Comparison of initial and recertification QOPI scores: Maintaining compliance through direct surveyor and practice interaction.

Abstract

246 Background: Since 2006, the ASCO QOPI certification program has certified 322 practices, of which 197 practices have recertified. This retrospective study compares the number and type of standards passed at the time of initial and subsequent re-certification, and examines if on-site audits at the original certification influenced re-certification scores. Methods: 87 unique US practices that obtained QOPI certification with on-site audits at the original and re-certification between 2006 and 2014 were included. 17 QOPI certification standards were included in the analysis. Standards are metric based, except 3 standards that are observable. We defined total score per certification round as the total number of standards passed and used a Wilcoxon Rank Sum Test to test the concordance of standards passed between rounds. Linear regression models were used to identify factors related to higher recertification scores. A two-sided p<0.05 defined statistical significance. Results: 31 practices (36%) showed concordance of the 3 observable standards in the initial and re-certification rounds. For standards that assess policies, procedure and credentials of the practice, and do not require direct observation, 52 practices demonstrated improvement whereas 14 did not (p<0.0001). In contrast, for the standards that require direct observation, only 22 practices showed improvement versus 34 that did not (p=0.07). Three standards were most commonly missed in both rounds: initial chart documentation and at each clinical visit, and double verification of chemotherapy administration. There were no significant predictors of higher recertification scores. Conclusions: Many diverse oncology practices are voluntarily achieving and maintaining QOPI certification. Sustainable improvement is easier to identify in policy-based measures compared to directly observed ones. Three standards not usually passed at recertification highlight the need for assessment of psychosocial and performance status, comprehension of treatment goals, and chemotherapy double-verification. On-site evaluation of practices is key for targeting and sustaining quality efforts.