Improving quality of cancer care: Lessons learned from the journey towards QOPI Certification.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 263-263
Author(s):  
Nafisa Abdelhafiez ◽  
Mona Mohamed Alshami ◽  
Mohammad Omar Al-Kaiyat ◽  
Tabrez Pasha ◽  
Nashmia Mutairi ◽  
...  
Keyword(s):  
Cancer Care ◽  
Treatment Plan ◽  
Lessons Learned ◽  
Team Members ◽  
Noticeable Improvement ◽  
Check System ◽  
American Society ◽  
Oncology Practice ◽  
Super Users

263 Background: To assess the quality of cancer care provided at our institution, we participated in Quality Oncology Practice Initiative (QOPI) of American Society of Clinical Oncology (ASCO). However, our initial two rounds revealed lower score than required for QOPI Certification. Our goal was to implement interventions based on lessons learned from the initial rounds. Methods: Prior to the third round and using plan-do-study-act (PDSA) cycles, we identified and worked on three processes: clarifying and enhancing the function of the team, optimizing communication and improving documentation. We created QOPI multi-disciplinary team to include more members from different disciplines. We enhanced the knowledge of the team regarding our electronic health records system (EHRS) by conducting educational sessions and nominating super users who are very competent in EHRS and peer-to-peer support was created. Members were entering data in group sessions with the help of super users. We established double check system for records to be reviewed by two team members before submission. communication was assured among team members through weekly in person meetings and with ASCO QOPI team via virtual meetings to address queries. Documentation was improved by creating newer templates that conform with QOPI requirements including chemotherapy treatment plan, end of treatment summary and documentation of treatment consent. Results: The implementation of these interventions over three PDSA cycles made noticeable improvement in the previously unmet standards resulting in a score that exceeded the benchmark in fall of 2017 (score of 93%). This made our practice eligible for on-site certification visit by ASCO QOPI surveyors on May 2018 to assess practice compliance with QOPI standards. After addressing the unmet standards from the visit, our center became the first QOPI Certified Center in the Middle East and Asia in October/2018. Conclusions: Our journey towards QOPI Certification highlights the importance of fundamental principles in health care: coordinated multidisciplinary team, effective communication and proper documentation that captures essential and critical items reflecting better quality of care.

Clinical Oncology Practice 2015: Preparing for the Future

2015 ◽  
pp. e622-e627 ◽  
Author(s):  
Michael P. Kosty ◽  
Anupama Kurup Acheson ◽  
Eric D. Tetzlaff
Keyword(s):  
Clinical Oncology ◽  
Nurse Practitioners ◽  
Cancer Care ◽  
Medical Knowledge ◽  
Physician Assistants ◽  
The United States ◽  
Practice Model ◽  
American Society ◽  
Oncology Practice

The clinical practice of oncology has become increasingly complex. An explosion of medical knowledge, increased demands on provider time, and involved patients have changed the way many oncologists practice. What was an acceptable practice model in the past may now be relatively inefficient. This review covers three areas that address these changes. The American Society of Clinical Oncology (ASCO) National Oncology Census defines who the U.S. oncology community is, and their perceptions of how practice patterns may be changing. The National Cancer Institute (NCI)-ASCO Teams in Cancer Care Project explores how best to employ team science to improve the efficiency and quality of cancer care in the United States. Finally, how physician assistants (PAs) and nurse practitioners (NPs) might be best integrated into team-based care in oncology and the barriers to integration are reviewed.

A Process for Measuring the Quality of Cancer Care: The Quality Oncology Practice Initiative

2005 ◽  
Vol 23 (25) ◽  
pp. 6233-6239 ◽  
Author(s):  
Michael N. Neuss ◽  
Christopher E. Desch ◽  
Kristen K. McNiff ◽  
Peter D. Eisenberg ◽  
Dean H. Gesme ◽  
...  
Keyword(s):  
Cancer Care ◽  
Quality Care ◽  
Pathology Report ◽  
Self Assessment ◽  
Colon And Rectal Cancer ◽  
High Concordance ◽  
American Society ◽  
Oncology Practice ◽  
Self Examination

Purpose The Quality Oncology Practice Initiative (QOPI) is a practice-based system of quality self-assessment sponsored by the participants and the American Society of Clinical Oncology (ASCO). The process of quality evaluation, development of the pilot questionnaire, and preliminary results are reported. Methods Physicians from seven oncology groups developed medical record abstraction measures based on practice guidelines and consensus-supported indicators of quality care. Each practice completed two rounds of records review and received practice and aggregate results. Mean frequencies of responses for each indicator were compared among practices. Results Participants universally, if informally, find QOPI helpful, and results show statistically significant variation among practices for several indicators, including assessing pain in patients close to death, documentation of informed consent for chemotherapy, and concordance with granulocytic and erythroid growth factor administration guidelines. Measures with universally high concordance include the use of serotonin antagonist antiemetics according to the ASCO guideline; the presence of a pathology report in the record; the use of chemotherapy flow sheets; and adherence to standard chemotherapy recommendations for patients with certain stages of breast, colon, and rectal cancer. Concordance with quality indicators significantly changed between survey rounds for several measures. Conclusion Pilot results indicate that the QOPI process provides a rapid and objective measurement of practice quality that allows comparisons among practices and over time. It also provides a mechanism for measuring concordance with published guidelines. Most importantly, it provides a tool for practice self-examination that can promote excellence in cancer care.

scholarly journals The Value of New Fields in the Medical Record for Quality Improvement

2021 ◽  
Author(s):  
Theodore Poufos ◽  
Georgios Rigakos ◽  
Stefanos Labropoulos ◽  
Kalliopi Stathaki ◽  
Ioanna Theodorakopoulou ◽  
...  
Keyword(s):  
Medical Record ◽  
Treatment Plan ◽  
Healthcare Delivery ◽  
Well Being ◽  
Psychosocial Assessment ◽  
Paper Medical Record ◽  
American Society ◽  
Oncology Practice ◽  
Quality In Healthcare

ABSTRACT Introduction Quality in healthcare delivery is important for the safety and experience of patients with cancer. Effective documentation is an integral component of quality improvment, and accurate documentation can be affected by prompts in the medical record, potentially improving quality of services. Methods The Contemporary Oncology Team (COT) is a Greek private oncology practice that participated in the American Society of Clinical Oncology's (ASCO's) Quality in Oncology Practice Initiative (QOPI). Between 2014 and 2019, COT implemented changes in its paper patient medical record, in order to improve quality of care and documentation. Fields regarding pain, emotional well-being and psychosocial assessment, discussions with the patient and consent about treatment and disease, medication details and cumulative dose, treatment goals, side-effect grading, pregnancy screening, treatment adherence and anticipated duration were added. In this report, we present the association of these improvements with COT performance in QOPI. Results Pain and emotional well-being assessment and documentation were significantly improved by the development of a structured patient follow-up form. In contrast, the assessment of fertility issues, tobacco use, and the documentation of treatment plan and intent did not present a drastic change, because COT performance was already above QOPI average. Conclusion A thorough reform of COT paper medical record according to QOPI standards improved QOPI scores, but more importantly effected a shift in the team's culture to safer and more standardized quality based care.

Patient and caregiver’s satisfaction with multidisciplinary vs. serial lung cancer care in a community setting.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 200-200
Author(s):  
Huibo Shao ◽  
Nicholas Faris ◽  
Meghan Brooke Taylor ◽  
Carrie Fehnel ◽  
Anita Patel ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Cancer Care ◽  
Care Delivery ◽  
Financial Burden ◽  
Treatment Plan ◽  
Hospital System ◽  
Team Members ◽  
Lung Cancer Patients

200 Background: Few existing studies examined lung cancer patients and caregivers’ satisfaction with the team-based multidisciplinary care (MD) in comparison to the usual serial care (SC). We hypothesized that MD, by providing early and concurrent input from key specialists collaborating as a team with patients and caregivers to develop a consensus care plan, can improve patients and caregivers’ satisfaction with care, compared to SC, in which multiple specialists independently screen, diagnose, and treat patients through a fragmented sequence of referrals. Methods: Data on newly diagnosed lung cancer patients, enrolled in a prospective matched cohort comparative effectiveness trial of MD or SC between Oct. 9th, 2014 and July 5th, 2017 in a Mid-South community hospital system, were collected at baseline, 3- and 6-month periods to assess patient and caregiver’s satisfaction with these two care-delivery models. Measures of satisfaction were adapted from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. Multivariate mixed linear models were used to examine the cross-group differences, the time-related variances, and how the interaction between groups and time-periods influenced patients’ and caregivers’ satisfaction. Results: Compared with SC (N = 297), patients in MD (N = 159) were older (66 vs. 69 years), more in an early cancer stage (33% vs. 41% in stage I or II), and lower in performance score (35% vs. 45% asymptomatic). Demographic and social-economic characteristics of caregivers in MD (N = 97) and SC (N = 122) were not significantly different. Patients and caregivers in MD were more likely than those in SC to perceive their care to be better than that received by other patients (p =.003 and p <.001 respectively). Greater satisfaction with their treatment plan at 6-month was observed among the MD patients (p =.004). Also, MD patients reported better overall satisfaction with team members (p =.038). Consistent with the findings among the patients in MD, caregivers in MD were more satisfied with the quality of care (p <.001) and with care received from team members (p <.001) than that reported by caregivers in SC. Conclusions: Coordinated MD care improved patients and caregivers’ satisfaction with lung cancer care in a community healthcare system. Further research will compare the quality of life and financial burden on patients in the MD and SC treatment models to provide more evidence for stakeholders to refine cancer care models.

Proposed Agenda for the Measurement of Quality-of-Care Outcomes in Oncology Practice

1999 ◽  
Vol 17 (8) ◽  
pp. 2614-2614 ◽  
Author(s):  
Jeanne S. Mandelblatt ◽  
Patricia A. Ganz ◽  
Katherine L. Kahn
Keyword(s):  
Breast Cancer ◽  
Quality Of Care ◽  
Outcome Measures ◽  
Cancer Care ◽  
The United States ◽  
Leadership Role ◽  
Institute Of Medicine ◽  
Oncology Practice ◽  
The Impact

ABSTRACT: Cancer is an important disease, and health care services have the potential to improve the quality and quantity of life for cancer patients. The delivery of these services also has recently been well codified. Given this framework, cancer care presents a unique opportunity for clinicians to develop and test outcome measures across diverse practice settings. Recently, the Institute of Medicine released a report reviewing the quality of cancer care in the United States and called for further development and monitoring of quality indicators. Thus, as we move into the 21st century, professional and regulatory agencies will be seeking to expand process measures and develop and validate outcomes-oriented measures for cancer and other diseases. For such measures to be clinically relevant and feasible, it is key that the oncology community take an active leadership role in this process. To set the stage for such activities, this article first reviews broad methodologic concerns involved in selecting measures of the quality of care, using breast cancer to exemplify key issues. We then use the case of breast cancer to review the different phases of cancer care and provide examples of phase-specific measures that, after careful operationalization, testing, and validation, could be used as the basis of an agenda for measuring the quality of breast cancer care in oncology practice. The diffusion of process and outcome measures into practice; the practicality, reliability, and validity of these measures; and the impact that these indicators have on practice patterns and the health of populations will be key to evaluating the success of such quality-of-care paradigms. Ultimately, improved quality of care should translate into morbidity and mortality reductions.

Public reporting outcomes of multidisciplinary cancer care: Conceptual issues.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 280-280
Author(s):  
James Austin Talcott
Keyword(s):  
Cancer Patient ◽  
Patient Outcomes ◽  
Cancer Care ◽  
Treatment Plan ◽  
Multidisciplinary Care ◽  
Collective Responsibility ◽  
Public Reporting ◽  
Analytic Description ◽  
Eligibility Criteria

280 Background: Patient outcomes are the most valid measures of quality of care. Public reporting makes them available to patients, referring physicians and payers. Our institution has committed to reporting all cancer patient outcomes. In carrying out that objective, we encountered novel analytical issues arising from differences between the usually reported treatments, surgical procedures, and multidisciplinary cancer care. We present important conceptual issues we identified. Methods: Analytic description of methodological issues encountered in publishing cancer patient outcomes. Results: Issues include: (1) Assigning responsibility. Patient outcomes of multidisciplinary cancer care can be influenced by multiple oncology specialties and institutions. While providers directly control only the treatment they provide, providers share collective responsibility for executing the treatment plan, coordinating care and vouching for the quality of collaborating providers. Therefore, reporting outcomes of one element of multidisciplinary care is incomplete and inadequate. (2) Claiming responsibility. Providers with institutional affiliations but no involvement in quality improvement or reporting processes should be excluded from public reporting. Minimum requirements to qualify for public institutional affiliation should be enforced and “free riders” identified. (3) Defining and presenting valid comparison populations. Treatment trials’ eligibility criteria and recruitment practices exclude poorer prognosis patients, producing biased comparisons to complete “registry” populations that distort patient expectations. Publishing outcomes of well-characterized subpopulations improves valid results and provides more individualized information. Conclusions: Reporting patient outcomes after multidisciplinary cancer care raises novel conceptual issues. We discuss our response to three important issues.

Developing and implementing EMR functionality to improve oral chemotherapy outcomes.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 159-159
Author(s):  
Thomas A. Hensing ◽  
Bruce Brockstein ◽  
George W. Carro ◽  
Ashton Marie Hullett ◽  
Brad Hughes ◽  
...  
Keyword(s):  
Anticancer Agents ◽  
Quality Care ◽  
Insurance Coverage ◽  
Team Members ◽  
Monitoring Tools ◽  
American Society ◽  
Oncology Practice ◽  
Documentation Tool ◽  
Similar Growth

159 Background: Approval of new oral anticancer agents (OAA) continues to rise, accounting for 75% of new oncology drugs approved so far in 2015. OAA prescriptions generated at our institution demonstrate similar growth, as the prescription volume for OAA is approximately 200% greater than it was 8 years ago. Challenges of OAA, including safe prescribing, monitoring toxicities, and assessing adherence, continue to be an obstacle to providing quality care. In recognition of these challenges, our institution employed the electronic medical record (EMR) to develop tools to enhance safe prescribing, monitoring, and follow up for patients receiving OAA. Methods: Comprehensive, regimen-specific, OAA protocols were built in the EMR using the American Society of Clinical Oncology’s Quality Oncology Practice Initiative criteria as a guide. Protocols included OAA prescriptions, laboratory tests, monitoring communications, supportive care medications, plan for follow up, and a monitoring order. The monitoring order, dated 7 to 10 days after the start of each cycle, was utilized to identify patients for follow up, and as a documentation tool. During follow up calls, pharmacists provided education, addressed adherence and toxicities, and communicated findings to team members. The initial analysis focused on six of the most commonly prescribed OAA agents at our institution. Results: Cycle 1 follow up calls were placed for 115 new start OAA patients. Over half of the patients (56.5%) required an intervention (ex: symptom management, alerting the medical team, counseling). Eleven patients had barriers to adherence (ex: confusion, incorrect technique, cost, obtaining insurance coverage, and toxicity). Overall, 98% of patients verbalized appropriate adherence. There were 191 subsequent follow up efforts, after the cycle 1 follow up call, which resulted in 39 interventions (20%). Conclusions: OAA requires the same intensive monitoring and follow up as IV chemotherapy, but is more difficult to provide given the nature of administration of these medications. Utilizing the EMR to develop prescribing and monitoring tools can help address these challenges by providing a means for enhanced documentation and follow up.

Improving the quality of oral cancer drug delivery across a health system.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 184-184
Author(s):  
Katherine Enright ◽  
Rosemary Ku ◽  
Daniela Gallo-Hershberg ◽  
Aliya Pardhan ◽  
Leta Marie Forbes
Keyword(s):  
Patient Education ◽  
Cancer Care ◽  
Care Delivery ◽  
Treatment Plan ◽  
Quality Measures ◽  
Patient Specific ◽  
Cancer Drug ◽  
Use Of Technology ◽  
Adherence Monitoring

184 Background: Oral systemic therapy (ST) presents unique care delivery challenges. Gaps in patient education and monitoring for patients on oral ST delivery are well documented and can result in decreased adherence or increased toxicity. Within Ontario, cancer care is provincially coordinated through Ontario Health- Cancer Care Ontario (OH-CCO), but locally implemented by 14 Regional Cancer Programs (RCPs). Using a centrally coordinated, but regionally implemented quality improvement (QI) approach, we aimed to improve the quality of oral ST delivery across Ontario by enabling the use of patient specific monitoring plans to optimize treatment adherence and toxicity management. Methods: Between 2018 and 2020 a 2 year focused QI project was undertaken. A suite of 19 quality measures were developed to measure different quality domains for oral ST delivery including treatment plan documentation, patient education, toxicity/adherence monitoring and toxicity outcomes. In year 1, all regions used the suite of quality measures to establish baseline performance and develop a QI plan using rapid cycle improvement methodology to improve performance in at least 1 domain based on regional gaps and priorities. Projects were implemented and evaluated during year 2. OH-CCO provided QI coaching through dissemination of standardized QI tools, a monthly discussion forum and project specific feedback. At the end of year 2, a post-implementation evaluation was performed for each region. Results: 15 centers participated, representing all RCPs across Ontario. The participating centers implemented QI projects focused on treatment plan documentation (N = 3), patient education (N = 10) and toxicity/adherence management (N = 5), with some focusing on multiple domains. All centers reported an improvement in at least 1 domain (see Table). Key enablers identified include engagement with a multi-disciplinary team and the use of technology, while barriers include lack of onsite dispensing pharmacy. Future work will continue to focus on quality of oral ST delivery and better pharmacy integration. Conclusions: Through a centrally coordinated, locally implemented QI project, improvement in quality of oral ST care was achieved across Ontario. This model of QI focus has the potential to be adaptable across health systems. [Table: see text]

Measuring Supportive Care in Medical Oncology Practice: Lessons Learned From the Quality Oncology Practice Initiative

2008 ◽  
Vol 26 (23) ◽  
pp. 3832-3837 ◽  
Author(s):  
Kristen K. McNiff ◽  
Michael N. Neuss ◽  
Joseph O. Jacobson ◽  
Peter D. Eisenberg ◽  
Pamela Kadlubek ◽  
...  
Keyword(s):  
Supportive Care ◽  
Chart Review ◽  
Medical Oncology ◽  
Quality Measurement ◽  
Lessons Learned ◽  
Self Assessment ◽  
Improvement Program ◽  
Medical Oncologists ◽  
American Society ◽  
Oncology Practice

We provide a brief review of the use of quality measures to assess supportive care in the medical oncology office. Specifically, we discuss the development and implementation of supportive care measures in the Quality Oncology Practice Initiative (QOPI), a voluntary quality measurement and improvement program of the American Society of Clinical Oncology. QOPI has demonstrated that medical oncologists voluntarily engage in self-assessment and often select measures related to supportive care for measurement and improvement. Results to date have demonstrated that there is room for improvement in this domain. Because supportive care measures appropriate for use through structured chart review in the outpatient oncology setting are not generally available in the published literature, measures have been developed and tested through the program. Additional measures are in development for implementation in QOPI in 2008.

Why the Quality Oncology Practice Initiative Matters: It’s Not Just About Cost

2016 ◽  
pp. e102-e107 ◽  
Author(s):  
Anne C. Chiang
Keyword(s):  
Quality Improvement ◽  
Clinical Oncology ◽  
Cancer Care ◽  
Treatment Options ◽  
Certification Program ◽  
Improved Outcomes ◽  
Regulatory Mandates ◽  
American Society ◽  
Oncology Practice ◽  
Changing Demographics

The nature and cost of cancer care is evolving, affecting more patients and often involving expensive treatment options. The upward cost trends also coincide with a national landscape of increasing regulatory mandates that may demand improved outcomes and value, but that often require significant up-front investment in infrastructure to achieve safety and quality. Oncology practices participating in the American Society of Clinical Oncology (ASCO) Institute for Quality’s Quality Oncology Practice Initiative (QOPI) and the QOPI Certification Program (QCP) continue to grow in number and reflect changing demographics of the provision of cancer care. QOPI and QCP benchmarking can be used to achieve quality improvement and to build collaborative quality communities. These programs may be useful tools for oncology practices to comply with new legislation such as the Medicare Access and CHIP Reauthorization Act (MACRA).

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