Implementing pregnancy screening prior to chemotherapy: A quality improvement initiative.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18274-e18274
Author(s):  
Brittany Kayla Rogers ◽  
Andrew Kolarich ◽  
Merry Jennifer Markham
Keyword(s):  
Quality Improvement ◽  
Radiation Oncology ◽  
Medical Oncology ◽  
Point Of Care ◽  
Surgical Oncology ◽  
Tubal Ligation ◽  
Quality Improvement Initiative ◽  
Screening Rate ◽  
Childbearing Potential ◽  
Treatment Start

e18274 Background: ASCO’s QOPI sets standards for excellence in oncologic care. One standard is screening appropriate female patients for pregnancy prior to chemotherapy. No guidelines exist regarding screening protocols or timing. Prior data collection at our institution from 2012-2014 revealed that 35% of women of childbearing potential were screened prior to chemo, with medical oncology performing only 7% of screening. Less than half (48%) of those tests were ordered within 14 days prior to treatment start. Methods: A quality improvement (QI) intervention was implemented at UF Health outpatient infusion center on 8/15/16 based on the above data. A checkbox was added to the pre-chemo checklist used by infusion nurses. For eligible patients (women ages 18-55 without prior tubal ligation or hysterectomy), a point of care pregnancy test, included in standing orders, was recommended. We reviewed data for women who received outpatient chemo during 9/16-11/16 to determine rates of pregnancy screening (PS) after intervention. Results: 49 women, ages 18-55, of childbearing potential were identified and presented for 174 chemo cycles from 9/1/16 to 11/30/16. Of these, 15 (30.6%) received PS before chemo. Fifty pregnancy tests were ordered during this period; all were negative. Of the 50 tests, 42 (84%) were ordered by medical oncology, 3 (6%) by a surgical oncology, 3 (6%) by radiation oncology, and 1 (2%) by emergency medicine. Of the PS tests ordered by medical oncology, 64.2% were within 14 days of chemotherapy. Conclusions: In three months of QI intervention, PS prior to chemo increased from 7% to 30.6%. Screening was 13% in women older than 45, but higher in women age 25-34 (60%) and 35-44 (67%). Although the screening rate improved, it remains below our goal of 80%. Possible explanations for low rates are inclusion of postmenopausal women and those older than 50. Excluding these patients could reduce screening burden while identifying appropriate patients. [Table: see text]

scholarly journals Adverse events in radiation oncology: A case series from wake up safe, the pediatric anesthesia quality improvement initiative

2019 ◽  
Vol 29 (3) ◽  
pp. 265-270 ◽  
Author(s):  
Robert E. Christensen ◽  
Rebecca C. Nause-Osthoff ◽  
Jeffrey C. Waldman ◽  
Daniel E. Spratt ◽  
Jason W. D. Hearn
Keyword(s):  
Quality Improvement ◽  
Adverse Events ◽  
Radiation Oncology ◽  
Pediatric Anesthesia ◽  
Case Series ◽  
Quality Improvement Initiative

Choosing oncology as specialization: Medical students' perception after clinical rotation in cancer center.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 10528-10528
Author(s):  
Omar Orlando Castillo Fernandez ◽  
Maria Lim ◽  
Lilian Hayde Montano ◽  
Gaspar Perez-Jimenez ◽  
Jhonattan Camaño ◽  
...  
Keyword(s):  
Palliative Care ◽  
Medical Students ◽  
Radiation Oncology ◽  
Cancer Care ◽  
Medical Oncology ◽  
Surgical Oncology ◽  
Cancer Center ◽  
Clinical Rotation ◽  
Chi Square ◽  
Field Methods

10528 Background: Cancer is a leading cause of death worldwide and the demand for oncologist and palliative care specialists is increasing dramatically. Two years ago, The Universidad de Panama incorporated Oncology in the curriculum in order to face the shortage of professionals involved in cancer care. Little information is available concerning young medical students desire to pursue a career in oncology.The aim of this study is to evalute medical students perception about Oncology as a specialization field. Methods: An electronic survey was sent to medical students from Universidad de Panama after finishing Oncology rotation the last 2 years. Chi square and Mann Whitney U tests were used to compare variables. Results: 145 questionnaries were responded (40%). 60% female and 40% male. Median age was 25 years old. Clinical rotation during Oncology practices were: 37% in Medical Oncology, 24% in Surgical Oncology, 21% in Radiation Oncology and 18% in Palliative Care. 20% (29) of students are highly motivated to pursue a career in Oncology. 8 in Radiation Oncology. 8 in Surgical Oncology, 8 in Medical Oncology and 5 in Palliative Care. Variable associated with a oncology preference were: male gender (p=0.007), lack of human resources (p=0.009), contact with patients and family (p=0.005), good experience with mentor (p=0.002), nature and complexity of disease (p<0.001). Potential emotional burden was negatively asssociated (p=0.004) with oncology preference. 66% of students acknowledged that clinical rotation changed positively their perception about cancer patient care and a third of students haved not rule out the possibility to choose Oncology in the near future. Conclusions: Early exposition to medical student to cancer care might help to reduce the global shortage of oncologist and palliative specialists.

Peer review in radiotherapy (RT): A national quality improvement initiative.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 221-221 ◽  
Author(s):  
Michael Donald Brundage ◽  
Brenda H Bass ◽  
Sophie Foxcroft ◽  
Ross Halperin ◽  
Thomas McGowan ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Peer Review ◽  
Quality Indicators ◽  
Radiation Oncology ◽  
Preliminary Evidence ◽  
Steering Committee ◽  
Perceived Barriers ◽  
Quality Improvement Initiative ◽  
Implementation Framework ◽  
National Quality

221 Background: Peer review (PR) in Radiation Oncology has been shown to be effective in improving quality of treatment by detecting and correcting deficiencies in proposed treatment plans prior to treatment. PR is also effective in: guiding departmental treatment planning policies and processes; reducing variation in practice; providing a venue for multi-disciplinary communication, and increasing staff and trainee awareness of evolving treatment processes. The importance of PR is reflected in the inclusion of 3 PR-specific quality indicators in the Canadian Partnership for Quality Radiotherapy QA Guidelines for Radiation Oncology programs. Given this endorsement, we aim to enhance PR implementation across all Canadian cancer centres using a knowledge-translation and implementation framework. Methods: This project will facilitate increased uptake of PR in Canadian RT programs by implementing the top-down model used with success in Ontario. This model has several key components, including: a) engaging the leadership of provincial cancer agencies to promote PR at every Provincial cancer centre; b) providing modest financial support for the acquisition of the required hardware and/or staff time for coordinating PR activities; c) systematic collection of each centre’s baseline PR activities, perceived barriers and potential facilitators of PR at each centre; d) creation of a continuous quality improvement cycle by monitoring PR quality indicators over time; e) systematic knowledge and information sharing regarding effective PR processes. Results: Funding for this initiative was obtained from the Canadian Partnership against Cancer (CPAC) in April 2014. A steering committee consisting of stakeholders from across Canada has been struck and provincial launches, based on the tenets used in Ontario, have commenced in 7 of 13 provinces with others expressing interest. A national survey to obtain baseline data relating to PR activities, perceived barriers, and facilitators is underway and will be reported. Conclusions: Preliminary evidence suggests a “snowball effect” of increasing PR uptake across Canada. The implementation model could be applied in other jurisdictions interested in increasing PR in radiation oncology.

scholarly journals Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016

2016 ◽  
Vol 23 (6) ◽  
pp. 605 ◽  
Author(s):  
D. Bossé ◽  
T. Ng ◽  
C. Ahmad ◽  
A. Alfakeeh ◽  
I. Alruzug ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Gastrointestinal Cancer ◽  
Radiation Oncology ◽  
Antineoplastic Agents ◽  
Consensus Statement ◽  
Medical Oncology ◽  
Surgical Oncology ◽  
Consensus Conference ◽  
Borderline Resectable ◽  
Gastrointestinal Malignancies

The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016 was held in Montreal, Quebec, 5–7 February. Experts in radiation oncology, medical oncology, surgical oncology, and infectious diseases involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics:Follow-up and survivorship of patients with resected colorectal cancerIndications for liver metastasectomyTreatment of oligometastases by stereotactic body radiation therapyTreatment of borderline resectable and unresectable pancreatic cancerTransarterial chemoembolization in hepatocellular carcinomaInfectious complications of antineoplastic agents

Rectal Cancer

2012 ◽  
Vol 10 (12) ◽  
pp. 1528-1564 ◽  
Author(s):  
Al B. Benson ◽  
Tanios Bekaii-Saab ◽  
Emily Chan ◽  
Yi-Jen Chen ◽  
Michael A. Choti ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Radiation Oncology ◽  
Multidisciplinary Approach ◽  
Clinical Presentation ◽  
Medical Oncology ◽  
Neoadjuvant Treatment ◽  
Surgical Oncology ◽  
Care Physician ◽  
Pathologic Staging ◽  
Localized Disease

These NCCN Clinical Practice Guidelines in Oncology provide recommendations for the management of rectal cancer, beginning with the clinical presentation of the patient to the primary care physician or gastroenterologist through diagnosis, pathologic staging, neoadjuvant treatment, surgical management, adjuvant treatment, surveillance, management of recurrent and metastatic disease, and survivorship. This discussion focuses on localized disease. The NCCN Rectal Cancer Panel believes that a multidisciplinary approach, including representation from gastroenterology, medical oncology, surgical oncology, radiation oncology, and radiology, is necessary for treating patients with rectal cancer.

scholarly journals Reduction of Wastes and Costs Through the Modified Kanban System in Unit Storerooms of HGH: A Value-for-Money Quality Improvement Initiative

2021 ◽  
Author(s):  
KENNETH JUN LOGRONO ◽  
BELAL SALEM ZU'BI
Keyword(s):  
Supply Chain ◽  
Quality Improvement ◽  
User Satisfaction ◽  
Point Of Care ◽  
Quality Improvement Initiative ◽  
Value For Money ◽  
End User ◽  
A Value ◽  
Kanban System ◽  
New Evidence

Abstract Most public health sectors in many countries were heavily burdened both financially and operationally as a result of the pandemic's new changes. Organizations have been pushed to develop innovative solutions to balance expenses and revenues through value-for-money initiatives as a result of erratic economic conditions.Purchasing and supply distribution to the point of care account for approximately 30–40% of the hospital's operating budget. The demand-based ordering system, also known as the par system, has inherently resulted in increased waste due to obvious estimations for the quantity of items. Increased waste and costs have become a widespread issue in the healthcare supply chain, which was identified as a priority for improvement.The project is aimed to reduce the costs by 50% by implementing the Kanban system in the unit storeroom of medical units within three months. The IHI Model of Improvement was undertaken to go through the implementation of the project. Several quality improvement tools were used to test different ideas of change and measurement of improvements were also made.Following the adoption of the modified Kanban System, the costs of consumable item supply decreased by 69% from 16,000 QAR to 5,000 QAR. The percentage of wastes has reduced significantly to 0% while limiting the percentage of out stocking to a median of 1%.Kanban as a lean method, reduces wastes by controlling the flow of consumables within a supply chain. Eliminating or reducing waste is a cornerstone of lean management. The project’s new evidence demonstrated significant and sustainable cost saving strategy by reducing waste and pre-quantifying items based on their usage and flow. The Kanban system ultimately improved nurses’ productivity, streamlined the unit’s stock supply, promoted value improvement, and helped increased end-user satisfaction.

scholarly journals Remote Contouring and Virtual Review during the COVID-19 Pandemic (RECOVR-COVID19): Results of a Quality Improvement Initiative for Virtual Resident Training in Radiation Oncology

2021 ◽  
Vol 28 (4) ◽  
pp. 2961-2968
Author(s):  
Andrew J. Arifin ◽  
Rohann J. M. Correa ◽  
Christopher D. Goodman ◽  
Joanna Laba ◽  
Robert E. Dinniwell ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Radiation Oncology ◽  
Learning Opportunities ◽  
Resident Training ◽  
Quality Improvement Initiative ◽  
Immediate Feedback ◽  
Educational Value ◽  
Competency Based Medical Education ◽  
Competency Based ◽  
Post Hoc

The need to minimize in-person interactions during the COVID-19 pandemic has led to fewer clinical learning opportunities for trainees. With ongoing utilization of virtual platforms for resident education, efforts to maximize their value are essential. Herein we describe a resident-led quality improvement initiative to optimize remote contouring and virtual contour review. From April to June 2020, radiation oncology (RO) residents at our institution were assigned modified duties. We implemented a program to source and assign cases to residents for remote contouring and to promote and optimize virtual contour review. Resident-perceived educational value was prospectively collected and analyzed. All nine RO residents at our institution (PGY1–5) participated, and 97 cases were contoured during the evaluation period. Introduction of the Remote Contouring and Virtual Review (RECOVR) program coincided with a significant increase in mean cases contoured per week, from 5.5 to 17.3 (p = 0.015), and an increased proportion of cases receiving virtual review, from 14.8% to 58.6% (p < 0.001). Residents reported that the value of immediate feedback during virtual review was similar to that of in-person review (4.6 ± 0.1 vs. 4.5 ± 0.2, p = 0.803) and significantly higher than feedback received post hoc (e.g., email; 3.6 ± 0.2, p < 0.001). The implementation of a remote process for contour review led to significant increases in contouring, and virtual contour review was rated as highly as in-person interactions. Our findings provide a data-driven rationale and framework for integrating remote contouring and virtual review into competency-based medical education.

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