ASCOs Quality Training Program Project Title: Providing Treatment - - PowerPoint PPT Presentation
ASCOs Quality Training Program Project Title: Providing Treatment Summary and Survivorship Care Plan to Early-Stage Breast Cancer Patients Beyond Their Initial Therapy in a smaller community-based practice set-up at Jones Cancer Clinic
1
Project Title: Providing Treatment Summary and Survivorship Care Plan to Early-Stage Breast Cancer Patients Beyond Their Initial Therapy in a smaller community-based practice set-up at Jones Cancer Clinic Presenter’s Names: Cynthia Rogers MSN. FNP, and Shailesh R.
Satpute MD. PhD.
Institution: Jones Cancer Clinic, Germantown, TN Date: 10/8/2015
3
4
Germantown)
New Albany)
What are the barriers to providing patients with treatment summary
Lack of Time Manpower Cost IT Issues Data Process Provider Issues Patient Factors Lack of time for the ancillary staff to enter the data Gathering data is time intensive Lack of time on provider’s part No reimbursement available for the time spent on creating survivorship data Underdeveloped EMR system for survivorship information Lack of seamless transfer of data to the patient portal Inadequate data entry Difficulty in obtaining treatment data on patients treated elsewhere Lack of universal data form customized to our clinic Patient lacks access to patient portal Loss to follow up Patient not interested Provider ‘buy in’ Lack of provider participation A standardized process does not exist No assigned person to complete the treatment plan IT support
.
No assigned person for giving the form to the patient
and lack of standardized data entry process
extraction of such data in a document.
6
First Visit Chemo Visits Visit after Surgery Chemo Visits Visit after RT Chemo Visits Post Therapy Visit Subsequent visits Processes Tasks & Assigned Persons Reminders
Pat hologic diagnosis
cancer Neo- Adj Chem Chemo Visit s
Yes
Surgery Visit aft er Surgery Chemo Visit s (if indicat ed)
No
Radiot herap y (if indicat ed) First Visit aft er RT HER2 Thera py Chemo Visit s End of Therapy visit
Yes No
Ent er Diagnosis (MD) MD Creat es Reminder Chemo det ails ent ered in MOSAIQ (Pharmacy) Chemo det ails ent ered in MOSAIQ (Pharmacy) Mannually Ent er Surgical det ails (Nursing Mannually Ent er RT det ails (Nursing st aff) Chemo det ails ent ered in MOSAIQ (Pharmacy) Generat e Summary Document (MD/ NP) Dict at e Missing component s approve document (MD/ NP) Mail document t o pat ient (t ranscript inist ) Est ablished Process Est ablished Process Est ablished Process Pop-up Reminder when chart
Pop-up Reminder when chart
Pop-up Reminder when chart
Pop-up Reminder when chart
7
lacking, it is generally believed that treatment summaries lead to improvements in
guidelines, such document should include
– Details of the diagnosis – A personalized treatment summary – Identification of providers – Identifying long term consequences of cancer therapy – Follow-up care plan including surveillance for cancer recurrence
cancer.
– 29 patients completed treatment during 1/1/2014 - 12/31/2014 – 11 patients completed treatment during 1/1/2015 - 7/31/2015.
A focus group consisted of six women who had completed curative therapy for breast cancer and one woman that was currently receiving treatment. All of the women in the group wanted a treatment summary to share with their PCP. Approximately half of the women would prefer to have the information in an electronic format.
8
100% of breast cancer patients completing adjuvant therapy on or after July 30, 2015, at Jones Clinic (both locations) will receive a treatment summary within 30 days of completion of therapy. We anticipate the projected volume will be 6 patients.
9
– Numerator: # of patients that received a treatment summary – Denominator: # of patients that completed adjuvant therapy
10
1 3 5 7 9 11 13 15
14-Sep 5-Oct
Cross-Check
Flagged Not-Flagged Total
11
10
Create reminders in EMR Incorporation of NCCN surveillance guidelines Provider compliance Staff Compliance Creating document in EMR Hiring Dedicated Personnel Task Assignments without proper Directions Integration into Patient Portal
12
Date of PDSA cycle Description of intervention Results Action steps July 27 - August 8
process
summaries to evaluate ease of process
quick and easy to create.
enter the flag in the EMR
created by IT demonstrating how to enter the flag in the EMR. August 9 – September 18
flagged charts among eligible patients
appropriately and created video to educate on ‘how to flag’ charts
was an issue in 1 patient September 20 – October 5
treatment summaries for accuracy and completeness
chemotherapy data
imported consistently
chemotherapy data and hormonal status
1 3 5 7 9 11 13 15
14-Sep 5-Oct
Cross-Check (performed once on Sep 14, 2015)
Flagged Not-Flagged Total
15
16
1 2 3
Provider 1 Provider 2 Provider 3 Provider 4
Performance by Providers
# Patients Receiving Summary # Patients Eligible for Summary
17
1 2 3 4
Germantown New Albany
Performance by Location
# Patients Receiving Summary # Patients Eligible for Summary
18
20
Shailesh R. Satpute MD. PhD Cynthia Rogers MSN. FNP
Providing Treatment Summary and Survivorship Care Plan to Early-Stage Breast Cancer Patients Beyond Their Initial Therapy in a smaller community-based practice set-up at Jones Cancer Clinic
Jones Cancer Clinic, Memphis TN
AIM: 100% of breast cancer patients completing adjuvant therapy on or after July 30, 2015, at Jones Clinic (both locations) will receive a treatment summary within 30 days of completion of therapy. We anticipate the projected volume will be 6 patients. INTERVENTION:
summaries
populate from available data
CONCLUSIONS:
plan for early stage breast cancer patients at treatment completion
participation in the process
QOPI measure at a smaller oncology practice
NEXT STEPS:
RESULTS:
Team Members
der) (Team Leader)
r, Nurse Practitioner, Germantown) (Team Leader)
ny)
Project Sponsor