Using a statewide collaborative approach to improve primary palliative care performance.

Abstract

53 Background: The Michigan Oncology Quality Consortium (MOQC) is a statewide collaborative of oncology practices. Using the Quality Oncology Practice Initiative (QOPI) measurement tool, MOQC identified a gap in the provision of palliative care. We designed and tested interventions to enhance the capacity and capabilities of the oncologist to deliver primary palliative care earlier in a patient’s course. Methods: MOQC created a process to assist oncology care teams in providing primary palliative care services using the Edmonton Symptom Assessment Scale tool. 11 practices participated in two pilots over 18 months. During and after these pilots, we disseminated tools for improvement, including customized palliative care dashboards, to the entire consortium. Pilot teams also shared their successes, insights, and best practices during semiannual live consortium meetings. Results: Shown are palliative care-focused QOPI results, comparing baseline (Fall 2011, F11) and post project (Spring 2013, S13) for all MOQC practices compared with all participating QOPI practices, using a paired t-test. MOQC sites outperformed the QOPI national average on multiple palliative care measures. Furthermore, the MOQC improvement rate since the project initiation was greater than that of national. Although clinically important, the measures did not reach standard statistical significance. Conclusions: Running successive pilot projects improved primary palliative care performance of the teams involved; additionally, this momentum and gain in knowledge facilitated dissemination of innovation and measurable improvement in all members of a statewide consortium. [Table: see text]