Outcomes

The ultimate measure of a hospital's cancer care quality is reflected in its patient outcomes, and the Maine Medical Center Cancer Institute's outcomes are superior when compared with national benchmarks. At the Cancer Institute we believe that optimal patient outcomes are achieved through our multidisciplinary team approach to diagnosis, staging and treatment.

A team of specialists meets on a regular basis to review and discuss individual cases. The teams include physician specialists from medical oncology, surgery, radiation therapy, radiology, and pathology, as well as clinical patient navigators, research nurses, dietitians, social workers, palliative care specialists, and other members of the care team. A team approach to cancer care can reduce mortality and improve patients' quality of life through timely diagnosis, staging, and treatment.

There is also a wealth of evidence linking higher volume to better patient outcomes. The Cancer Institute cares for more patients diagnosed with cancer, including some of the most difficult cases in the state, than any other hospital in Maine.

The success of our programs is also measured by patient satisfaction. Patient feedback is solicited regularly to ensure that we are providing high quality care, and to provide us with opportunities for quality improvement.

Volume & Benchmarking Data

There is a wealth of evidence linking higher volume to better patient outcomes. MMC cares for more patients diagnosed with cancer, including some of the most difficult cases in the state, than any other hospital in Maine. Of the estimated 8,000 people in this state who are diagnosed with cancer each year, more than 2,700—or one-third—will turn to MMC Cancer Institute for some aspect of their diagnosis or treatment.

Using Informatics to Improve the Quality of Cancer Care

MMC has what is arguably the most robust medical informatics program in the state. As a Commission on Cancer-accredited institution (MMC is Maine's only teaching hospital to achieve this level of accreditation), the medical center maintains a comprehensive cancer registry. This is a repository of data drawn from medical records on the incidence of cancer, and it includes demographic, pathologic, quality-of-life outcomes and cancer-specific outcomes of patients treated at MMC. The data are continually analyzed to evaluate how specific cancer treatments affect patient outcomes, providing accurate information with which physicians can develop and refine best practices and compare themselves against state and national quality benchmarks. Our data is also used to provide patients with accurate information when they are trying to make a well-informed choice about which treatment to undergo for their cancer.

Volume and Types of Patients with Cancer Diagnosed at Maine Medical Center

Chart 1: Indicates the distribution of cancer case sites for 2016 – the most recent year the data is available through the American College of Surgeons' Commission on Cancer (CoC) approved Network Cancer Registry.

Cancer at Maine Medical Center in 2016

4091 MMCCI Quality Outcomes 3 18 01

Chart 2: Among these types of cancers, MMC treats more patients than any other hospital in Maine. For patients, this means your care team at MMC has a level of experience that is unmatched in the state.

Percentage of all Maine Cancers Seen at Maine Medical Center

4091 MMCCI Quality Outcomes 3 18 02

* 1-year average based on 2014-2016
 

Chart 3: Specific information about the types of cancer treated at MMC can also be found by reviewing cancer staging data, which uses a system of numbers and letters to describe how much cancer has spread. This information helps physicians make treatment plans for individual patients. For a more detailed breakdown of the number and percent of cancer cases diagnosed by body part and American Joint Committee on Cancer (AJCC) stage, visit the CoC website: www.facs.org/cancer. You will be able to search for specific information regarding the cancer program at Maine Medical Center.

The Cancer Program Practice Profile Reports (CP3R) have been implemented for the purpose of fostering quality improvement at cancer programs awarded Commission on Cancer Accreditation. As a hospital which has been awarded accreditation as an Academic Comprehensive Cancer Program, Maine Medical Center participates in these studies. The CP3R provides feedback to CoC programs to improve the quality of data as well as clinical management and coordination of patient care in the multidisciplinary setting. In addition, the CP3R is designed specifically to promote quality improvement activities that can assist facilities in the fulfillment of the CoC Accreditation Standards requirements. The estimated performance rates shown below are an indication of MMC’s concordance with evidence based treatment guidelines for high volume tumor sites (i.e. breast, colorectal, genitourinary, gynecologic oncology, and lung) for patients diagnosed in 2015.

Cancer Program Practice Profile Reports (CP3R)

  2013 2014 2015 Maine Avg New England All CoC
BREAST
Breast conservation surgery rate for women with AJCC clinical Stage 0, I, or II breast cancer. 57% 58% 54% 61% 76% 66%
Image or palpation-guided needle biopsy (core or FNA) is performed to establish diagnosis of breast cancer. 99% 100% 99% 94% 93% 92%
Radiation therapy is considered or administered following any mastectomy within 1 year (365 days) of diagnosis of breast cancer for women with 4 or more positive regional lymph nodes. 100% 100% 100% 93% 94% 89%
Radiation therapy is administered within 1 year (365 days) of diagnosis for women under age 70 receiving breast conserving surgery for breast cancer. 98% 95% 93% 95% 95% 92%
Combination chemotherapy is considered or administered within 4 months (120 days) of diagnosis for women under 70 with AJCC T1cN0M0, or Stage II or III ERA and PRA negative breast cancer. 100% 100% 100% 95% 97% 93%
Tamoxifin or third generation aromatase inhibitor is considered or administered within 1 year (365 days) of diagnosis for women with AJCC Stage T1cN0M0, or Stage II or III ERA and/or PRA positive breast cancer. 98% 97% 96% 96% 96% 93%
COLORECTAL
Adjuvant chemotherapy is considered or administered within 4 months (120 days) of diagnosis for patients under the age of 80 with AJCC Stage III (lymph node positive) colon cancer.
92% 100% 92% 93% 89% 89%
At least 12 regional lymph nodes are removed and pathologically examined for resected colon cancer.
95% 98% 99% 96% 95% 92%
Preoperative chemo and radiation are administered for clinical AJCC T3N0, T4N0, or Stage III; or Postoperative chemo and radiation are administered within 180 days of diagnosis for clinical AJCC T1-2N0 with pathologic AJCC T3N0, T4N0, or Stage III; or treatment is recommended; for patients under the age of 80 receiving resection for rectal cancer.
100% 82% 100% 93% 87% 88%
GENITOURINARY
BLADDER
At least 2 lymph nodes are removed in patients under 80 undergoing partial or radical cystectomy.
90% 100% 92% 100% 92% 93%
Radical or partial cystectomy: or tri-modality therapy (Local tumor destruction/excision with chemotherapy and radiation) for clinical T234N0M0 patients with urothelial carcinoma of the bladder, first treatment within 90 days of diagnosis.
91% 67% 82% 82% 62% 60%
Neo-adjuvant of adjuvant chemotherapy recommended or administered for patients with muscle invasive cancer undergoing radical cystectomy.
70% 71% 92% 100% 68% 67%
GYNECOLOGIC ONCOLOGY
CREVIX
Radiation therapy is completed within 60 days of initiation of radiation among women diagnosed with any stage of cervical cancer.
75% 92% 86% 89% 87% 80%
Chemotherapy is administered to cervical cancer patients who received radiation for Stages IB2-IV cancer (Group 1) or with positive pelvic nodes, positive surgical margin, and/or positive parametrium (Group 2).
86% 71% 100% 92% 93% 90%
Use of brachytherapy in patients treated with primary radiation with curative intent in any stage of cervical cancer.
100% 88% 100% 82% 80% 70%
OVARY
Salpingo-oophorectomy with omentectomy, debulking/cytoreductive surgery, or pelvic exenteration in Stages I-IIIC ovarian cancer.
82% 77% 66% 61% 66% 71%
ENDOMETRIUM
Chemotherapy and/or radiation is administered to patients with Stage IIIC or IV endometrial cancer.
82% 85% 100% 100% 93% 84%
Endoscopic, laparoscopic, or robotic surgery is performed for all endometrial cancer (excluding sarcoma and lymphoma), for all stages except Stage IV.
93% 92% 89% 88% 83% 78%
LUNG
At least 10 regional lymph nodes are removed and pathologically examined for AJCC Stage IA, IB, IIA and IIB resected NSCLC.
57% 60% 73% 61% 41% 48%
Surgery is not the first course of treatment fo AJCC Stage cN2, M0 lung cases.
86% 91% 95% 92% 93% 92%
Systemic chemotherapy is administered within 4 months to day preoperatively or day of surgery to 6 months postoperatively, or it is considered for surgically resected cases with pathologic lymph node-positive (pN1) and (pN2) NSCLC.
93% 100% 100% 97% 95% 92%
* National Accreditation Program for Breast Centers' benchmark is greater than 50%. Data Source: CP3R, Commission on Cancer, first released: November 2008, last updated: October 2017. For a more complete description of the Commission on Cancer Practice Profile Report, please visit the following website: www.facs.org/cancer

Patient Satisfaction

The Maine Medical Center Cancer Institute strives to ensure that our health care team is as caring and efficient as possible. An important way that we measure our success is through patient feedback. Surveys are distributed to patients on a regular basis by NRC Picker, a highly regarded national healthcare quality assessment organization. These surveys provide important information that allows our staff to learn how patients feel about services as compared to other hospitals in the country. This information is used to continuously improve the level of patient satisfaction with our services. Survey results are available from patients admitted to Gibson Pavilion, our 44-bed medical oncology unit, which also includes gynecology and surgical oncology patients. We also survey patients in our key outpatient services, such as Radiation Oncology (Portland, Scarborough and Bath sites) and our outpatient clinics located on the MMC Scarborough campus.
 

4218 MMC PatientSatisfaction Charts 042018 V1

Source: Quarterly data from NRC Picker, national healthcare quality assessment organization, March 2018.
All cancer procedures present unique risks and such risks may affect a particular patient’s outcome.