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Camps C, López R, Antón A, Aranda E, Carrato A, Cruz JJ, Cunquero-Tomás AJ, Díaz-Rubio E, Feyjóo M, García-Foncillas J, Gascón P, Lugo I, Rogado Á, Guillem V. Implementation of the Quality Oncology Practice Initiative Program in Spain: First Results and Implications. JCO Oncol Pract 2021; 17:e1162-e1169. [PMID: 33621121 DOI: 10.1200/op.20.00683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Measuring and tracking quality of care is highly relevant in today's health care. The Quality Oncology Practice Initiative (QOPI) program is a referral for evaluating oncology practices worldwide. Excellence and Quality in Oncology Foundation, a collaboration of oncology experts from major Spanish hospitals involved in cancer treatment, reached an agreement with QOPI to include Spanish hospitals in this program. METHODS We analyzed the results of the QOPI Core module measures from 19 Spanish hospitals over nine rounds (from fall 2015 to fall 2019). RESULTS Of the 19 hospitals, 15 completed more than one round; none participated in all nine (two hospitals participated in eight rounds). The highest scores were for pathology report confirming malignancy, documenting a plan of care for moderate or severe pain and chemotherapy dose, and chemotherapy administered to patients with metastatic solid tumor with performance status undocumented. Measures regarding a summary of chemotherapy treatment, tobacco use cessation counseling, and assessment of patient emotional well-being were among the lowest scored measures. Six of the 15 practices that participated repeatedly achieved a better score in their last round compared with their first. Overall, scores of Spanish hospitals improved from 67.79% in fall 2015 to 68.91% in fall 2019. CONCLUSION To our knowledge, this is the first study to evaluate QOPI scores in Spain. There was high variability in scores, with quality of care improving with repeated participation in some hospitals, but worsening in others. Excellence and Quality in Oncology Foundation will support practices to increase their participation to improve oncology care and implement strategies that address the areas for improvement.
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Affiliation(s)
- Carlos Camps
- Servicio de Oncología Médica, Hospital General de València, València, Spain; CIBERONC, Madrid, Spain.,CIBERONC, València, Spain.,Departament de Medicina, Universitat de València, València, Spain.,Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain
| | - Rafael López
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain.,Servicio de Oncología Médica, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Antonio Antón
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain.,Servicio de Oncología Médica, Hospital Universitario Miguel Servet, IIS Aragón, Zaragoza, Spain
| | - Enrique Aranda
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain.,Servicio de Oncología Médica, Hospital Reina Sofía, Córdoba, Spain
| | - Alfredo Carrato
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain.,Servicio de Oncología Médica, Hospital Ramón y Cajal, Madrid, Spain.,IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - Juan Jesús Cruz
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain.,Servicio de Oncología Médica, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
| | - Alberto Jacobo Cunquero-Tomás
- Servicio de Oncología Médica, Hospital General de València, València, Spain; CIBERONC, Madrid, Spain.,Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain
| | - Eduardo Díaz-Rubio
- CIBERONC, València, Spain.,Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain.,Real Academia Nacional de Medicina, Madrid, Spain.,IdISCC, Madrid, Spain
| | - Margarita Feyjóo
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain.,Servicio de Oncología Médica, Hospital Universitario La Moraleja, Sanitas, Madrid, Spain
| | - Jesús García-Foncillas
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain.,Servicio de Oncología Médica, Fundación Jiménez Díaz, Madrid, Spain
| | - Pere Gascón
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain.,Servicio de Oncología Médica, Hospital Universitario Clinic, Barcelona, Spain
| | - Ilse Lugo
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain
| | - Álvaro Rogado
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain
| | - Vicente Guillem
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain.,Servicio de Oncología Médica, Instituto Valenciano de Oncología, València, Spain
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Peña-Curiel O, Villarreal-Garza C, Canavati M, Velazquez-Ayala KM, Castro-Carrasco J, Garza-Ledezma MA, Zarzar-Handal K, Díaz-Pérez HM, De la Garza-Ramos C, Ferrigno AS, Martínez EF, Guerrier V. Successful Implementation of a Quality Improvement Intervention Toward a QOPI-Certified Breast Cancer Center in Mexico. JCO Oncol Pract 2020; 16:e1406-e1411. [PMID: 32735508 DOI: 10.1200/op.20.00230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION As part of a quality improvement (QI) project undertaken during the 2018 edition of the American Society of Clinical Oncology's Quality Training Program (QTP), we evaluated our practice's compliance to 70 measures regarding the Core, Symptom/Toxicity and Breast Cancer modules from the Quality Oncology Practice Initiative (QOPI) database. Thirteen measures were identified as being consistently low in documentation rate in our medical records (MR). METHODS After establishing a multidisciplinary QI team, we defined to accomplish 100% documentation rate of these 13 QOPI measures in ≥ 80% of the monthly new patient MRs during the 6-month QTP. We designed a Microsoft Word MR template and implemented a new pre-consultation process. Monthly Plan-Do-Study-Act cycles were conducted to assess the performance of the intervention. RESULTS After the 6-month QI intervention, > 80% of our monthly MRs achieved 100% compliance to the aimed-for 13 QOPI measures. Furthermore, our new pre-consultation process proved to be valuable in facilitating the documentation of data without interfering with the oncology appointment. CONCLUSION The development of a systematic QI approach effectively enhanced our compliance to 13 QOPI measures over a 6-month period. These results led to the standardization of the current model of care at our institution. To our knowledge, Hospital Zambrano Hellion's Breast Cancer Center is the first Mexican cancer center to pursue a QOPI certified practice.
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Affiliation(s)
- Omar Peña-Curiel
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico
| | - Cynthia Villarreal-Garza
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico
| | - Mauricio Canavati
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico
| | - Karen Marlene Velazquez-Ayala
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico
| | - Janeth Castro-Carrasco
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico
| | - María Alejandra Garza-Ledezma
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico
| | - Katia Zarzar-Handal
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico
| | - Héctor Marcelino Díaz-Pérez
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico
| | - Cynthia De la Garza-Ramos
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico
| | - Ana S Ferrigno
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico
| | - Enrique Francisco Martínez
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico
| | - Vedner Guerrier
- Oncology Service at Memorial Healthcare System, Hollywood, FL
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Jazieh AR, Abdelhafiez N, Al Mutairi N, Hashem A, Alkaiyat M, Al Shami M, Jahanzeb M. Improving Quality of Cancer Care by Participating in Quality Oncology Practice Initiative Certification Program. JCO Glob Oncol 2020; 6:1087-1092. [PMID: 32673077 PMCID: PMC7392688 DOI: 10.1200/go.20.00217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE ASCO developed the Quality Oncology Practice Initiative (QOPI) to ensure patient safety in oncology outpatient services. We evaluated the impact of participation in QOPI certification on patient care at our institution. METHODS To participate in QOPI, we created a multidisciplinary team, and we chose the required modules and began QOPI participation per program requirement. In the initial round, we scored lower than the required score of 75% to be eligible for QOPI certification. We then implemented multiple measures and interventions, and we conducted multiple Plan, Do, Study, Act cycles (PSDA) cycles to achieve our goal. RESULTS Our score in the initial round was 68%; in the second round, our score remained low at 65%; in the third round, we exceeded the target score by achieving 93%. We completed the certification process with a site visit. In October 2018, we became the first QOPI-certified center in the Middle East and Asia. CONCLUSION We learned many lessons during our journey toward QOPI certification. Essential elements of success included timely assembly of the right multidisciplinary team and clear communication between team members within the institution and with the ASCO QOPI team.
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Affiliation(s)
- Abdul Rahman Jazieh
- Department of Oncology, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Nafisa Abdelhafiez
- Department of Oncology, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Nashmia Al Mutairi
- Department of Oncology, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Ahmed Hashem
- Department of Oncology, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mohammad Alkaiyat
- Department of Oncology, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mona Al Shami
- Department of Oncology, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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O'Neil DS, Chen WC, Ayeni O, Nietz S, Buccimazza I, Singh U, Čačala S, Stopforth L, Joffe M, Crew KD, Jacobson JS, Neugut AI, Ruff P, Cubasch H. Breast Cancer Care Quality in South Africa's Public Health System: An Evaluation Using American Society of Clinical Oncology/National Quality Forum Measures. J Glob Oncol 2020; 5:1-16. [PMID: 31770052 PMCID: PMC6882520 DOI: 10.1200/jgo.19.00171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE The quality of breast cancer care in sub-Saharan Africa contributes to the region’s dismal breast cancer mortality. ASCO has issued quality measures focusing on delivery of adjuvant chemotherapy, radiotherapy, and endocrine therapy. We applied these measures in five South African public hospitals and analyzed factors associated with care concordance. MATERIALS AND METHODS Among 1,736 women with breast cancer who were enrolled in the South African Breast Cancer and HIV Outcomes study over 24 months, we evaluated care using ASCO’s three measures. We also evaluated adjuvant chemotherapy receipt in 957 women with an indication. We used logistic regression to estimate associations between measure-concordant care and patient factors. RESULTS Of 235 women with hormone receptor–negative cancer, 173 (74%) began adjuvant chemotherapy within 120 days from diagnosis. Of 194 patients who received breast-conserving surgery, 73 (37%) began radiotherapy within 365 days from diagnosis. Of 999 women with hormone receptor–positive cancer, 719 (72%) initiated endocrine therapy within 365 days from diagnosis. Chemotherapy and radiotherapy measure-concordant care were more common among women residing < 20 km from the hospital (odds ratio [OR], 1.79; 95% CI, 1.32 to 2.44 and OR, 3.17; 95% CI, 1.57 to 6.42). Endocrine therapy measure-concordant care was more common among English-speaking women (OR, 2.12; 95% CI, 1.12 to 4.02). Participating hospitals varied in care concordance. HIV infection did not affect care quality. CONCLUSION More timely delivery of chemotherapy, radiotherapy, and endocrine therapy is needed in South Africa, particularly for women living > 20 km from the hospital or not speaking English. Focused quality improvement efforts could support that goal.
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Affiliation(s)
- Daniel S O'Neil
- University of Miami Leonard M. Miller School of Medicine, Miami, FL
| | - Wenlong Carl Chen
- Wits Health Consortium, Johannesburg, South Africa.,National Cancer Registry, Johannesburg, South Africa.,University of the Witwatersrand, Johannesburg, South Africa
| | - Oluwatosin Ayeni
- Wits Health Consortium, Johannesburg, South Africa.,University of the Witwatersrand, Johannesburg, South Africa
| | - Sarah Nietz
- Wits Health Consortium, Johannesburg, South Africa.,Charlotte Maxeke Johannesburg Academic Hospital, University of Witwatersrand, Johannesburg, South Africa
| | - Ines Buccimazza
- Wits Health Consortium, Johannesburg, South Africa.,Inkosi Albert Luthuli Central Hospital, Durban and Ngwelezane Hospital, University of KwaZulu Natal, Empangeni, KwaZulu Natal, South Africa
| | - Urishka Singh
- Wits Health Consortium, Johannesburg, South Africa.,Inkosi Albert Luthuli Central Hospital, Durban and Ngwelezane Hospital, University of KwaZulu Natal, Empangeni, KwaZulu Natal, South Africa
| | - Sharon Čačala
- Wits Health Consortium, Johannesburg, South Africa.,Grey's Hospital, University of KwaZulu Natal, Pietermaritzburg, KwaZulu Natal, South Africa
| | - Laura Stopforth
- Wits Health Consortium, Johannesburg, South Africa.,Grey's Hospital, University of KwaZulu Natal, Pietermaritzburg, KwaZulu Natal, South Africa
| | - Maureen Joffe
- Wits Health Consortium, Johannesburg, South Africa.,University of the Witwatersrand, Johannesburg, South Africa
| | | | | | | | - Paul Ruff
- Wits Health Consortium, Johannesburg, South Africa.,University of the Witwatersrand, Johannesburg, South Africa.,Chris Hani Baragwanath Academic Hospital, University of Witwatersrand, Johannesburg, South Africa
| | - Herbert Cubasch
- Wits Health Consortium, Johannesburg, South Africa.,University of the Witwatersrand, Johannesburg, South Africa.,Chris Hani Baragwanath Academic Hospital, University of Witwatersrand, Johannesburg, South Africa
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