Rush University Medical Center, Chicago, IL
James Gerhart, Christine B. Weldon, William Dale, Urjeet Patel, Paramjeet Khosla, Shelly S. Lo, Carol Newsom, Patricia A. Robinson, Joanna Martin, Desiree Azizoddin, Eileen Knightly, Rosa Berardi, Aidnag Diaz, Teresa Lillis, Julia Rachel Trosman, Frank J. Penedo
Background: The Institute of Medicine (IOM) and Commission on Cancer (CoC) recommend systematic delivery of supportive oncology and survivorship care to all cancer patients. CSOC aims to improve the quality of supportive care across Chicago-area providers. Methods: 35 CSOC participating institutions (cancer centers, support centers, hospice) formed care delivery design teams - Distress, Survivorship and Palliative. Teams collaboratively developed solutions to supportive oncology gaps: patient screening tools, care delivery processes, provider training, and quality metrics to assess supportive oncology quality and the CSOC impact. Six implementation centers (2 safety-net, 3 academic & 1 public) reviewed charts at baseline (2014 diagnoses) and after the initial implementation period (2015 diagnoses), compared by frequencies and Fisher’s exact test. Results: Eight metrics contained patient data at 2 time points; improvements were seen in 7/8 metrics. (See Table). Conclusions: CSOC developed supportive oncology screening, and care processes aligned with IOM and CoC standards. Significant improvements were shown after implementation across diverse settings. Ongoing work will further evaluate the impact of CSOC efforts on patient care.
Metric | % Patients Dx in 2014 | % Patients Dx in 2015 | P-value |
---|---|---|---|
Documented discussion on understanding of illness within 30 days (d) of diagnosis (dx) -QOPI 2 NQF 0386 | 54 (453/843) | 55 (592/1075) | NS |
Pts given prognosis timeframe (ds to weeks, ws to months, mths to years, yrs+) within 30 d of dx - QOPI 2 NQF 0386 | 24 (205/843) | 34 (364/1075) | <0.0001 |
Documented health care agent / validated POA within 90 d of dx -QOPI 25a | 5 (42/843) | 11 (115/1075) | <0.0001 |
Stage IV pts with documented advance directive within 90 d of dx -QOPI 25a | 1 (10/452) | 27 (101/379) | <0.0001 |
Stage I-III pts with supportive oncology needs screening -QOPI 24 CoC 3.2 | 38 (148/391) | 60 (415/691) | <0.0001 |
Stage IV pts with supportive oncology needs screening within 30 d of dx | 6 (27/452) | 15 (58/379) | <0.0001 |
Stage IV pts with documented palliative referral - QOPI 43 NQF 0215 | 15 (68/452) | 43 (163/379) | <0.0001 |
Stage I-III pts receiving treatment summary and Survivor Care Plan within 180 d of treatment -QOPI 18 20 CoC 3.3 | 2 (9/391) | 7 (47/691) | =0.0009 |
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Abstract Disclosures
2019 ASCO Quality Care Symposium
First Author: Michael T. Halpern
2019 ASCO Annual Meeting
First Author: Hira Latif
2017 Cancer Survivorship Symposium
First Author: Julia Rachel Trosman
2024 ASCO Quality Care Symposium
First Author: Michelle Payan