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全州口服肿瘤治疗计划对五个参与实践的影响。

Impact of a Statewide Oral Oncolytic Initiative on Five Participating Practices.

机构信息

Michigan Oncology Quality Consortium; University of Michigan, Ann Arbor, MI; and Virginia Commonwealth University, Richmond, VA.

出版信息

J Oncol Pract. 2018 May;14(5):e304-e309. doi: 10.1200/JOP.18.00058. Epub 2018 Apr 11.

Abstract

PURPOSE

The shift from infusion to oral oncolytic therapy presents challenges to oncology practitioners. The purpose of this study was to describe how a statewide quality-improvement collaborative can enhance quality of care for patients receiving oral oncolytic therapy.

METHODS

The Michigan Oncology Quality Consortium hosted a series of learning sessions focused on oral oncolytic quality improvement, providing multiple resources to oncology community practices. The first five participating practices reported which of the evidence-based Michigan Oncology Quality Consortium resources provided were implemented at their site. They also performed prepost self-assessments in October 2013 and April 2015 and another in December 2017 to assess sustainability. Concordance with the ASCO Quality Oncology Practice Initiative oral chemotherapy standards, including documentation (five measures), patient education (seven measures), and follow-up/monitoring (four measures), was compared.

RESULTS

All practices showed improvement between 2013 and 2015 in documentation (32% to 88%; P = .03), patient education (37% to 100%; P could not be calculated), and monitoring (40% to 80%; P > .2). Overall, a significant improvement in concordance was observed (36% to 91%; P = .03). Use of resources from each practice varied, and practices that used more resources showed greater improvements. There was a slight decrease in overall concordance between 2015 and 2017, which was not found to be significant (91% to 84%; P = .53).

CONCLUSION

Use of tools from a quality-improvement collaborative improved concordance with national standards of care. Large-scale deployment of this model program may provide a clinically efficient and effective mechanism to enhance widespread change.

摘要

目的

从输液治疗向口服肿瘤治疗的转变给肿瘤临床医生带来了挑战。本研究旨在描述全州范围的质量改进合作如何增强接受口服肿瘤治疗患者的护理质量。

方法

密歇根肿瘤质量联盟举办了一系列专注于口服肿瘤质量改进的学习会议,为肿瘤社区实践提供了多种资源。前五个参与的实践报告了他们在现场实施了哪些基于证据的密歇根肿瘤质量联盟资源。他们还在 2013 年 10 月、2015 年 4 月和 2017 年 12 月进行了前后自我评估,以评估可持续性。与 ASCO 质量肿瘤实践倡议口服化疗标准的一致性,包括文档记录(5 项措施)、患者教育(7 项措施)和随访/监测(4 项措施)进行了比较。

结果

所有实践在文档记录(32%到 88%;P =.03)、患者教育(37%到 100%;无法计算 P 值)和监测(40%到 80%;P >.2)方面均显示出从 2013 年到 2015 年的改善。总体而言,一致性的显著改善是观察到的(36%到 91%;P =.03)。每个实践对资源的使用情况各不相同,使用更多资源的实践显示出更大的改善。在 2015 年和 2017 年之间,总体一致性略有下降,但未发现显著差异(91%到 84%;P =.53)。

结论

使用质量改进合作的工具提高了与国家护理标准的一致性。该模型方案的大规模部署可能为广泛变革提供一种临床有效和有效的机制。

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