume of 35 cases or
more
What
MCCs are regularly scheduled meetings
where health care providers from a variety
of disciplines - Surgeons, Radiologists,
Pathologists, Oncologists and other specialists
from all Erie St. Clair hospitals - come together
to review individual cancer cases and make
recommendations on the best treatment options.
MCCs ensure that cancer patients receive all
of the most appropriate diagnostic tests, and
treatment options/recommendations.
MCCs are currently based on specific disease
sites within the body – breast, gastrointestional,
genitourinary, lung, hepatobiliary, hematology
and endocrine disease sites. Our program will
now expand to include gynecology, head and
neck and neurology disease sites. We will
also increase the participation of hospitals
and physicians in MCCs across ESC so more
patients can benefit from this multidisciplinary
approach.
Why
Evidence shows that, up to 43 per cent of the
time, a patient’s treatment plan will change
following an MCC review. Moreover, up to
95 per cent of all MCC recommendations are
followed. The wider perspective of input made
possible by MCCs clearly provides direct
benefits to our patients.
How
• increase MCC participation at all ESC
hospitals
• phase in MCCs for all disease sites for which
35 or more surgeries are performed
Goal 7: Ensure regional access
to organized Diagnostic
Assessment Programs for the
four major cancer sites: breast,
colorectal, lung and prostate
cancer
What
When symptoms or findings suggest the
possibility of cancer, patients want and need
rapid assessment. That’s what Diagnostic
Assessment Programs (DAPs) do, by providing:
• a personalized contact for access to care
• standardized care plans based on known best
practices
• information/support for patients and their
families throughout the assessment process
• ongoing program performance evaluation

9. The design for DAPs in ESC is unique. They
are virtual programs that operate within
existing community services and providers.
Expanding DAPs to include colorectal and
prostate cancer patients will provide faster
access to quality diagnostic programs. That’s a
very good thing for patients, their families and
for care providers.
Why
Being assessed for cancer is an anxious time
for patients, families and care providers. Poor
coordination and lengthy wait times only
make it worse.
Diagnostic Assessment Programs are
designed to minimize those added strains
by coordinating “the right tests at the right
time by the right person.” Now, with a single
referral, the entire assessment process is
coordinated through a personalized point of
contact. It works well; our existing DAPs
(for breast and lung cancer) have provided
significant reductions in wait times. Patients
and caregivers agree that the programs
improve the assessment process. They value
the information, support and coordination
provided through DAPs. More than 80 per
cent say they are “highly satisfied” with the
program.
With our DAP’s expansion to include
colorectal and prostate cancer, many more
patients will now enjoy the benefits of this
successful program.
How
• implement a colorectal DAP pilot program
• design and implement county-based
colorectal DAPs
• design and implement a regional prostate
DAP
Goal 8: Implement systemic
standards of care across
Erie St. Clair
What
CCO has coordinated a province-wide plan
for systemic treatment (chemotherapy). This
plan ensures all cancer patients requiring
chemotherapy have access to the same
standard of treatment, available at locations as
close to home as possible.
Why
As Ontario’s population ages in coming years,
the number of people diagnosed with cancer
is expected to increase – estimates range
from 11 to 17 per cent by 2012/13. More and
more people will require cancer treatment that
includes chemotherapy. This demand may
affect wait times.
With the introduction of newer, more
successful and more complex drug
combinations to treat a wider variety of
cancers, there is a greater need for education
and care delivery standards.
Priority #3:
IMPROVE PATIENT OUTCOMES
( conti N ued )
Diagnostic Assessment Programs (DAPs)
help patients and their families understand
the diagnostic process and contribute to a
more streamlined diagnosis. More than
80 per cent of patients within the ESC
DAPs are highly satisfied with the program.

10. New training and certification requirements
for care providers will:
• enhance the safe handling and administration
of cytotoxic drugs
• ensure patient safety
The standards extend to all ESC sites
delivering chemotherapy programs.
How
• enhance pharmacist/pharmacy technician
services
• implement Cancer Care Ontario’s Systemic
Collaborative Initiative across ESC
• achieve wait time targets
Goal 9: Design and develop a
regional scorecard consisting
of core indicators to support
the provision of unique data at
a regional, organizational and
service level
What
The ESC Regional Cancer Program uses
a very successful “scorecard system” to
track the quality of cancer care at a regional
level. Now, our regional partners will have
a new scorecard to track their work at an
organizational or service delivery level.
Together these scorecards will provide regular
snapshots of our regional cancer care system,
allowing us to compare our performance
against targeted benchmarks. Doing so will
help us identify opportunities for quality
improvement which, in turn, will result in an
improved cancer care experience for patients,
families and their supporters.
Why
Scorecards identify performance strengths
and weaknesses, reveal quality improvement
opportunities and help us evaluate the
effectiveness of our operational strategies. By
allowing us to compare performance standards
across the region, we can ensure that our
patients across ESC have access to the same
quality of care, regardless of where they live.
How
• determine core indicators common to all
ESC hospitals
• determine unique organizational indicators
related to cancer care service provision
Hard to reach populations like First Nations
and Metis communities face unique barriers
to screening and participation.
Culturally sensitive strategies have proven
effective in breaking down these barriers
and increasing screening participation.
Priority #3:
IMPROVE PATIENT OUTCOMES
( conti N ued )

11. Priority #4: G E N E T I C S C R E E N I N G
C O U N S E L L I N G
Teresa’s family has a history of breast cancer. When her
younger sister was diagnosed, doctors recommended
that Teresa undergo genetic screening to determine if
she too was predisposed to cancer. The results were
positive, leaving her with a difficult decision. Today,
after undergoing preventative surgeries, she’s a vocal
advocate of genetic screening. It has given her, she
believes, a more confident future with her husband
and young children. Genetic counselling is available
at Windsor Regional Hospital, or at London Health
Sciences Centre. Wait times in Windsor are six months
compared to just two in London. That’s why improving
access to cancer genetic screening and counselling
is a priority.
Teresa is a vocal
supporter of
genetic screening
Goal 10: Improve access to
cancer genetic screening
counselling for Erie St Clair
residents
What
Hereditary cancers account for five to ten
per cent of all cancers. For members of the
affected families, genetic screening can help
identify those who are at greater risk, often in
advance of symptom onset.
Genetic counselling is the first step in
identifying those for whom genetic screening
is an appropriate approach.
Why
We’ve learned a lot about genes and cancers
in the last 10 years. We know that genetics
play an important role in the incidence of
cancer and that screening can, for some
families, be part of an important pre-emptive
strategy. There are currently three cancers
for which genetic counselling may be useful:
breast, ovarian and colorectal.
The South West Medical Genetics Program
provides these services to patients in ESC.
Residents can access the services through
monthly satellite clinics at the Cancer
Centre at Windsor Regional Hospital or
anytime at London Health Sciences Centre.
Unfortunately, wait times for patients who
prefer local care are long – six months
compared to two months for those willing to
travel to London.
The volume of referrals from ESC suggests
this is an underutilized service for those who
are at higher risk.
How
• deliver community and physician education
re. cancer genetics and counselling/
screening services
• implement a High Risk breast screening
program within Ontario Breast Screening
Program (OBSP)
• explore the potential of establishing a
regional genetic High Risk breast clinic
Genetic Screening saves lives by alerting
patients to cancer risks early on. Hereditary
cancers account for 5%-10% of all cancers.

12. Priority #5: C A N C E R S E RV I C E
D E S I G N D E L I V E RY
Shortly after being diagnosed with breast cancer,
Lise connected with Shannon Bellaire, one of the
Nurse Practitioners with the Cancer Program at
Windsor Regional Hospital. Lise credits Shannon with
greatly simplifying and easing her journey through
treatment. From being available to answer questions
and discussing alternative therapies, to helping her
quickly access prescription drugs, Shannon made
the experience more relaxed and responsive to her
personal needs.
The challenge in designing or improving services is to
understand the complete patient experience. In doing
so, we will define the roles of the cancer care delivery
team members and maximize our resources to deliver
the right care to the right person, at the right time and
in the right place – all the while supporting the patient
in self-managed care.
Lise appreciates
the support of her
Nurse Practitioner
Goal 11: Establish a
philosophy of patient
centred care as a key driver
of cancer services design
and delivery
What
Patients are our reason for being. Their
experiences, along with those of the public
and health care staff, provide valuable
information that can and should be used
to improve our services.We will continue
to work to better understand the needs and
concerns of our patients. We will build a
patient-centred model of care that ensures
patients’ needs remain front and foremost
and that care providers organize and work
together to provide patients with the right
care, at the right time, by the right person.
Why
Our challenge is to go beyond consultation,
compliments and complaints. We want to
truly and fully understand the complete
patient experience and to use this insight
when re-designing our services. “The biggest
untapped resources in the health system
are not physicians, but users. We need
systems that allow people and patients to be
recognized as producers and participants, not
just receivers of systems.”
How
• capture patient experiences in the form of
shared stories and use this knowledge to
design or improve services, resulting in
more appropriate, efficient, cost-effective
and sustainable services
• define the role/scope of the members of the
cancer care delivery team
• maximize provider resources to deliver the
right care to the right person, at right time,
at the right place
• support the patient as an active partner in
their self-managed care
Goal 12: Facilitate and/
or provide professional
education for clinicians
What
Our goal is to support attendance at, or create
opportunities for, clinical education and
knowledge exchange. These opportunities
may take a variety of forms – from self-
directed learning activities and journal clubs
to formal conferences and seminars.
Why
When care providers maintain their
competencies and remain abreast of new
knowledge and new directions in cancer care,

13. patients are assured of their expertise and of
their ability to deliver quality care.
Emerging technologies, care standards and
guideline developments often necessitate
additional training and certification.
CCO holds all cancer service providers
accountable to meeting standards of quality
and performance. Professional bodies also
hold health care practitioners accountable for
their ongoing learning and maintenance of
expertise.
How
• provide and/or ensure access to professional
education opportunities for clinicians
Priority #5:
Cancer Service Design
and Delivery ( conti N ued )
Everything about the care delivery system
should focus on improving the patient
experience. Having access to qualified and
compassionate Nurse Practitioners is
just one way service delivery is improving.

14. Priority #6: I M P R O V E PAT I E N T
E X P E R I E N C E
Art’s family is all too aware of the realities of cancer,
in part because of his own diagnosis. After completing
his treatments, he decided to use his experiences to
contribute to cancer services planning and joined the
Erie St. Clair Regional Cancer Program Community
Advisory Committee.
Patients are uniquely able to provide insights and
suggestions for quality improvements. By talking to
patients in a variety of ways – through surveys, focus
groups, comment cards, internet, formal and informal
discussions – we obtain valuable feedback that helps
us improve our patient-focused care.
Art draws on his
own experience
to help others
Goal 13: Ensure that patient
and family voices influence
and guide our quality care
improvements
What
It’s important to know how patients and
families feel about the care they receive
through our programs. We are expanding
our existing feedback mechanisms to
provide more ways to share their stories
and experiences. Some people prefer a
quick note written in a care setting while
others are comfortable completing surveys
or participating in focus groups. Still others
want to become more actively involved, in
an advisory capacity. By making it easier
for everyone to become involved, at their
comfort level, we obtain a broader and
clearer picture of patient experiences. That
feedback helps us identify opportunities for
improvement.
Why
Patients remain the focus of all cancer care.
The quality of their experience is the ultimate
test of our efforts. By involving patients
in our process reviews and development,
our care teams gain a deeper and more
meaningful insight into the patient impacts of
their decisions.
How
• establish and build an ESC Community
Advisory Committee
• strengthen patient satisfaction survey and
focus group/feedback processes across ESC
• model an experience-based design guide
• ensure patient stories guide planning and
improvement initiatives
Goal 14: Establish a patient
education framework that
uses Oncology Interactive
Navigator™ (OIN) as a key
patient/family/provider
resource
What
The Oncology Interactive Navigator™
(OIN) provides patients and families with
information and linkages to evidence-
based, disease specific, community support
programs and services. The web based
tool provides information on all stages of
the cancer journey - from pre-diagnostic
suspicions through survivorship or end of
life.
OIN™ allows patients to get information
about their disease in the comfort of their
homes. That’s important, especially in the
hours and days following diagnosis, when
anxieties and fears are heightened.

15. Why
Our goal has been to connect patients with
the OIN™ system as soon as possible after
diagnosis (at the time of referral to the Cancer
Centre and through surgeons at the time of
diagnosis), for patients with melanoma and
colorectal cancer. Now it will be expanded to
include lung cancer and also be provided to
patients referred to the Diagnostic Assessment
Programs. So far, results have been promising:
• 38 per cent and 53 per cent of patients
with colorectal and melanoma cancers
(respectively) who received OIN™
information via their New Patient Referral
package have accessed the OIN™
• Nearly 80 per cent of patients given
information about OIN™ by their surgeon at
the time of diagnosis have used the system
The site is authoritative and up to date, thanks
to a team of experts from across Canada
whose ongoing input reflects the latest
evidence and practice. OIN™ also provides
information on ESC community resources and
services.
Patients commonly receive large volumes of
repeated information that is overwhelming
to sort through. OIN™ provides a user-
friendly way to access information whenever
it is needed, even late at night. And because
it is also accessible to friends and family,
OIN™ relieves patients from having to
repeat information over and over and ensures
that everyone supporting them has the same
accurate information about the disease, the
treatment and management of symptoms, etc.
How
• Integrate OIN™ within DAP structure and
processes
• Explore opportunities for expanding OIN™
to other disease sites
Goal 15: Roll-out Pain
Symptom Management
Guidelines across ESC
What
CCO has released pain and symptom
guidelines that help care providers assess and
manage patients’ symptoms.
Many assessment tools may be used but the
primary tool consistently used in Ontario is
the Edmonton Symptom Assessment System
(ESAS). Patients or their caregiver are asked
to complete an ESAS survey, both at the
Cancer Centre and in the community.
ESAS assesses and tracks nine common
symptoms experienced by cancer patients over
time – pain, tiredness, nausea, depression,
anxiety, drowsiness, appetite, well-being
and shortness of breath – rates their severity
from the patient’s perspective, and alerts care
providers to actions needed to better manage
these symptoms.
Why
The patient’s opinion of symptom severity
is paramount. ESAS alerts the Health care
Practitioner to symptoms that require relief
and comfort. It also provides a standardized
way to rank and communicate symptom
severity.
Priority #6:
IMPROVE PATIENT experience
( conti N ued )
Our Community Advisory Committee allows
patients, families and other concerned people
to inform the growth and development of our
programs and services from a unique and
important perspective.

16. CCO’s guidelines are based on evidence and
best practice. They identify consistent and
effective interventions to alleviate patient
symptoms.
How
• Deliver education sessions to care providers
• Conduct audits to ensure adherence to the
guidelines
Goal 16: Continue to build
a cross-sector, high-quality
‘system’ of Hospice palliative
care for Erie St. Clair
What
When active treatment is no longer the
primary goal of cancer care, integrated
palliative care is critical to ensuring that
patient care is well-coordinated, their
symptoms are well managed and that they
are properly supported.
Why
A comprehensive ESC Hospice Palliative
Care report was released in 2008. It
included recommendations for improved
quality, coordination and integration of
hospice palliative care services across
ESC. Wide implementation of the report’s
recommendations is now underway, including:
• educational strategies for care providers
• the formation of expert care teams
• the development of accountability and
reporting systems
• the planning for a full continuum of care
settings
Key goals of the program across ESC are:
• better coordination of care among multiple
providers
• development of interest and expertise in
Palliative Medicine among a larger group of
Family Physicians
How
• support advancement of a full continuum
of care settings and services for End of Life
Care / Hospice Palliative Care in all three
ESC counties
• support building and integration of Hospice
Palliative Care programs in all care settings
where patients die
• continue with Hospice and Palliative
Medicine integration activities and projects
Priority #6:
IMPROVE PATIENT experience
( conti N ued )

17. Erie St. Clair
Regional Cancer
Program
Communities
Served
L a k E E r i e
L a k E
S T. C L A I R
L a k E
H U R O N
“Together we are committed
to minimize the impact of
cancer and improve the quality
of life for the residents of the
Erie St. Clair Region.”
2220 Kildare Road, Windsor, ON N8W 2X3
519-253-3191 ext 58540
www.wrh.on.ca/escrcp