Development of a collaborative improvement network by a state affiliate of the American Society of Clinical Oncology.

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79 Background: Participation in the Quality Oncology Practice Initiative (QOPI) by members of the Northern New England Oncology Society (NNECOS) has been historically low (two practices consistently participating). A survey of members identified a lack of resources (time, personnel, financial) as the principal obstacles. In alignment with NNECOS’ mission “To assure the availability of and access to high quality oncology care in our region,” NNECOS sought to determine if it could establish a Collaborative Improvement Network (CIN) in which 1) experienced practices mentor inexperienced practices in QOPI, and 2) practices benchmark results against each other, sharing best practices. Methods: Six practices from the NNECOS member states of Maine, New Hampshire, and Vermont agreed to join the CIN and participate in the fall 2010 and spring 2011 QOPI data collection. Meetings were held following each QOPI data collection and blinded results were compared. High achievers on individual metrics shared their processes/tools with all the participants in the CIN. Results: To develop consistency in data collection, a joint training program for abstractors was developed. There was rapid agreement to eliminate the blinding of results, allowing candid discussions about the barriers to success and strategies for overcoming those barriers. The following tools that successful practices had used were shared: a “one page chemotherapy treatment summary,” chemotherapy consent forms, an oral chemotherapy procedure, and a “chair-side smoking cessation program.” Interventions piloted included a “hardwired chemotherapy treatment summary” and a “hardwired intervention for emotional distress.” Improvement was seen in “plan of care for severe pain” (72% to 85%), “signed consent for chemotherapy” (59% to 81%), and “infertility risk discussions” (14% to 35%). The CIN continues to operate, with 8 of the 17 practices in the three states participating. It is currently engaged in a project to implement specific performance improvement processes for end-of-life care. Conclusions: We have shown that it is possible for an ASCO State Affiliate to sponsor and develop a CIN.