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.

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.

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]

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.

scholarly journals A Clinical Training Program for Hybrid Closed Loop Therapy in a Pediatric Diabetes Clinic

2019 ◽  
Vol 14 (2) ◽  
pp. 290-296 ◽  
Author(s):  
Cari Berget ◽  
Sarah E. Thomas ◽  
Laurel H. Messer ◽  
Katelin Thivener ◽  
Robert H. Slover ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Training Program ◽  
Clinical Training ◽  
Insulin Pump ◽  
Improvement Project ◽  
Quality Improvement Process ◽  
Pediatric Diabetes ◽  
Clinical Training Program

Background: Hybrid closed loop (HCL) therapy is now available in clinical practice for treatment of type 1 diabetes; however, there is limited research on how to educate patients on this new therapy. The purpose of this quality improvement project was to optimize a HCL education program for pediatric patients with type 1 diabetes (T1D). Methods: Our multidisciplinary team developed a novel HCL clinical training program for current insulin pump users, using a quality improvement process called the Plan-Do-Study-Act model. Seventy-two patients participated in the HCL training program, which included (1) an in-person group class to reinforce conventional insulin pump and CGM use on the new system, (2) a live video conference class to teach HCL use, and (3) three follow-up phone calls in the first 4 weeks after HCL training to assess system use, make insulin adjustments, and provide targeted reeducation. Diabetes educators collected data during follow-up calls, and patients completed a training satisfaction survey. Results: The quality improvement process resulted in a training program that emphasized education on HCL exits, CGM use, and optimizing insulin to carbohydrate ratio settings. Patients successfully sustained time in HCL in the initial weeks of use and rated the trainings and follow-up calls highly. Conclusions: Ongoing educational support is vital in the early weeks of HCL use. This quality improvement project is the first to examine strategies for implementation of HCL therapy into a large pediatric diabetes center, and may inform best practices for implementation of new diabetes technologies into other diabetes clinics.

scholarly journals Trends in Radiation for Bone Metastasis During a Period of Multiple National Quality Improvement Initiatives

2019 ◽  
Vol 15 (4) ◽  
pp. e356-e368 ◽  
Author(s):  
Jennifer K. Logan ◽  
Jing Jiang ◽  
Ya-Chen Tina Shih ◽  
Xiudong Lei ◽  
Ying Xu ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Bone Metastasis ◽  
Time Trends ◽  
Linear Models ◽  
Geographic Region ◽  
Quality Initiatives ◽  
Total Cost ◽  
Single Fraction ◽  
National Quality ◽  
American Society

PURPOSE: To evaluate trends in fractionation and cost of radiation for bone metastasis during a time period of multiple national quality improvement initiatives that focused on reducing the number of fractions per radiation episode. METHODS: Using nationwide Medicare claims from 2011 to 2014, we identified radiation episodes for bone metastasis from prostate, lung, and breast cancer. Details regarding fractionation, radiation therapy (RT) modality, and sociodemographic characteristics were abstracted from claims. Time trends in use of 10 or fewer RT fractions per episode were evaluated using the Cochran-Armitage test. Total cost per episode was calculated from a payer’s perspective and reported in 2017 dollars; time trends in cost were assessed using linear regression. Generalized linear models identified predictors of treatment with 10 or fewer fractions. RESULTS: Of 51,533 episodes identified, 46,326 used 2D/3D RT, 3,199 used intensity-modulated RT, and 2,008 used stereotactic body RT. The proportion of 2D/3D RT episodes using 10 or fewer fractions increased from 65.5% to 79.7% ( Ptrend < .001), and mean total cost per episode decreased from $6,742 to $6,067 ( Ptrend < .001). Use of single-fraction radiation increased modestly for 2D/3D treatment (6.5% to 8.1%; Ptrend < .001). Predictors of 10 or fewer fractions included treatment in recent years, advanced age (≥ 85 years), and higher comorbidity score. Variation was noted based on geographic region and primary cancer. CONCLUSION: During a period with quality initiatives launched by the American Society for Radiation Oncology, American Board of Internal Medicine, and National Quality Forum, use of 10 or fewer fractions for bone metastasis increased by 14.2%, but single-fraction regimens increased by only 1.6%, highlighting opportunities for quality improvement.

scholarly journals ReCAP: Feasibility and Effectiveness of a Pilot Program to Facilitate Quality Improvement Learning in Oncology: Experience of the American Society of Clinical Oncology Quality Training Program

2016 ◽  
Vol 12 (2) ◽  
pp. 177-177 ◽  
Author(s):  
Arif H. Kamal ◽  
Doris Quinn ◽  
Timothy D. Gilligan ◽  
Barbara Corning Davis ◽  
Carole K. Dalby ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Training Program ◽  
Real Life ◽  
Pilot Project ◽  
Early Adopters ◽  
High Participation ◽  
American Society ◽  
Structured Program

CONTEXT AND QUESTION ASKED: Improving quality of oncology delivery is an important responsibility for busy oncology practices. Is it feasible to construct a training program for oncology professionals to teach quality improvement that is applicable to practice? SUMMARY ANSWER: Using a longitudinal, project-based program with a mix of in-person and distance-learning components, the ASCO Quality Training Program is a highly feasible method to facilitate quality improvement learning in oncology. METHODS: The ASCO Quality Training Program (QTP) consisted of three in-person Learning Sessions and four phases: pre-work, planning, implementation, and sustain and spread. We measured two primary outcomes: program feasibility and effectiveness. BIAS, CONFOUNDING FACTOR(S), DRAWBACKS: Although we observed high participation, satisfaction, and applicability of content to the needs of the oncology learners, it should be noted that this represents a small, pilot project. REAL-LIFE IMPLICATIONS: Even busy oncology clinicians find a structured program to learn and practice quality improvement skills valuable. Conclusions regarding long-term applicability effectiveness and feasibility among non-early adopters require further study.

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).

Using Lean methodology to improve the time to antibiotics in oncology patients on chemotherapy who present to the ED with neutropenic fever.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 31-31
Author(s):  
Brian J. Byrne ◽  
Frederick Bailey ◽  
Pat Montanaro ◽  
Patricia Anne DeFusco
Keyword(s):  
Quality Improvement ◽  
Substantial Improvement ◽  
Neutropenic Fever ◽  
Medical Emergency ◽  
Antibiotic Administration ◽  
Improvement Project ◽  
The Third ◽  
Pdsa Cycle ◽  
Time To Antibiotics ◽  
American Society

31 Background: Neutropenic fever is a medical emergency. Delays in treatment can lead to increase in morbidity, mortality, and increase length of stay. The American Society of Clinical Oncology currently recommends that antibiotics be prescribed within 60 minutes of triage. Literature review shows through a multidisciplinary effort involving the ED, lab, oncology, and pharmacy significant improvement in time to antibiotics can be achieved. Since many patients with neutropenic fever present with sepsis, these guidelines also will need to be followed. Methods: Three PDSA cycles were conducted. The first involved education of the ED staff on the importance of treating neutropenic fever and using the correct antibiotic. The second PDSA cycle involved the laboratory and the calling of critical white counts and low neutrophil counts. The third PDSA involves patient education on the importance of temperature monitoring and reporting they are on chemotherapy to ED staff. Results: Baseline data show only 33% of patients receive the correct antibiotic and the average time to administration is 3 hours and 41 minutes. Results of the quality improvement project show a substantial improvement in time to antibiotic administration to 1 hour 58 minutes and an increase in the percentage of patients who receive the correct antibiotic. The time from the specimen received in the lab until critical called also improved from 1 hour 14 minutes to 18.5 minutes. Conclusions: This quality improvement led to a significant improvement in time to correct antibiotics, but several additional steps need to be taken to meet ASCO guidelines. [Table: see text]

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