Multi-institution quality improvement in supportive oncology: Results of the Coleman Supportive Oncology Collaborative (CSOC).

Authors

null

Julia Rachel Trosman

Center for Business Models in Healthcare, Chicago, IL

Julia Rachel Trosman, Betty Roggenkamp, Paramjeet Khosla, Teresa Lillis, Joanna Martin, Mary Pasquinelli, Eileen Knightly, Shelly S. Lo, Anne Bowman, Selina Lai-ming Chow, Urjeet Patel, Rosa Berardi, Aidnag Diaz, Sheetal Mehta Kircher, Christine B. Weldon

Organizations

Center for Business Models in Healthcare, Chicago, IL, Mount Sinai Hospital, Chicago, IL, Rush University Medical Center, Chicago, IL, Jesse Brown VA Medical Center, Chicago, IL, University of Illinois Hospital and Health Sciences System, Chicago, IL, Loyola University Medical Center, Maywood, IL, UnityPoint Health Methodist, Peoria, IL, University of Chicago Medical Center, Chicago, IL, John H. Stroger Jr. Hospital of Cook County, Chicago, IL, Coleman Foundation, Chicago, IL, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, Northwestern University Feinberg School of Medicine, Chicago, IL

Research Funding

Other Foundation
The Coleman Foundation.

Background: The Institute of Medicine and Commission on Cancer recommend systematic delivery of supportive oncology care for cancer patients. The CSOC is focused on quality improvement (QI) of supportive care across Chicago cancer centers (Weldon ASCO ’17). Supportive oncology includes distress, practical, family, physical, nutrition, pain, fatigue and care concerns. To support QI, cross-institution teams developed unique, relevant tools, methods, care delivery processes, patient handouts and online training. Methods: Ten centers (5 academic, 1 VA, 1 public, 2 safety net, 1 community) implemented supportive oncology screening and care delivery quality improvements. Centers collected data for relevant Quality Oncology Practice Initiative (QOPI) metrics. Analyses used simple frequencies and Fishers exact test. Results: Five of six QOPI measures were improved at statistically significant levels from 2014 to 2017, p < .00001. Improvements are more modest in 2016 & 2017 as 4 of the centers started this QI in 2017. Conclusions: The CSOC achieved significant improvements in supportive oncology screening and identifying and addressing patients’ needs and concerns. Additional work is needed to improve these measures to achieve the best quality of cancer care possible for every patient based on their needs and concerns.

Measure QOPI # 2014 2015 2016 2017 P-value 2014 to 2017
Patients screened for supportive oncology needs, including distress 24 17%
(148/843)
38%
(415/1075)
53%
(678/1283)
69%
(537/779)
< 0.0001
Stage IV patients screened for supportive oncology needs, within 30 days of diagnosis 24 6%
(27/452)
15%
(58/379)
22%
(78/359)
35%
(91/261)
< 0.0001
Patients with one or more supportive oncology need identified and addressed 25 36%
(303/843)
38%
(413/1075)
46%
(587/1283)
56%
(439/779)
< 0.0001
Documented discussion on understanding of illness 2 54%
(453/843)
55
(592/1075)
66
(627/945)
55
(432/779)
NS
Patients given prognosis time frame (days to weeks, weeks to months, months to years, years+) 2 24%
(205/843)
34%
(364/1075)
43%
(403/945)
44%
(340/779)
< 0.0001
Stage IV patients with documented palliative referral 43 15%
(68/452)
43%
(163/379)
36%
(128/359)
36%
(94/261)
< 0.0001

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Abstract Details

Meeting

2019 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session A: Cost, Value, and Policy; Health Equity and Disparities

Track

Cost, Value, and Policy,Health Care Access, Equity, and Disparities

Sub Track

Guideline-Concordant Care Initiatives

Citation

J Clin Oncol 37, 2019 (suppl 27; abstr 33)

DOI

10.1200/JCO.2019.37.27_suppl.33

Abstract #

33

Poster Bd #

C12

Abstract Disclosures

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