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"Literature indicates that 99% of clinicians believe that timely Goals of Care (GOC) conversations are important. However, only 11% of patients report having had GOC conversations with their providers throughout the trajectory of their disease. Congruent to this, it is reported that only 41% of patients feel that they have received care consistent with their preferences. One can therefore deduct that there is a great ethical gap in how patients are approached by healthcare providers, especially respecting their autonomous decision-making. As a concept, GOC refers to discussing patients' therapy intend, which is informed by the patients' hope, fears, information preferences, presumed minimally acceptable quality of life, and expectations for their future. Therefore it needs to be an explicit conversation which is personalized to each patient's context and circumstances. Within these conceptual ideas there are a myriad of ethical values which needs to be addressed. The author will explain how a Goals of Care initiative was started at the hospital where the author is a clinical ethicist and how these interactions with various members of the care team have been used to build ethics competencies of all the members of the care team. This innovative approach has been applauded by the participants for making ethics practical and applicable. The structure of the talk will focus on basic literature review, discussion on initiative (how it was set up), challenges, lessons learnt, value in ethics competency development. "

International audience ; In 2006, a remarkable collaboration between University of Texas MD Anderson Cancer Center clinicians andTexas and New Mexico State legislators led to the formation of a dedicated IBC Research Program and Clinicat MD Anderson. This initiative provided funding and infrastructure to foster coordination of an IBC WorldConsortium of national and international experts, and launch the first ever IBC international conference in2008, which brought together experts from around the world to facilitate collaborations and accelerateprogress. Indeed great progress has been made since then. National and international experts in IBCconvened at the 10th Anniversary Conference of the MD Anderson IBC Clinic and Research Program andpresented the most extensive sequencing analysis to date comparing IBC to non-IBC, gene- andprotein-based immunoprofiling of IBC versus non-IBC patients, and converging lines of evidence on thespecific role of the microenvironment in IBC. Novel models, unique metabolic mechanisms, and prominentsurvival pathways have been identified and were presented. Multiple clinical trials based on the work of thelast decade are in progress or in development. The important challenges ahead were discussed. This progressand a coordinated summary of these works are presented herein.

International audience ; In 2006, a remarkable collaboration between University of Texas MD Anderson Cancer Center clinicians andTexas and New Mexico State legislators led to the formation of a dedicated IBC Research Program and Clinicat MD Anderson. This initiative provided funding and infrastructure to foster coordination of an IBC WorldConsortium of national and international experts, and launch the first ever IBC international conference in2008, which brought together experts from around the world to facilitate collaborations and accelerateprogress. Indeed great progress has been made since then. National and international experts in IBCconvened at the 10th Anniversary Conference of the MD Anderson IBC Clinic and Research Program andpresented the most extensive sequencing analysis to date comparing IBC to non-IBC, gene- andprotein-based immunoprofiling of IBC versus non-IBC patients, and converging lines of evidence on thespecific role of the microenvironment in IBC. Novel models, unique metabolic mechanisms, and prominentsurvival pathways have been identified and were presented. Multiple clinical trials based on the work of thelast decade are in progress or in development. The important challenges ahead were discussed. This progressand a coordinated summary of these works are presented herein.

International audience ; In 2006, a remarkable collaboration between University of Texas MD Anderson Cancer Center clinicians andTexas and New Mexico State legislators led to the formation of a dedicated IBC Research Program and Clinicat MD Anderson. This initiative provided funding and infrastructure to foster coordination of an IBC WorldConsortium of national and international experts, and launch the first ever IBC international conference in2008, which brought together experts from around the world to facilitate collaborations and accelerateprogress. Indeed great progress has been made since then. National and international experts in IBCconvened at the 10th Anniversary Conference of the MD Anderson IBC Clinic and Research Program andpresented the most extensive sequencing analysis to date comparing IBC to non-IBC, gene- andprotein-based immunoprofiling of IBC versus non-IBC patients, and converging lines of evidence on thespecific role of the microenvironment in IBC. Novel models, unique metabolic mechanisms, and prominentsurvival pathways have been identified and were presented. Multiple clinical trials based on the work of thelast decade are in progress or in development. The important challenges ahead were discussed. This progressand a coordinated summary of these works are presented herein.

International audience ; In 2006, a remarkable collaboration between University of Texas MD Anderson Cancer Center clinicians andTexas and New Mexico State legislators led to the formation of a dedicated IBC Research Program and Clinicat MD Anderson. This initiative provided funding and infrastructure to foster coordination of an IBC WorldConsortium of national and international experts, and launch the first ever IBC international conference in2008, which brought together experts from around the world to facilitate collaborations and accelerateprogress. Indeed great progress has been made since then. National and international experts in IBCconvened at the 10th Anniversary Conference of the MD Anderson IBC Clinic and Research Program andpresented the most extensive sequencing analysis to date comparing IBC to non-IBC, gene- andprotein-based immunoprofiling of IBC versus non-IBC patients, and converging lines of evidence on thespecific role of the microenvironment in IBC. Novel models, unique metabolic mechanisms, and prominentsurvival pathways have been identified and were presented. Multiple clinical trials based on the work of thelast decade are in progress or in development. The important challenges ahead were discussed. This progressand a coordinated summary of these works are presented herein.

Report of the Texas State Auditor's Office related to performance measure certification, quality assurance team reviews, and information system vulnerability assessments of the University of Texas M.D. Anderson Cancer Center.

This unique book provides a retrospective analysis of the changes in survival outcomes at the University of Texas, M.D. Anderson Cancer Center over the past six decades. Since opening its doors in 1944, M.D. Anderson has kept a continuous, uninterrupted data repository of the treatment and outcomes of each of its patients. It is this visionary database from the center's tumor registry which makes this groundbreaking book possible. Tracking results across time, this book shows radical shifts in outcomes trends, where great progress has been made, and where there is still a long way to go, and o

Bill introduced by the Texas Senate relating to a contract for the acquisition of goods or services to which The University of Texas M. D. Anderson Cancer Center is a party.

Dr. Hicks begins this chapter by commenting that the state legislature in Austin monitors MD Anderson because the financial health of the institution has an impact on the entire University of Texas system. He notes that MD Anderson has returned to a solid financial footing.||Dr. Hicks comments on Dr. Peter Pisters' style, noting that he is a "student of leadership." He also observes that leadership used to take culture for granted, but now there is a concerted effort to cultivate the culture of the institution.||Next, Dr. Hicks sketches the leadership approaches of the MD Anderson presidents. He explains that Dr. Pisters is particularly attuned to the fact that healthcare is changing and brings skills in preparing the institution to navigate changes as the stakes and risks rise.||Dr. Hicks then explains that presidents need to resist the temptation to operate solely within their comfort zones. He comments on his own comfort zone and notes that he was tested by a financial crisis during his period as interim president. ; https://openworks.mdanderson.org/mchv_interviewchapters/1214/thumbnail.jpg

Intro -- Contents -- Preface -- Acknowledgments -- CHAPTER 1 R. Lee Clark, History, and the Dread Disease -- CHAPTER 2 Present at the Creation -- CHAPTER 3 Designing a Dream, 1946-1950 -- CHAPTER 4 The Pink Palace, 1950-1955 -- CHAPTER 5 Changing Paradigms, 1956-1963 -- CHAPTER 6 M. D. Anderson and the Rise of Medical Oncology, 1964-1969 -- CHAPTER 7 The Summit, 1970-1971 -- CHAPTER 8 Waging War and Fading Away, 1971-1977 -- CHAPTER 9 Charles A. LeMaistre and the Consolidation of Excellence, 1978-1983 -- CHAPTER 10 Chasing the Devil, 1984-1988 -- CHAPTER 11 Victory, Defeat, and an Elusive Enemy, 1988-1996 -- CHAPTER 12 John Mendelsohn and the New Frontiers in Oncology, 1996-2000 -- CHAPTER 13 New Offensives, 2001-2007 -- CHAPTER 14 Tipping History? -- Epilogue -- Notes -- Bibliography -- Index -- A -- B -- C -- D -- E -- F -- G -- H -- I -- J -- K -- L -- M -- N -- O -- P -- Q -- R -- S -- T -- U -- V -- W -- Y -- Z -- Illustrations.

Dr. Gehan talks about patient referral practices and perspectives between the Department of Medicine, headed by Dr. Clifton "Cliff" Howe, and the Department of Developmental Therapeutics headed by Dr. Emil Frei III. He discusses direct referrals to Dr. Frei III and Freireich, Dr. C. C. Shullenberger (chronic leukemias), and Dr. Raymond "Ray" Alexanian (multiple myeloma). ; https://openworks.mdanderson.org/mchv_interviewchapters/1315/thumbnail.jpg

The interviewers ask Dr. Gehan to talk about his MD Anderson colleagues. A statistician by nature he offers to evaluate his colleagues on a 1-10 rating scale while identifying the strengths and weaknesses of each individual. ; https://openworks.mdanderson.org/mchv_interviewchapters/1321/thumbnail.jpg

In this chapter, Ms. Yadiny characterizes the "MD Anderson way of leadership training." She explains that in 2002 her office settled on a skill-based approach that differed from the theoretical focus of earlier programs. She notes that Dr. Margaret Kripke advocated adoption of this approach and that the program for women faculty, Executive Leadership in Academic Medicine [ELAM], served as a model and was enthusiastically welcomed by all faculty. She next gives examples of challenging situations that MD Anderson leaders can find themselves in (e.g. emotional blackmail and manipulation). She notes that a psychologist at Rice University introduced her to the idea that transition into leadership is a turbulent process akin to an identity crisis. She talks about the learning curve for developing as a leader and emphasizes that MD Anderson is a very complex culture: some leadership consultants have characterized it as the most challenging and toxic they have encountered. ; https://openworks.mdanderson.org/mchv_interviewchapters/1256/thumbnail.jpg

In this chapter, Dr. Arlinghaus offers his views of the four MD Anderson presidents. He describes Dr. R. Lee Clark as a "true visionary" who realized surgery wasn't sufficient to address cancer and other specialties were needed to unravel its mysteries.Dr. Arlinghaus confirms that Dr. Charles LeMaistre was very supportive of him.He talks about some tensions among department chairs and comments on his own leadership style.He recalls the influence of his mother, Loretta, on his character and behavior.Dr. Arlinghaus next talks about Dr. John Mendelsohn.[The recorder is paused]Dr. Arlinghaus notes that Dr. Mendelsohn's discovery of a new cancer drug was a "remarkable achievement" and that he added to the strength of the institution.Next he talks about Dr. Ronald DePinho, offering the view that the institution will grow under his leadership. ; https://openworks.mdanderson.org/mchv_interviewchapters/1296/thumbnail.jpg