Improving plan-of-care visit completion.

Authors

null

Nicholas Rinaldi

Cleveland Clinic, Cleveland, OH

Nicholas Rinaldi, Vanessa March, Serena Wiseman, Susan McInnes, Bassam N. Estfan

Organizations

Cleveland Clinic, Cleveland, OH, Cleveland Clinic Foundation, Cleveland, OH, Taussig Cancer Institute, Cleveland, OH

Research Funding

No funding received
None.

Background: Plan of Care Visits (POCV) facilitate communicating daily plan of care among providers, nursing, and patients and their families together at the bedside. This discussion standardizes how patients and caregivers collaboratively develop treatment plans that provide the highest quality of care. Daily Plan of Care Visit Completion is expected to improve patient experience with regards to provider effectiveness and interaction. Improved opportunities for understanding, communication, and patient care planning amongst patients, patient family members, and caregivers are a function of Plan of Care Visits. The documented completion of daily POCV in 2020 on the inpatient solid oncology unit was 42% compared to an expected target of 80%. Methods: Team utilized A3 thinking and tools including process mapping, trips to gemba, brainstorming, 5 Whys and fishbone to determine which Potential Root Causes drove failure to complete POCV. Results: Team identified multiple root causes including: Lack of awareness amongst providers that POCV needs to be completed Lack of provider understanding of how to complete a POCV Inconsistent notification of the nurse and staff of when POCV are occurring. Providers unaware of the results of their POCV documentation completion rate Physician attestation templates do not include an option for proper POCV documentation. By implementing retraining and standard procedures for handoff and setting expectations at the start of each change of provider, the team was able increase POCV completion. The subsequent development of a routine to notify staff of their performance daily (and later weekly), and the integration of the POCV completion documentation option into their attestation enhanced completion from 42% in 2020 to 74% in 2021 to 85% in 2022. Conclusions: Following our QI project, POCV completion exceeded the original enterprise target of 55% and revised target of 80%. Improvement in POCV has been sustained for over a year. POCV completion led to improved communication between physicians and nurses on the inpatient unit. The standardization of the process led to consistent completion and improved interaction with the patient. The interdisciplinary care and team were a large contributor to the success of this process.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2022 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session A

Track

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

Sub Track

Provider Impact on Quality From the Patient Perspective

Citation

J Clin Oncol 40, 2022 (suppl 28; abstr 288)

DOI

10.1200/JCO.2022.40.28_suppl.288

Abstract #

288

Poster Bd #

G27

Abstract Disclosures

Similar Abstracts

First Author: Cassidy Rose Davis

Abstract

2022 ASCO Quality Care Symposium

Improving documentation of zoledronic acid interval in ambulatory oncology patients.

First Author: Tanvi Dandawate

Abstract

2024 ASCO Genitourinary Cancers Symposium

Improving health education through a patient-clinician partnered intervention in the patient with genitourinary cancer.

First Author: Jessica Parker

Abstract

2024 ASCO Quality Care Symposium

Oncology nurses’ assessment of providing equitable care for patients with developmental disabilities.

First Author: Sabrina Q. Mikan