Assessing quality in a rural oncology program using the Quality Oncology Practice Initiative (QOPI).

Abstract

275 Background: Molokai General Hospital (MGH) is a critical access hospital for 7,400 people on the isolated island of Molokai. It is a small 14 bed medical center that started an outpatient oncology program six years ago. Over this period, 213 patients received care through an innovative telemedicine program partnership with the Queens Medical Center in Honolulu, Hawaii. Methods: Study design was a retrospective chart review. Results: The most common types of cancers seen were breast cancer 57 (26.7%), lung cancer 29 (13.6%), colon cancer 26 (12.2%), prostate cancer 29 (13.6%), lymphoma 8 (3.7%), and liver cancer 3 (1.4%). Cancer patients were almost 80 % minorities; over 55% were native Hawaiians or part Hawaiian. The percentage of Caucasians, Hispanic, and African American were lower than the national averages. Hawaiian 118 (55.3%), Caucasian 43 (20.8%), Filipino 30 (14%), Japanese 17 (7.9%), African American 2 (0.9%), Other Pacific Islanders 2 (0.9%), Hispanic 1 (0.4%) Using national and local benchmarks from QOPI, areas of excellence and deficiency were identified. In 29% of the core measures, MGH did a better job than the urban comparison in Honolulu, Hawaii. For breast and colon cancer, the quality was better than the national QOPI aggregate. Similarly, the symptom care was better than national average. A survivorship program was initiated 2 years ago and treatment summaries were beginning to be sent. Since its start, 45 of the total 213 (21.1%) patients have been enrolled in the Survivorship program. Conclusions: The QOPI program helped review a small rural program which lacks staff and resources for a full time Quality Improvement program. This may be a model for other small programs to check for quality of care.