Improving cancer treatment handoffs: Wilmot Cancer Institute’s (WCI) ASCO Quality Training Program experience.

Authors

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David W. Dougherty

Wilmot Cancer Institute/University of Rochester Medical Center, Rochester, NY

David W. Dougherty, Elizabeth Scarsella, Tammy Clarke, Elizabeth Alvino, Lynn Rich, Sean Goonan, Karen Mietus, Nathaniel Wade, Alex Alongi, Melanie Bobry, Elizabeth A. Guancial, Margaret Blaney, Stephanie Buia Amport, Chintan Pandya

Organizations

Wilmot Cancer Institute/University of Rochester Medical Center, Rochester, NY, Wilmot Cancer Institute/URMC, Rochester, NY, Wilmot Cancer Institute, Rochester, NY, Wilmot Cancer Institute, University of Rochester, Rochester, NY, Smilow Cancer Hospital At Yale New Haven, Woodbridge, CT, University of Rochester Medical Center, Rochester, NY

Research Funding

Other

Background: Ineffective handoffs contribute to gaps in patient care and medication errors, jeopardizing patient safety and leading to poor quality of care. Ineffective handoffs accounted for 59% of reported medication events at WCI Infusion Center. The completion rate of WCI’s existing electronic medical record (EMR) based free text handoff note for patients treated with anti-cancer therapy on the same day as a clinic visit was 32%. The project aim is to create an effective EMR integrated treatment handoff tool and establish standard workflow processes to ensure optimal communication among WCI providers for improved patient safety and quality of care. Methods: We convened a multidisciplinary team to develop an efficient and safe treatment handoff tool. WCI nurses were surveyed to evaluate the baseline state of the handoff process. Tool development was performed over a series of phases, including creation of a project charter and aim statement, outlining current workflow process, identifying gaps and limitations in the process, identifying potential causes of ineffective hand-off and using a Pareto chart to prioritize them. Utilizing the Situation-Background-Assessment-Recommendation framework, an EMR-integrated handoff tool with standardized workflow process was developed, along with an educational plan for the tool. Results: 52% (N = 22/42) of nurses found the current handoff note to be ineffective at preventing errors and 48% (N = 20/42) identified incomplete or missing information as a significant factor for ineffective communication. Other barriers identified included poor note design, lack of standardization in workflow and variation in note use. During the 1 week implementation of the new handoff tool, the utilization rate was 100% (N = 32) with completion rate of 41% (13 of 32). Further data collection is ongoing and nursing perception of the new tool will be evaluated at 3 months. Conclusions: Multidisciplinary stakeholders’ guided development and implementation of an EMR-integrated treatment handoff tool to optimize the communication between cancer care providers during patient transition is associated with improvement in handoff tool utilization and communication.

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Abstract Details

Meeting

2017 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session A: Cost, Value, and Policy in Quality; Practice of Quality

Track

Cost, Value, and Policy in Quality,Practice of Quality

Sub Track

Use of IT/Analytics to Improve Quality

Citation

J Clin Oncol 35, 2017 (suppl 8S; abstract 139)

DOI

10.1200/JCO.2017.35.8_suppl.139

Abstract #

139

Poster Bd #

F6

Abstract Disclosures

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