Center for Business Models in Healthcare, Glencoe, IL
Julia Rachel Trosman , Christine B. Weldon , Carol A. Rosenberg , James Gerhart , Sofia F. Garcia , William Dale , Urjeet Patel , Pam Khosla , Shelly S. Lo , Javier Macias , Patricia A. Robinson , Oana Cristina Danciu , Stephanie Boecher , Rosa Berardi , Aidnag Diaz , Frank J. Penedo
Background: The Institute of Medicine (IOM) and Commission on Cancer (CoC) recommend supportive oncology and survivorship care. The Coleman Supportive Oncology Collaborative (CSOC) aims to improve quality of supportive care and survivorship in Chicago. Methods: CSOC includes 35 institutions (cancer centers, support and hospice), structured in two design teams (Distress & Survivorship and Palliative). Participants identified opportunities and gaps in supportive and survivorship care in an iterative development of: screening tools, follow-up processes, provider training, and quality metrics to assess CSOC impact. Six process improvement sites (2 safety-net, 3 academic & 1 public) reviewed patient charts at baseline and Q1 2015, compared by Fisher’s exact test. Results: Eight metrics contained patient data at the 2 time points; improvements were seen in 6/8 metrics. Conclusions: CSOC successfully developed supportive oncology, survivorship screening, and care processes aligned with IOM and CoC standards. Significant improvements were shown after implementation in diverse settings. Ongoing work will continue to evaluate the impact of the CSOC on patient care.
Metric | % Patients Dx in 2014 | % Patients Dx in Q1 2015 | P-value |
---|---|---|---|
Documented discussion on understanding of illness within 30 days (d) of diagnosis (dx) -QOPI 2 NQF 0386 | 54 (453/843) | 67 (210/313) | <0.0001 |
Patients provided prognosis timeframe (ds to weeks, ws to months, mths to years, yrs+) within 30 d of dx - QOPI 2 NQF 0386 | 24 (205/843) | 23 (71/313) | NS |
Documented health care agent / validated POA within 90 d of dx -QOPI 25a | 5 (42/843) | 18 (58/313) | <0.0001 |
Stage IV patients with documented advance directive within 90 d of dx -QOPI 25a | 1 (10/452) | 10 (10/103) | <0.0001 |
Stage I, II, III patients with supportive oncology needs screening within 30 d of dx -QOPI 24 CoC 3.2 | 38 (148/391) | 34 (72/210) | NS |
Stage IV patients with supportive oncology needs screening within 14 d of dx | 6 (27/452) | 10 (10/103) | <0.0001 |
Stage IV patients with documented palliative care referral - QOPI 43 NQF 0215 | 15 (68/452) | 30 (31/103) | =0.0006 |
Stage I, II, III patients receiving treatment summary and Survivor Care Plan within 180 d of treatment -QOPI 18 20 CoC 3.3 | 2 (9/391) | 19 (33/172) | <0.0001 |
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Abstract Disclosures
2017 ASCO Quality Care Symposium
First Author: Julia Rachel Trosman
2019 ASCO Quality Care Symposium
First Author: Michael T. Halpern
2023 ASCO Quality Care Symposium
First Author: Emily H. Douglas
2016 ASCO Annual Meeting
First Author: Julia Rachel Trosman