Baystate Medical Center, Springfield; and Tufts University School of Medicine, Boston, MA.
J Oncol Pract. 2014 Jan;10(1):58-62. doi: 10.1200/JOP.2013.000953. Epub 2013 Oct 22.
To demonstrate the use of American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) measures as part of a financial incentive plan for an academic health center-based hematology-oncology division.
An 11-member QOPI-certified hematology-oncology division participated in a pilot variable compensation (VC) plan with group-specific targets selected based on prior below-average performance. Twenty percent of overall VC was linked to success in two QOPI categories: completion of treatment summaries within 90 days of end of chemotherapy and assessment of patients' emotional well-being by second office visit. Three tiers of achievement were set for each goal. A formula combining VC goals into year-end payout was driven by three levels of percent base salary: 8%, 12%, and 24%, with probability of achievement of each goal of 90%, 50%, and 10%, respectively. Practice leadership was educated about QOPI acceptance in the oncology community.
The division participated in QOPI during spring and fall 2012. With systems-based improvements, 40.54% of medical records audited had treatment summaries, resulting in achievement of tier III compensation. Documentation of emotional well-being increased, yielding 63% of patient cases compliant; however, the national benchmark concurrently improved, making this insufficient to achieve tier I.
QOPI metrics can be used as a quality incentive for oncologists in a VC plan. Non-oncologists can appreciate the strength of QOPI as a quality tool. The combination of a QOPI program through ASCO and use of various QOPI metrics can drive continuous improvement in an oncology group.
展示将美国临床肿瘤学会（ASCO）质量肿瘤实践倡议（QOPI）措施作为学术医疗中心为基础的血液肿瘤科部门的财务激励计划的一部分。
一个由 11 名成员组成的 QOPI 认证的血液肿瘤科部门参与了一个试点可变补偿（VC）计划，该计划根据以往低于平均水平的表现选择了特定于小组的目标。20%的整体 VC 与两个 QOPI 类别相关联：在化疗结束后 90 天内完成治疗总结，以及通过第二次就诊评估患者的情绪健康。为每个目标设定了三个成就层次。将 VC 目标结合到年终支出的公式是由三个级别的基本工资驱动的：8%、12%和 24%，每个目标的实现概率分别为 90%、50%和 10%。实践领导团队接受了关于 QOPI 在肿瘤学界接受程度的教育。
该部门在 2012 年春季和秋季参加了 QOPI。通过系统改进，40.54%的审核病历都有治疗总结，从而实现了第三级补偿。情绪健康状况的记录有所增加，达到了 63%的患者病例符合要求；然而，同期的国家基准也有所提高，这使得无法达到第一级。
QOPI 指标可以作为 VC 计划中肿瘤学家的质量激励措施。非肿瘤学家也可以欣赏 QOPI 作为质量工具的优势。通过 ASCO 的 QOPI 计划和使用各种 QOPI 指标的组合，可以推动肿瘤组的持续改进。
