Effect of intervention on a quality measure of pain management at Medstar Washington Cancer Institute.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 218-218
Author(s):  
Vishal Navnitray Ranpura ◽  
Puja Chokshi ◽  
Charan Yerasi ◽  
Sundeep Agrawal ◽  
Lynne Wood ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Pain Scale ◽  
Quality Improvement Project ◽  
Administrative Staff ◽  
Improvement Project ◽  
Pareto Chart ◽  
Numeric Pain Scale ◽  
American Society ◽  
Oncology Practice ◽  
Pain Documentation

218 Background: Appropriate cancer pain documentation is one of the quality indicators in American Society of Clinical Oncology (ASCO)’s Quality Oncology Practice Initiative (QOPI). Medstar Washington Cancer Institute (MWCI) has participated in QOPI since 2008. Documentation of plan of care for moderate/severe pain defined as a pain score of ≥4 on a numeric pain scale was 69%, (compared to QOPI aggregate of 79%) during the fall 2011 round which led to a quality improvement project with an aim of ≥ 90%. Methods: MWCI created a team of physicians, nurses and administrative staff. We attended ASCO’s quality training workshop from October 2013 to March 2014 for guidance. We implemented a Plan Do Study Act (PDSA) methodology for our quality improvement project. We created a process map, cause and effect diagram and Pareto chart based on survey of physicians citing common reasons for lack of documented plan of care for pain. Results: Baseline rate of documented plan of care for pain control in November 2013 was 70%. In January 2014, we implemented action plans to increase the awareness of pain documentation (Electronic Health Record (HER) trigger for pain ≥ 4, fellows and mid level education and faculty consensus on documenting management for pain unrelated to cancer). After intervention, the pain documentation rate was improved to 90.2% (Table). Conclusions: After one cycle of PDSA, we achieved our goal of pain documentation rate. In order to sustain our project, we will continue to monitor the pain documentation rate quarterly in 2014 and continue the process of education and orientation to new staff as well rotating residents and fellows. [Table: see text]

Implementation of the Quality Training Program in Spain.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18296-e18296
Author(s):  
Rafael Lopez ◽  
Antonio Anton ◽  
Enrique Aranda ◽  
Alfredo Carrato ◽  
Manuel Constenla ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Training Program ◽  
Cancer Patients ◽  
Waiting Time ◽  
Improvement Project ◽  
Management Of Complications ◽  
Time Reduction ◽  
American Society ◽  
Oncology Practice ◽  
Initiative Program

e18296 Background: The ECO Foundation is a collaboration of experts representing the major Spanish hospitals in the pursuit of excellence in cancer treatment. Since 2015, ECO has been collaborating with ASCO (American Society of Clinical Oncology) in quality initiatives in cancer care, like the QOPI (Quality Oncology Practice Initiative) program and the QOPI Certification Program (QCP). The Quality Training Program (QTP) is a 6-month program with 3 in-person learning sessions that prepares oncology teams to design implement and lead successful quality improvement activities in their practices. In 2018, ECO reached a new agreement with ASCO to implement this program in Spain. Methods: The QTP was developed in Spain by the ECO Foundation in collaboration with ASCO, following the same methodology and contents of ASCO’s program. The first session was carried out on October 2018, with 12 Spanish teams participating with diverse quality improvement projects. The program counted with ASCO and ECO faculty, constituted by experts in the quality and oncology field. Results: The QTP Spanish teams counted with 2-3 representatives from their hospitals. Each team develop an improvement project, following the methodology of the course, including a problem statement, process map, cause and effect diagram, diagnostic data, aim statement, measures, baseline data, priority/pay-off matrix of possible changes/interventions, change data, next steps/plan for sustainability, among others. The projects were mainly focused on the waiting time reduction in the Emergency Area, the waiting time reduction for cancer patients from the visit to the oncologist until treatment administration, burnout reduction on oncology professionals, improvement of the identification and management of complications for cancer patients receiving immunotherapy, improvement of the uniformity in the medical records registry, among others. QTP participants will present the results of their projects on the third and last session of the program, on April 2019. Conclusions: The quality improvement approach followed in the QTP allows Spanish teams and the ECO Foundation to enhance the goal of a quality-oriented health care system. ECO will continue pursuing excellence and quality with further initiatives like the QOPI program, the QCP and the QTP.

Standardization of cardiac monitoring practices in patients receiving cardiotoxic cancer therapy at an ambulatory oncology center.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 251-251
Author(s):  
Hannah DeLuna ◽  
Thomas A. Hensing ◽  
Bruce Brockstein ◽  
Amit Pursnani ◽  
Poornima Saha ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Improvement ◽  
Treatment Plan ◽  
Strain Imaging ◽  
Quality Improvement Project ◽  
Cardiac Monitoring ◽  
Improvement Project ◽  
Pareto Chart ◽  
Ambulatory Oncology

251 Background: A significant number of cancer-directed therapies are associated with cardiotoxicity. This adverse effect is well-established in anthracyclines and anti-HER2 agents. At our ambulatory oncology practice, the recent availability of echocardiograms with strain imaging has prompted an evaluation of current practices for cardiotoxicity monitoring. A review of the electronic health record (EHR) in 2019 found that although our institution maintains high rates of baseline monitoring, follow-up monitoring is not standardized and not consistent between different practices. Methods: A multidisciplinary team was formed to conduct a quality improvement project with the aim of increasing the rate of follow-up monitoring in patients who receive anthracyclines or infusional anti-HER2 agents. A survey of providers identified the potential reasons that follow-up cardiac monitoring was not completed. A Pareto chart showed that lack of familiarity with clinical necessity and appropriate timing were the most common barriers to follow-up monitoring. Our first plan-do-study-act focused on addressing these barriers, and a pilot in breast cancer treatment plans was started. Cardiac monitoring orders were added to curative intent protocols containing doxorubicin, trastuzumab, or pertuzumab. Education was provided to physician and nursing teams regarding utility and timing of cardiotoxicity monitoring. Collaboration with the cardiology group ensured timely access and result turnaround time. Results: An initial review of the EHR was conducted to identify current trends in cardiac monitoring. The review showed that there was an increase in the use of echocardiograms with strain imaging for baseline and follow-up monitoring in our patients. From January to April 2020, there was a total of 102 echocardiogram orders which was a 23% increase compared to the same timeframe in the previous year. The majority (61%) of those echocardiogram orders included strain imaging compared to 8% in the previous year. Review of treatment plan utilization and appropriate timing of cardiac monitoring in breast cancer patients is ongoing. Conclusions: This quality improvement project suggests that efforts to standardize cardiac monitoring practices can be achieved through provider education and workflow modifications. Further long-term review of the EHR will be needed to determine whether the timing of follow-up monitoring is appropriate and to identify what changes to the intervention should be made.

Implementation of the quality training program in Spain.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 11-11
Author(s):  
Rafael Lopez ◽  
Antonio Anton ◽  
Enrique Aranda ◽  
Alfredo Carrato ◽  
Manuel Constenla ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Training Program ◽  
Quality Initiatives ◽  
Improvement Project ◽  
Management Of Complications ◽  
Treatment Administration ◽  
American Society ◽  
Oncology Practice ◽  
Initiative Program ◽  
Cause And Effect Diagram

11 Background: The ECO Foundation is a collaboration of experts representing the major Spanish hospitals in the pursuit of excellence in cancer treatment. Since 2015, ECO has been collaborating with ASCO (American Society of Clinical Oncology) in quality initiatives in cancer care, like the QOPI (Quality Oncology Practice Initiative) program and the QOPI Certification Program (QCP). The Quality Training Program (QTP) is a 6-month course with 3 in-person learning sessions that prepares oncology teams to design, implement and lead successful quality improvement activities in their practices. In 2018, ECO reached a new agreement with ASCO to implement this program in Spain. Methods: The QTP was developed in Spain by ECO in collaboration with ASCO, following the same methodology and contents of ASCO’s program. The first session was carried out in October 2018, with 12 Spanish teams participating with diverse quality improvement projects. The program counted with ASCO and ECO faculty, constituted by experts in the quality and oncology field. Results: Each QTP Spanish team counted with 2-3 representatives from their hospitals and developed an improvement project, following the methodology of the course, including a problem statement, process map, cause and effect diagram, diagnostic data, aim statement, measures, baseline data, priority/pay-off matrix of possible changes/interventions, change data, next steps/plan for sustainability, among others. The projects were mainly focused on the waiting time reduction in the Emergency Area and from the patient’s visit to the oncologist until treatment administration, burnout reduction on oncology professionals, improvement of the identification and management of complications for cancer patients receiving immunotherapy, improvement of the uniformity in the medical records registry, among others. QTP participants presented their projects’ results on the third and last session of the program in April 2019 with positive outcomes. Conclusions: The QTP’s quality improvement approach allows Spanish teams and the ECO Foundation to enhance the goal of a quality-oriented health care system. ECO will continue pursuing excellence and quality with further initiatives like the QOPI program, the QCP and the QTP.

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