Developing a virtual collaborative to facilitate palliative care and quality improvement learning in oncology.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 252-252 ◽  
Author(s):  
Arif Kamal ◽  
Kristen McNiff ◽  
Ann A. Prestrud ◽  
Dale Lupu ◽  
Molly Gavigan ◽  
...  
Keyword(s):  
Palliative Care ◽  
Quality Improvement ◽  
Best Practices ◽  
Technology Development ◽  
Evidence Base ◽  
Evaluation Methods ◽  
Quality Improvement Intervention ◽  
Learning Collaborative ◽  
Care Needs ◽  
Oncology Practice

252 Background: Despite a strong evidence base and increasing calls for integration, oncologists find it difficult to deliver primary palliative care concurrent with standard oncology care. Solutions that promote practical integration of palliative care in oncology are needed. In an AHRQ-funded pilot, ASCO and the American Academy of Hospice and Palliative Medicine are developing the Virtual Learning Collaborative (VLC) to develop and test a scalable model for quality improvement and dissemination of best practices in palliative care within the oncology setting. Methods: The VLC will be a web-based learning and collaboration system built upon existing ASCO technology resources. We will select at least 25 oncology practices to participate in regular, facilitated learning sessions, collaborative discussions, and sharing of best practices. The VLC will equip each practice with the knowledge, tools, and coaching to select, test, and adopt a quality improvement intervention relevant to their own palliative care needs. Development of the VLC is ongoing; oncology practices begin participation in Spring 2014. Results: We will assess the VLC using protocol-driven evaluation methods common to technology development, quality improvement, implementation science, and educational initiatives. VLC usability, feasibility, and acceptability will be assessed through surveys of participating practices and focus groups. Longitudinal changes in conformance to palliative care metrics will be assessed using ASCO’s Quality Oncology Practice Initiative (QOPI) system. We will use mixed qualitative and quantitative evaluation methods to assess ongoing changes in clinician knowledge and self-efficacy in applying palliative care principles. Conclusions: We aim to develop and test a novel method for facilitating quality improvement and palliative care learning in oncology. Through this pilot, we will refine the VLC for implementation in the greater oncology community. Ultimately, this effort supports other ASCO and AAHPM quality improvement initiatives focused on clinician education and dissemination of best practices.

Infrastructure to improve together: Fostering palliative care (PC) and quality improvement (QI) learning in oncology through a virtual learning collaborative (VLC).

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 20-20
Author(s):  
Arif Kamal ◽  
Ann Alexis Prestrud ◽  
Katherine Ast ◽  
Julie Bruno ◽  
Molly Gavigan ◽  
...  
Keyword(s):  
Palliative Care ◽  
Quality Improvement ◽  
Best Practices ◽  
Needs Assessment ◽  
Virtual Learning ◽  
Pilot Project ◽  
Lessons Learned ◽  
Learning Collaborative ◽  
Services Research ◽  
Learning Platform

20 Background: PC and oncology teams can most effectively improve patient experience during cancer when the specialties improve care processes together through collaborative QI activities. To support collaboration ASCO, the American Academy of Hospice and Palliative Medicine, and Duke University developed a partnership to pilot the ASCO VLC. This pilot will develop and test a scalable model for quality improvement and dissemination of best practices, focused on improving palliative care in oncology. Methods: The ASCO VLC integrates lessons learned through the Breakthrough Series, ASCO Quality Training Program, and others. An Advisory Committee representing expertise in medical oncology, palliative care, geriatrics, nursing, social work, survivorship, health services research, and quality improvement oversees the pilot project. Content in the VLC website was refined based on feedback gathered through a needs assessment survey of pilot participants. Results: The online collaborative and learning platform went live in June 2014. The site houses live and recorded educational sessions covering PC and QI topics, includes discussion boards to foster interactions between practices, supports sharing of tools and resources, and allows practices to submit their problems and aims statements, and results of their work for peer review and feedback. 24 practices were recruited to participate; 73% from community/private practice sites. In response to the needs assessment, 85% of participants responded with a high sense of comfort with PC; yet, only 33% had similar comfort with QI. When asked to rank their top preference, respondents were most interested in learning about pain and symptom management (44%), or advance care planning (22%). Ongoing mixed qualitative and quantitative assessments through Spring 2015 will assess feasibility and acceptability of the ASCO VLC model. Conclusions: We are creating an online virtual learning collaborative as a sustainable infrastructure to support and foster clinician education and dissemination of PC best practices in oncology.

Patient-Centered Palliative Care for Patients With Advanced Lung Cancer

2022 ◽  
Author(s):  
Jennifer S. Temel ◽  
Laura A. Petrillo ◽  
Joseph A. Greer
Keyword(s):  
Lung Cancer ◽  
Palliative Care ◽  
Checkpoint Inhibitors ◽  
Care Delivery ◽  
Cancer Therapeutics ◽  
Evidence Base ◽  
Advanced Lung Cancer ◽  
Care Needs ◽  
Patient Centered ◽  
Patient Reported

The evidence base demonstrating the benefits of an early focus on palliative care for patients with serious cancers, including advanced lung cancer, is substantial. Early involvement of specialty-trained palliative care clinicians in the care of patients with advanced lung cancer improves patient-reported outcomes, such as quality of life, and health care delivery, including hospice utilization. Since the time that many of these palliative care trials were conducted, the paradigm of cancer care for many cancers, including lung cancer, has changed dramatically. The majority of patients with advanced lung cancer are now treated with immune checkpoint inhibitors or targeted therapies, both of which have had a significant impact on patient's experience and outcomes. With this changing landscape of lung cancer therapeutics, patients are facing new and different challenges, including dealing with novel side effect profiles and coping with greater uncertainty regarding their prognosis. Patients who are living longer with their advanced cancer also struggle with how to address survivorship issues, such as sexual health and exercise, and decision making about end-of-life care. Although palliative care clinicians remain well-suited to address these care needs, they may need to learn new skills to support patients treated with novel therapies. Additionally, as the experience of patients with advanced lung cancer is becoming more varied and individualized, palliative care research interventions and clinical programs should also be delivered in a patient-centered manner to best meet patient's needs and improve their outcomes. Tailored and technology-based palliative care interventions are promising strategies for delivering patient-centered palliative care.

Medical-Legal Partnership: Lessons from Five Diverse MLPs in New Haven, Connecticut

2018 ◽  
Vol 46 (3) ◽  
pp. 602-609 ◽  
Author(s):  
Emily A. Benfer ◽  
Abbe R. Gluck ◽  
Katherine L. Kraschel
Keyword(s):  
Palliative Care ◽  
Best Practices ◽  
Social Determinants ◽  
Research Agenda ◽  
Evidence Base ◽  
Law School ◽  
New Haven ◽  
Formerly Incarcerated ◽  
Patients With Cancer ◽  
The Social

This article examines five different Medical-Legal Partnerships (MLPs) associated with Yale Law School in New Haven, Connecticut to illustrate how MLP addresses the social determinants of poor health. These MLPs address varied and distinct health and legal needs of unique patient populations, including: 1) children; 2) immigrants; 3) formerly incarcerated individuals; 4) patients with cancer in palliative care; and 5) veterans. The article charts a research agenda to create the evidence base for quality and evaluation metrics, capacity building, sustainability, and best practices; it also focuses specifically on a research agenda that identifies the value of the lawyers in MLP. Such a focus on the “L” has been lacking and is overdue.

scholarly journals Re-Engineering a Small Oncology Practice for Quality Using the ASCO Quality Oncology Practice Initiative

2013 ◽  
Vol 9 (3) ◽  
pp. 169-170 ◽  
Author(s):  
Carolyn B. Hendricks
Keyword(s):  
Palliative Care ◽  
Quality Improvement ◽  
Quality Measures ◽  
Future Challenges ◽  
Oncology Practice

The field of quality improvement is expanding rapidly, and small oncology practices need to adapt and rise to future challenges. Additional quality measures from ASCO and other organizations will likely focus on palliative care, the Top Five, and electronic measures.

Formation of an international quality improvement collaborative for palliative care: The Global Palliative Care Quality Alliance (GPCQA).

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 91-91
Author(s):  
Arif Kamal ◽  
Jonathan Nicolla ◽  
Fred Friedman ◽  
Charles S. Stinson ◽  
Laura Patel ◽  
...  
Keyword(s):  
Palliative Care ◽  
Quality Improvement ◽  
Data Collection ◽  
Best Practices ◽  
Point Of Care ◽  
Shared Vision ◽  
Care Quality ◽  
Quality Data ◽  
Spiritual Assessment ◽  
National Quality

91 Background: Formal mechanisms to share data on quality remain immature in specialty palliative care. As the field grows, infrastructure that promotes collaboration among academic and community-based practice will be required to foster comparisons and benchmarking of data to inform areas for quality improvement. Further, such relationships will create a palliative care “quality improvement laboratory”, where proposed guidelines and best practices can be developed, implemented, and tested. Methods: We set out to bring together specialty palliative care practices with a shared vision for collaborative quality improvement. We modeled our approach after the Institute for Healthcare Improvement Breakthrough Series alongside our Rapid Learning Quality Improvement paradigm. We use a set of common data collection procedures, across an electronic point-of-care platform called Quality Data Collection Tool (QDACT), alongside a centralized data registry. Further, we meet and discuss challenges and issues, compare best practices, and brainstorm new projects through biweekly conference calls. Results: We have created a multi-institutional collaboration for quality assessment and improvement in specialty palliative care. Termed the Global Palliative Care Quality Alliance, we have brought together 11 academic and community organizations, both general and oncology-specific, across six states to study various areas of quality practice. Short-term, we will conduct rapid-cycling quality improvement projects addressing National Quality Forum domains for quality palliative care, including documentation of spiritual assessment and timely advance care planning. Long-term, we aim to study the link between quality measure adherence and outcomes and further align our initiatives with those of other large consortia, like the Palliative Care Research Cooperative and Palliative Care Quality Network. Conclusions: Collaborative quality improvement is needed in specialty palliative care across a national platform. Developing the infrastructure to perform standardized quality improvement is achievable across multiple palliative care settings.

scholarly journals Improving Social Work in Intensive Care Unit Palliative Care: Results of a Quality Improvement Intervention

2010 ◽  
Vol 13 (3) ◽  
pp. 297-304 ◽  
Author(s):  
Andrew J. McCormick ◽  
J. Randall Curtis ◽  
Patti Stowell-Weiss ◽  
Carol Toms ◽  
Ruth Engelberg
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Quality Improvement ◽  
Social Work ◽  
Quality Improvement Intervention ◽  
Improvement Intervention

Successful Implementation of a Quality Improvement Intervention Toward a QOPI-Certified Breast Cancer Center in Mexico

2020 ◽  
Vol 16 (11) ◽  
pp. e1406-e1411
Author(s):  
Omar Peña-Curiel ◽  
Cynthia Villarreal-Garza ◽  
Mauricio Canavati ◽  
Karen Marlene Velazquez-Ayala ◽  
Janeth Castro-Carrasco ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Improvement ◽  
Current Model ◽  
Cancer Center ◽  
Quality Improvement Intervention ◽  
Successful Implementation ◽  
Consultation Process ◽  
Microsoft Word ◽  
American Society ◽  
Oncology Practice

INTRODUCTION: As part of a quality improvement (QI) project undertaken during the 2018 edition of the American Society of Clinical Oncology’s Quality Training Program (QTP), we evaluated our practice’s compliance to 70 measures regarding the Core, Symptom/Toxicity and Breast Cancer modules from the Quality Oncology Practice Initiative (QOPI) database. Thirteen measures were identified as being consistently low in documentation rate in our medical records (MR). METHODS: After establishing a multidisciplinary QI team, we defined to accomplish 100% documentation rate of these 13 QOPI measures in ≥ 80% of the monthly new patient MRs during the 6-month QTP. We designed a Microsoft Word MR template and implemented a new pre-consultation process. Monthly Plan-Do-Study-Act cycles were conducted to assess the performance of the intervention. RESULTS: After the 6-month QI intervention, > 80% of our monthly MRs achieved 100% compliance to the aimed-for 13 QOPI measures. Furthermore, our new pre-consultation process proved to be valuable in facilitating the documentation of data without interfering with the oncology appointment. CONCLUSION: The development of a systematic QI approach effectively enhanced our compliance to 13 QOPI measures over a 6-month period. These results led to the standardization of the current model of care at our institution. To our knowledge, Hospital Zambrano Hellion’s Breast Cancer Center is the first Mexican cancer center to pursue a QOPI certified practice.

A Quality Improvement Intervention to Increase Palliative Care in Nursing Homes

2005 ◽  
Vol 8 (3) ◽  
pp. 576-584 ◽  
Author(s):  
Laura C. Hanson ◽  
Kimberly S. Reynolds ◽  
Martha Henderson ◽  
C. Glenn Pickard
Keyword(s):  
Palliative Care ◽  
Quality Improvement ◽  
Nursing Homes ◽  
Quality Improvement Intervention ◽  
Improvement Intervention

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]

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

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e16532-e16532
Author(s):  
Robert D. Siegel ◽  
Donna M. Bryant ◽  
Holley Stallings ◽  
Pamela Kadlubek ◽  
Laurel Borowski ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Best Practices ◽  
Fertility Preservation ◽  
Assessment Tool ◽  
Standards Of Care ◽  
Quality Initiatives ◽  
Practice Performance ◽  
Care Models ◽  
Oncology Practice ◽  
The Impact

e16532 Background: The NCCCP is a consortium of 30 community based institutions funded by the NCI. Quality of care has been a priority of the NCCCP with participation in the Quality Oncology Practice Initiative (QOPI) serving as a fundamental element in those efforts. QOPI provides both a metric for baseline assessment and a means for measuring improvement across the network. Participation in QOPI became required with expansion of the NCCCP in 2010. Utilizing QOPI methodology, we describe our efforts to optimize adherence to fertility preservation standards of care. NCI Contract No. HHSN261200800001E Methods: A data sharing agreement allows individual practice performance to be electronically forwarded to the NCI twice a year where it is aggregated with the other NCCCP QOPI participants. This allows for ongoing evaluation of group statistics as well as comparisons between participating institutions. Those practices scoring highest on individual parameters are queried for best practices. Results: In Spring 2011, 38 practices/23 NCCCP sites participated resulting in 2653 chart reviews. 258 charts were applicable to fertile individuals as defined by QOPI. 46 charts were in compliance with suggested standards (17.8%) compared with the national rate of 26.1%. Four practices performed well above the national average and became the NCCCP's leaders for establishing best practices. The NCCCP then embarked upon a process of defining barriers to compliance with the fertility preservation recommendations, created an assessment tool by which each practice could identify the degree it integrated fertility preservation into their care models, and began the process of integrating nationally available educational materials and speakers. QOPI metrics will be used to measure the impact of these interventions. Conclusions: QOPI is a useful tool for measuring quality within a network, identifying barriers to compliance with ASCO fertility preservation recommendations and assessing quality improvement efforts. This methodology has allowed us to proceed with quality initiatives despite the logistical challenges of working with institutions and physicians from Maine to Hawaii.

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