The Quality Oncology Practice Initiative (QOPI): Understanding and improving “Best Practices” by a community of oncologists

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6023 Background: One goal of the QOPI project is to provide tools for practitioners to implement “best practices.” In an effort to provide comparative data regarding best practices, QOPI has developed a set of evidence and consensus-based measures. Concordance is assessed through a structured chart review that allows numeric scoring and generation of practice reports. Results can be compared over time and among practices. Methods: 23 practices of various sizes from across the U.S. were invited to participate. Measures relate to ASCO practice guidelines, national standards, or expert consensus. 2,410 charts have been abstracted to date. Observations and comparisons among groups are analyzed by construction of 95% confidence intervals (CI). Conclusions: We observed a clinically meaningful and statistically significant variation in achieving quality measures in oncology practices. The QOPI process provides a mechanism for documenting concordance with quality measures, testing interventions and documenting improvement. Measure N Mean %Yes 95% CI Lowest Ob- served Value Highest Ob- served Value Was pain addressed on the visit prior to death? 394 65.0% 55–75% 15.0% 92.9% Were granulocytic growth factors given per guideline? 203 30.6% 34–50% 0% 100% Were serotonin antagonist antiemetics given per guideline? 1160 97.0% 96–98% 84.1% 100% Were corticosteroids added per guideline? 1102 97.9% 97–99% 90.3% 100% Were erythroid growth factors given per guideline? 824 72.7% 68–77% 36.7% 94.7% Was a pathology report available in the chart? 2410 97.1% 96–98% 88.2 % 100% Was staging completed prior to definitive therapy? 2159 96.1% 94–98% 70.2% 100% Were flow sheets used when chemotherapy was given? 1997 99.8% 99–100% 97.3% 100% Was a signed consent for non-protocol chemotherapy in the chart? 1997 39.5% 28–51% 0% 100% Was verbal consent for chemotherapy documented? 692 88.7% 80–96% 73.6% 100% Was adjuvant chemotherapy given to breast cancer patients per NICCQ specifications? 131 100% N/A N/A N/A Was adjuvant chemotherapy given to colorectal cancer patients per NICCQ specifications? 270 99.2% 99–100% 91.7% 100% No significant financial relationships to disclose.