Leveraging PrOFILE data to illustrate and benchmark the Institute of Medicine quality aims in global pediatric oncology.

Abstract

e18706 Background: PrOFILE is a dynamic 360o evaluation of health service delivery that helps care teams and institutions committed to increasing childhood cancer survival define an improvement strategy. PrOFILE stands for Pediatric Oncology Facility Integrated Local Evaluation. As of December 2021, PrOFILE has been utilized in over 130 facilities from over 25 countries around the globe. The standard outputs are presented by module, which reflect the patient-care continuum. The Institute of Medicine (IOM) has proposed six aims for improvement to drive fundamental change in health care delivery. The IOM Committee recommends periodically evaluating progress and developing strategies for overcoming barriers.However, a tool to assist facilities to set a baseline and periodically assess progress does not exist. We evaluated the feasibility of leveraging PrOFILE data to identify (1) the status of each quality aim as defined by IOM and (2) the status compared to facilities in the same country or region. Methods: This study employed a multi-step mapping approach. We first mapped the 1,279 PrOFILE variables to the six IOM quality aims. Mapping was first performed independently by two authors, then reviewed by PrOFILE experts to achieve consensus. Each variable could only contribute to one aim. We then validated the mapping by running the previously collected data available from two cohorts (one with 13 and one with 17 facilities) and benchmarking institutional data to cohort data. Quality improvement experts and local stakeholders provided feedback on further use of the illustrations and benchmarks. Results: We identified 305 PrOFILE variables that reflect the IOM quality aims (Table). More PrOFILE questions could be used as proxy for safety, effectiveness, and timeliness aims, than patient-centeredness, efficiency, and equity (Table), however, all domains could be represented. Benchmarking the institution results to the regional or country cohort results allowed for context-relevant insightful benchmarking. Framing PrOFILE results utilizing the IOM six aims allowed local healthcare teams and relevant stakeholders to evaluate their baseline and set targets for improvement. Conclusions: This exercise demonstrates the feasibility of leveraging PrOFILE data to assess institutional alignment with the IOM quality aims. The results allow illustrating, benchmarking, and engaging with stakeholders in conversations aimed at improving delivery of pediatric oncology care in global real-world settings utilizing this perspective. Future PrOFILE reports will incorporate this feature, supporting establishing a baseline and tracking of progress over time.[Table: see text]