title: Improving documentation of oral chemotherapy at a community cancer center.
abstract: OBJECTIVE
  Safe administration of oral chemotherapy is a complex process that represents a potential threat to patient safety. Clear documentation of the plan of care for patients receiving oral chemotherapy can improve patient safety by ensuring complete health information is available to the health care team.
  
  
  METHODS
  We undertook a rapid-cycle improvement project to improve documentation of oral chemotherapy by increasing the number of components of an oral chemotherapy care plan (as outlined by American Society of Clinical Oncology and Oncology Nursing Society) documented in the medical record before starting a new oral chemotherapy drug. Three improvement cycles were implemented, including: introduction of a standardized nursing flow sheet, use of computerized physician order entry for oral chemotherapy prescribing, and a review of computerized physician order entry to ensure all oral chemotherapy regimens were included.
  
  
  RESULTS
  Our intervention resulted in a meaningful and sustained improvement in the number of components of oral chemotherapy care plans documented in the medical record, from a mean of 67% (eight of 12 components) to a mean of 92% (11 of 12).
  
  
  CONCLUSIONS
  We are hopeful that this improvement project will enhance patient safety by improving communication within the health care team regarding the details of the chemotherapy care plan.
authors.affiliation: Trillium Health Partners-Credit Valley Hospital, Mississauga; Trillium Health Partners-Queensway Health Centre; and Cancer Care Ontario, Toronto, Ontario, Canada katherine.enright@trilliumhealthpartners.ca.
authors.forename: Katherine
authors.initials: K
authors.lastname: Enright
authors.affiliation: Trillium Health Partners-Credit Valley Hospital, Mississauga; Trillium Health Partners-Queensway Health Centre; and Cancer Care Ontario, Toronto, Ontario, Canada.
authors.forename: Meghan
authors.initials: M
authors.lastname: MacMillan
authors.affiliation: Trillium Health Partners-Credit Valley Hospital, Mississauga; Trillium Health Partners-Queensway Health Centre; and Cancer Care Ontario, Toronto, Ontario, Canada.
authors.forename: Patricia
authors.initials: P
authors.lastname: Lymburner
authors.affiliation: Trillium Health Partners-Credit Valley Hospital, Mississauga; Trillium Health Partners-Queensway Health Centre; and Cancer Care Ontario, Toronto, Ontario, Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Sodoski
authors.affiliation: Trillium Health Partners-Credit Valley Hospital, Mississauga; Trillium Health Partners-Queensway Health Centre; and Cancer Care Ontario, Toronto, Ontario, Canada.
authors.forename: Simerjit
authors.initials: S
authors.lastname: Gollee
authors.affiliation: Trillium Health Partners-Credit Valley Hospital, Mississauga; Trillium Health Partners-Queensway Health Centre; and Cancer Care Ontario, Toronto, Ontario, Canada.
authors.forename: Maritza
authors.initials: M
authors.lastname: Carvalho
authors.affiliation: Trillium Health Partners-Credit Valley Hospital, Mississauga; Trillium Health Partners-Queensway Health Centre; and Cancer Care Ontario, Toronto, Ontario, Canada.
authors.forename: Laurie
authors.initials: L
authors.lastname: Van Dorn
authors.affiliation: Trillium Health Partners-Credit Valley Hospital, Mississauga; Trillium Health Partners-Queensway Health Centre; and Cancer Care Ontario, Toronto, Ontario, Canada.
authors.forename: Ron
authors.initials: R
authors.lastname: Fung
authors.affiliation: Trillium Health Partners-Credit Valley Hospital, Mississauga; Trillium Health Partners-Queensway Health Centre; and Cancer Care Ontario, Toronto, Ontario, Canada.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Almeida
mesh_terms: D000284:Administration, Oral; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D003153:Community Health Services / Q000592:standards*; D004282:Documentation / Q000592:standards*; D006801:Humans; D008495:Medical Oncology / Q000592:standards*; D050316:Medical Order Entry Systems / Q000592:standards; D008499:Medical Records / Q000592:standards*; D009369:Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000451:nursing; D009739:Nursing Services / Q000592:standards; D009864:Ontario; D010348:Patient Care Team / Q000592:standards; D061214:Patient Safety / Q000592:standards; D017064:Process Assessment, Health Care / Q000592:standards*; D058996:Quality Improvement / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000592:standards*; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D057188:Workflow