Development of a quality infrastructure for a 135-site statewide network of community oncologists.

Abstract

74 Background: The delivery of patient centered, high-value care requires a formal system of continuous quality improvement. In order to bring metrics to the site and physician level the need to revamp our program for 364 physicians was apparent The starting point was 4 physician-led network wide quality committees. Methods: In 2010, the position of Director of Quality Programs was created to assist in the development of a quality infrastructure for a statewide network of community oncologists. Beginning in January 2011 meetings were held with the management team of each site for education on national quality initiatives and the IOM 6 aims for improvement in healthcare. The discussion also included review of quality metrics set forth by ASCO’s QOPI, evidence-based pathway reporting, variance reporting on patient safety and employee safety, and processes to improve patient satisfaction. Each site then identified their team members, physician champion, and frequency of committee meetings. An action plan format was provided with discussion on components of the plan and the reporting structure to the physician-lead quality oversight committees. Results: The network currently has 38 quality committees serving 84 sites of service. Within a year’s time pathways assessable data improved from 84% to 90%, pathways adherence improved from 60% to 68%, and exception documentation rose from 14% to 25%. Variance reporting increased 35% and a network Patient Satisfaction Survey was created and administered with 10 surveys per physician collected and tabulated for baseline data. The survey process was reviewed and refined and will now be administered twice yearly at each site. Documentation of hospice referrals and follow-up processes on deceased patient information are key initiatives at each site. Conclusions: Development of a robust quality infrastructure at the site level can increase adherence to quality measures by identifying common barriers to improvement, sharing of best practices, and supporting the delivery of patient-centered, value-based care.