Building a statewide clinical trials network for cancer care in West Virginia.

In the United States, mortality rates have been declining for certain tumors, For the majority of advanced stage cancer types, cure is unattainable but treatment is still evolving. Advances in the treatment of cancer can be achieved by enrolling patients in cancer clinical trials. Presently, less than 3% of adult cancer patients participate on clinical trials in the United States. Providing cancer care and access to clinical trials are a challenge in a rural state, with a dispersed population base, such as West Virginia. Building upon recognition of barriers to clinical trials awareness and access, oncology leaders in the state are in the formative stages of developing a statewide cancer clinical trials network. Realization of this network will have an enormous impact on cancer care in our state and perhaps can serve as a model for other community and physician teams for other diseases.

From high tech to high touch: integrating community voices in mobile mammography outreach.

Providing mobile screening mammography services across the state of West Virginia (WV) presents unique challenges. The ability of new machines to screen for breast cancer is modern medicine at its best. The use of the mobile unit, "Bonnie's Bus", holds promise for getting this high tech equipment to women in rural areas of West Virginia where it is most needed. Cancer detected in early stages is more treatable and women have a better chance of becoming survivors. The key to the program's success resides with the women who come for the screening, the extension network of community members who help set up and assist women to access the screening system, and community health care providers who care for the women if cancer is found. Linking "community voices" with the programs funded under the WV Komen grant screening programs provides a winning solution for West Virginia and the women served by Bonnie's Bus. Information obtained from five focus groups of 58 community leaders and women residing in rural WV was used to develop the mobile program. Building upon established relationships with the West Virginia Breast and Cervical Cancer Screening Program (WV BCCSP) coordinators and providers, outreach and information gleaned from WV communities, is being used to develop community partnerships based on mutual trust and respect to advance the common goal of decreasing breast cancer related illness and death in West Virginia women.

The development and outcomes of a statewide network of hospital-based palliative care teams.

BACKGROUND: Health care systems need to be developed that meet the palliative care needs of patients and their families. OBJECTIVE: The West Virginia Initiative to Improve End-of-Life Care charged its Palliative Care Delivery System Task Force with developing hospital-based palliative care teams in West Virginia. SETTING/SUBJECTS: A descriptive study of a state-community partnership to improve palliative care. MEASUREMENTS: Numbers of member hospitals, number and nature of palliative care consultations, number of patients referred to hospice programs. RESULTS: What began as a palliative care network of five hospitals has grown into a network of 16. Network members advise one another on financing, staffing, and obtaining administrative buy-in, and the network leaders provide educational programs to prepare physicians and nurses to serve as consultants on hospital-based palliative care teams. There was a 300% increase in the number of palliative care consultations between 2000 and 2003 in 49 of West Virginia's 55 counties. Analysis of the submitted data collections forms has allowed the network to promote improvement in palliative care consultations in member hospitals and to initiate interventions on a statewide basis to improve decision-making with the appropriate legal agent, treatment of pain, and referral of patients for hospice care. CONCLUSION: Hospital participation in the Palliative Care Delivery System Task Force led to a sustained membership organization, the West Virginia Palliative Care Network that promotes hospital-based palliative care.