Driving improvement in oncofertility.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 183-183
Author(s):  
Shelby Darland ◽  
Jennifer N. Eichmeyer ◽  
Kelli Christiaens ◽  
Kallie Penchansky ◽  
Michele Betts ◽  
...  
Keyword(s):  
Support Staff ◽  
Perceived Barriers ◽  
Reproductive Age ◽  
Patient Identification ◽  
Cancer Centers ◽  
Process Implementation ◽  
Chart Audits ◽  
American Society ◽  
Oncology Practice

183 Background: In 2006 the American Society of Clinical Oncology (ASCO) recommended that oncologists discuss infertility as a result of cancer treatment with patients of reproductive age and provide referrals to specialists as needed. Despite these guidelines the majority of cancer centers are not in compliance. Mountain States Tumor Institute (MSTI) piloted a process to improve quality of oncofertility preservation (OP) through identification, documentation, and referral to reproductive specialists. Methods: A physician survey in 2010 indicated that perceived barriers to OP discussion were a lack of accessible materials as well as oversight on the part of the provider. Random chart audits of the Quality Oncology Practice Initiative (QOPI) measures (infertility risks discussed prior to treatment and fertility preservation options discussed/referral to a specialist) occurred biannually at that time. To increase awareness of the data chart audits and reporting shifted to quarterly and included all patients that met OP criteria. Additionally, a committee was formed in 2011 to develop patient/provider packets, collaborate with the local reproductive specialists, and create an OP process. The committee established an OP algorithm involving support staff to flag patients of reproductive age at initial medical oncology consultation and utilizing genetic counselors (GC) and social workers (SW) to expedite and facilitate referrals to reproductive specialists. GC/SW were chosen due to sensitivity with psychosocial issues and to share the additional workload. The OP program was launched in October of 2012. Results: Baseline assessment in 2009 revealed MSTI was compliant 6% and 6%. Six months after program initiation the OP measures improved to 47% and 45% respectively. Notably March and April 2013 showed dramatic improvements with 100% and 75% compliance for both OP measures. Conclusions: It is well known that OP has been a challenge for many cancer centers. This multipronged approach is an example of a novel process implementation that demonstrated significant improvement with the QOPI oncofertility measures. Continued work is needed on improving physician documentation and consistency of OP patient identification.

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.

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.

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.

Measuring the Improving Quality of Outpatient Care in Medical Oncology Practices in the United States

2013 ◽  
Vol 31 (11) ◽  
pp. 1471-1477 ◽  
Author(s):  
Michael N. Neuss ◽  
Jennifer L. Malin ◽  
Stephanie Chan ◽  
Pamela J. Kadlubek ◽  
John L. Adams ◽  
...  
Keyword(s):  
Clinical Information ◽  
The United States ◽  
Measuring Process ◽  
The Past ◽  
The Mean ◽  
Highly Correlated ◽  
American Society ◽  
Oncology Practice ◽  
Over Time

Purpose The American Society of Clinical Oncology Quality Oncology Practice Initiative (QOPI) has provided a method for measuring process-based practice quality since 2006. We sought to determine whether QOPI scores showed improvement in measured quality over time and, if change was demonstrated, which factors in either the measures or participants were associated with improvement. Methods The analysis included 156 practice groups from a larger group of 308 that submitted data from 2006 to 2010. One hundred fifty-two otherwise eligible practices were excluded, most commonly for insufficient data submission. A linear regression model that controlled for varied initial performance was used to estimate the effect of participation over time and evaluate participant and measure characteristics of improvement. Results Participants completed a mean of 5.06 (standard deviation, 1.94) rounds of data collection. Adjusted mean quality scores improved from 0.71 (95% CI, 0.42 to 0.91) to 0.85 (95% CI, 0.60 to 0.95). Overall odds ratio of improvement over time was 1.09 (P < .001). The greatest improvement was seen in measures that assessed newly introduced clinical information, in which the mean scores improved from 0.05 (95% CI, 0.01 to 0.17) to 0.69 (95% CI, 0.33 to 0.91; P < .001). Many measures showed no change over time. Conclusion Many US oncologists have participated in QOPI over the past 6 years. Participation over time was highly correlated with improvement in measured performance. Greater and faster improvement was seen in measures concerning newly introduced clinical information. Some measures showed no change despite opportunity for improvement.

Evaluation of Spanish hospitals participating in the Quality Oncology Practice Initiative program.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 222-222
Author(s):  
Rafael Lopez ◽  
Antonio Antón ◽  
Enrique Aranda ◽  
Alfredo Carrato ◽  
Manuel Constenla ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Performance Status ◽  
Well Being ◽  
Pathology Report ◽  
Tobacco Use Cessation ◽  
Counseling And Assessment ◽  
American Society ◽  
Oncology Practice ◽  
Initiative Program

222 Background: Measuring and tracking quality of care is highly relevant in today’s healthcare. The Quality Oncology Practice Initiative (QOPI) program is a referral for evaluating oncology practices worldwide. The ECO Foundation (Excellence and Quality in Oncology), a collaboration of oncology experts from the major Spanish hospitals involved in cancer treatment, reached an agreement with ASCO (American Society of Clinical Oncology) to include Spanish hospitals in its QOPI program. Methods: We analyzed the results of the QOPI core module measures from 19 Spanish hospitals submitting their data in nine rounds (from Fall 2015 to Fall 2019). Results: Of the 19 hospitals, 15 participated more than once; none participated in all 9 rounds (2 hospitals participated in 8 rounds). The highest scores were for pathology report confirming malignancy, documenting plan of care for moderate/severe pain and chemotherapy dose, and chemotherapy administered to patients with metastatic solid tumor with performance status undocumented. Measures regarding a summary of chemotherapy treatment, tobacco use cessation counseling, and assessment of patient emotional well-being were among the lowest scored measures. Six of the 15 practices who participated repeatedly achieved a better score in their last round compared to their first. Overall, scores of Spanish hospitals improved from 67.79% in Fall 2015 to 68.91% in Fall 2019. Conclusions: This is the first study to evaluate QOPI scores in Spain; it showed that repeated participation enhances quality of care, although there is room for improvement. The ECO Foundation will continue supporting and engaging with practices to increase their participation in order to improve oncology care and implement strategies that address the areas for improvement.

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.

Utilizing QOPI in the quality improvement efforts of the NCI Community Cancer Centers Program (NCCCP).

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 208-208
Author(s):  
Robert D. Siegel ◽  
Holley Stallings ◽  
Donna M. Bryant ◽  
Pamela Kadlubek ◽  
Laurel Borowski ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Of Care ◽  
Best Practices ◽  
New England ◽  
Community Based ◽  
Quality Initiatives ◽  
Cancer Centers ◽  
High Performing ◽  
Oncology Practice

208 Background: The NCCCP is a network of community based institutions from New England to Hawaii funded by the NCI. Quality of care is a priority of the NCCCP with participation in ASCO’s Quality Oncology Practice Initiative (QOPI) playing a fundamental role. QOPI provides a process for quality assessment but we have also used it as a measure of quality improvement (QI) network-wide. Using QOPI methodology, we have analyzed our performance twice a year in an effort to enhance our implementation of quality indicators relevant to program aims. Methods: A data sharing agreement allows individual practice QOPI data to be electronically sent to the NCI where it is aggregated with the other NCCCP QOPI participants. Data are presented via webinar within the network using a variety of QI strategies. For example, blinded site performance distributions are benchmarked against NCCCP national averages on specific indicators. High performing practices voluntarily present their QI initiatives and best practices to the network. The NCCCP Quality of Care Subcommittee then selects QI projects and areas to focus quality improvement efforts. Results: In Spring 2012, 44 practices affiliated with 25 NCCCP sites participated in QOPI, a consistent pattern since Fall 2010. The table below describes the percent compliance with certain QOPI measures for the NCCCP aggregate over time. Selected measures were perceived as having had suboptimal compliance in Fall 2010. Conclusions: QOPI is an effective tool for assessing quality within a network and for measuring quality improvement efforts. Best practices from within the network can be leveraged and disseminated to enhance the quality of cancer care. This methodology facilitates quality initiatives despite the logistical challenges of working with practices across the country. [Table: see text]

Organizational partnership to expand the ASCO Quality Training Program to oncology pharmacists.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 198-198
Author(s):  
Emily R. Mackler ◽  
Amy Morris ◽  
George W. Carro ◽  
Vedner Guerrier ◽  
Gene Cunningham ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Training Program ◽  
Response Rate ◽  
Medication Management ◽  
Interdisciplinary Team ◽  
Training And Education ◽  
American Society ◽  
Oncology Practice

198 Background: Pharmacists have a recognized role in optimizing medication management and enhancing patient quality of care. In an effort to enhance knowledge related to oncology quality improvement (QI), the Hematology/Oncology Pharmacy Association (HOPA) partnered with the American Society of Clinical Oncology (ASCO) Quality Training Program (QTP) to provide a 1-day HOPA-ASCO QTP Workshop. Methods: HOPA’s Quality Oversight Committee identified several areas of priority focus, including identifying and developing opportunities for members to participate in education focused on oncology value and quality-based patient care. The ASCO QTP program most closely met HOPA goals for training due to the practical outcomes associated with the program, the interdisciplinary focus, the successful experience of prior HOPA-member participants, and expertise of the faculty. In addition, both organizations have a unified goal in improving the care of cancer patients. Surveys were formulated to assess knowledge pre- and post-participation and actionable efforts participants made given knowledge gained from the workshop. Results: A total of 24 HOPA members participated in the 1-day workshop with 40% having been in oncology practice for 15+ years and 70% involved in some aspect of QI within their role. Primary reasons for participation were – to help lead oncology multidisciplinary initiatives in my organization (44%), to increase skills to complete QI projects (28%), and to help lead oncology pharmacy practitioners in my organization (20%). Measures of knowledge and competence increased after participation. Knowledge increased by an average of 3 points from 4.57 to 7.55 (0-10 scale) and competence increased an average of 2.8 points from 4.48 to 7.32. In a 3-month follow-up survey (67% response rate), the majority (93%) of participants indicated they were very likely or extremely likely to use the skills gained from the workshop in practice and 88% of respondents indicated they used the skills gained from the program somewhat often, very often or extremely often. Since the 9 months from the workshop, 2 pharmacists who participated have enrolled in the ASCO QTP 6-month course. Conclusions: The 1-day HOPA-ASCO QTP Workshop proved to be a successful partnership between the two organizations, providing excellent training and education to HOPA members. Next steps of this collaboration include additional 1-day workshops available to more members and a modified 6-month ASCO QTP program for HOPA members with oncology pharmacists serving as the interdisciplinary team leader.

Improving chemotherapy consent compliance.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 130-130
Author(s):  
Patricia D. Hegedus ◽  
James D. Bearden ◽  
Bruce Grant
Keyword(s):  
Best Practice ◽  
Cancer Center ◽  
Extensive Literature ◽  
Improvement Project ◽  
Cancer Centers ◽  
Chemotherapy Administration ◽  
Patient Consent ◽  
American Society ◽  
Oncology Practice ◽  
Key Staff

130 Background: Palmetto Hematology Oncology (PHO) is the medical oncology practice of Spartanburg Regional Healthcare System (SRHS) and has participated in QOPI since 2009 and earned QOPI certification in September 2011. Our Fall 2010 QOPI Patient Consent for Chemotherapy score was 70.73%, lower than the QOPI aggregate score of 86.46%. Methods: A workgroup was convened to address chemotherapy consent documentation compliance. QOPI data revealed the need for a uniform, system-wide chemotherapy consent process. A chemotherapy consent form specifically for our cancer center was created following an extensive literature review and benchmarking with American Society of Clinical Oncology guidelines, NCI Designated Cancer Centers, NCI Community Cancer Centers Program (NCCCP funded with federal funds from the NCI, Contract # HHSN261200800001E) resources, and other healthcare institutions. Our chemotherapy administration policy was revised to include a “hard stop” if a signed chemotherapy consent was not available prior to administration of chemotherapy in all areas of our institution. Results: Patient Consent for Chemotherapy QOPI scores revealed an increase from Fall 2010 to Spring 2012 of 70.73% to 100%. As a result of the workgroup’s efforts, it was approved by our Cancer Care Committee to develop a Chemotherapy Safety Committee (CSC) to standardize chemotherapy practices throughout our system. The CSC integrated key staff responsible for chemotherapy administration. The CSC was instrumental in reviewing and updating policies and procedures during our QOPI certification efforts. Conclusions: Our participation in QOPI provided data to support efforts for a system-wide chemotherapy consent revision and process implementation. The availability of ASCO, Oncology Nursing Society, and other key resources provided turn key processes for this performance improvement project. Practice scores for the Patient Consent for Chemotherapy have reached 100% compliance signifying our performance at a “best practice” level. References: QOPI The Quality Oncology Practice Initiative, available at: http://qopi.asco.org/program .

Measuring the improving quality of outpatient care in medical oncology practices in the United States.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 66-66
Author(s):  
Michael N. Neuss ◽  
Jennifer Malin ◽  
Stephanie Chan ◽  
Pamela Kadlubek ◽  
John L. Adams ◽  
...  
Keyword(s):  
Clinical Information ◽  
The United States ◽  
Time Period ◽  
Medical Oncologists ◽  
The Mean ◽  
Highly Correlated ◽  
American Society ◽  
Oncology Practice ◽  
Over Time

66 Background: The American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) has provided a method for measurement of process based practice quality since 2006. We sought to determine whether QOPI participants show improvement in measured quality over time, and if change is demonstrated, those factors in either the measures or participants which are associated with change. Methods: 156 participant medical practice groups, which did not submit trainee data, participated in at least two collection rounds from 2006 through 2010, and reported on ≥30 patients per round from were included in analysis from a larger group of 306 participants from this time period. A database of these reports was used to evaluate trends in scoring among participants. A linear regression model, which controlled for varied initial performance, was used to estimate the effect of participation over time and evaluate participant and measure characteristics. Measures were aggregated into categories to evaluate which factors correlated with change. Results: Participants completed a mean of 5.71 (S.D. 1.84) rounds of data collection. Adjusted mean quality scores improved from 0.71 (95% C.I. 0.42 – 0.91) to 0.85 (95% C.I. 0.60 – 0.95). Overall odds ratio of improvement over time was 1.09 (p < 0.0001). The greatest improvement was seen in measures assessing newly introduced clinical information, where the mean scores improved from 0.05 (95% C.I. 0.01 – 0.17) to 0.69 (95% C.I. 0.33 – 0.91), (p ≤ 0.0001). Many measures showed no change over time. Conclusions: QOPI has gained widespread adoption and approximately 15% of U.S. medical oncologists participate. Participation over time is highly correlated with improvement in measured performance. Much of this improvement is the result of the adoption of newly introduced clinical information. Some measures show no change despite significant opportunity for improvement.

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