QIM19-118: Oral Anti-Cancer Therapy Initiation: A Standardized Approach for Patient Care and Education

Background: The availability and popularity of oral anti-cancer therapy has recently increased. In this shift of delivery, control over downstream steps in the process moves to patients, families, and the extended care team. Unique challenges have been identified including effective patient education, adherence, and monitoring. The purpose of this quality improvement project was to standardize the approach to initiating oral anti-cancer patient care. Methods: A quality improvement team developed and implemented a standard approach for before, during, and after initiation of oral anti-cancer therapy. Key components included ensuring completion of informed consent, electronic orders within an evidence-based treatment plan, and adherence monitoring with a specific emphasis on patient education. Education prior to initiating therapy was standardized through both an education folder and one-on-one teaching sessions with an oncology nurse. A voluntary, anonymous 4-question paper survey (deemed clinical quality improvement by the IRB) solicited feedback from patients to assess both the educational materials and teaching session. Questions included perceived acceptability of the content and whether materials guided conversation, provoked questions, and complimented the teaching. An opportunity for comments was provided. Results: A 3-month collection period yielded overwhelmingly positive results. 100% of patients (n=18) felt the education materials provided were “just right” and provoked discussion with the care team. 94% of patients felt the educational materials and teaching session were complimentary. Conclusions: As oral anti-cancer therapy becomes more common, it is vital to form a collaborative partnership with the patient, family, and the extended care team to ensure overall success. Standardized educational content supports the transfer of expert knowledge to ensure adherence, management, and patient safety, ultimately improving patient outcomes. A standard approach that includes informed consent, orders within a treatment plan, adherence monitoring, and patient education prior to initiating oral anti-cancer therapy is one way to ensure quality, comprehensive patient care.