CHAMBER: A Regional Performance Improvement CME Initiative for Breast Cancer Health Care Providers.
CHAMBER was a regional educational initiative for providers of care to patients with HER2+ breast cancer. The study goals were to (1) enhance testing for HER2/neu overexpression in patients with invasive breast cancer; (2) increase the appropriate use of targeted therapy for patients with HER2+ breast cancer; and (3) enhance patients' coping ability. This Performance Improvement Continuing Medical Education (PI-CME) initiative included clinical practice assessment, educational activities, and reassessment. Chart review revealed a high rate of HER2 testing (98%) before and after education. Targeted therapy for patients with HER2+ breast cancer declined after the program (from 96% to 61%), perhaps attributable to an increase in awareness of medical reasons to avoid use of targeted therapy. Assessment for patients' emotional coping ability increased after education (from 55% to 76%; P=.01). Rates of testing for HER2 amplification and assessment of emotional well-being after education were consistent with ASCO Quality Oncology Practice Initiative benchmark values. Documentation of actions to address emotional problems remained an area for improvement.
From Department of Medicine, Duke School of Medicine and Health System, and Department of Pathology, Duke University Medical Center, Durham, North Carolina; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, Tennessee; The France Foundation, Old Lyme, Connecticut; Duke Medicine, Center For Educational Excellence, Duke Clinical Research Institute, and Duke School of Medicine, Center for Educational Excellence, Durham, North Carolina; and American Anesthesiology, Mednax National Medical Group, Sunrise, Florida.
Linda M
LM
Sutton
From Department of Medicine, Duke School of Medicine and Health System, and Department of Pathology, Duke University Medical Center, Durham, North Carolina; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, Tennessee; The France Foundation, Old Lyme, Connecticut; Duke Medicine, Center For Educational Excellence, Duke Clinical Research Institute, and Duke School of Medicine, Center for Educational Excellence, Durham, North Carolina; and American Anesthesiology, Mednax National Medical Group, Sunrise, Florida.
Joseph
J
Geradts
From Department of Medicine, Duke School of Medicine and Health System, and Department of Pathology, Duke University Medical Center, Durham, North Carolina; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, Tennessee; The France Foundation, Old Lyme, Connecticut; Duke Medicine, Center For Educational Excellence, Duke Clinical Research Institute, and Duke School of Medicine, Center for Educational Excellence, Durham, North Carolina; and American Anesthesiology, Mednax National Medical Group, Sunrise, Florida.
Erika P
EP
Hamilton
From Department of Medicine, Duke School of Medicine and Health System, and Department of Pathology, Duke University Medical Center, Durham, North Carolina; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, Tennessee; The France Foundation, Old Lyme, Connecticut; Duke Medicine, Center For Educational Excellence, Duke Clinical Research Institute, and Duke School of Medicine, Center for Educational Excellence, Durham, North Carolina; and American Anesthesiology, Mednax National Medical Group, Sunrise, Florida.
Kathleen A
KA
Havlin
From Department of Medicine, Duke School of Medicine and Health System, and Department of Pathology, Duke University Medical Center, Durham, North Carolina; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, Tennessee; The France Foundation, Old Lyme, Connecticut; Duke Medicine, Center For Educational Excellence, Duke Clinical Research Institute, and Duke School of Medicine, Center for Educational Excellence, Durham, North Carolina; and American Anesthesiology, Mednax National Medical Group, Sunrise, Florida.
Gretchen G
GG
Kimmick
From Department of Medicine, Duke School of Medicine and Health System, and Department of Pathology, Duke University Medical Center, Durham, North Carolina; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, Tennessee; The France Foundation, Old Lyme, Connecticut; Duke Medicine, Center For Educational Excellence, Duke Clinical Research Institute, and Duke School of Medicine, Center for Educational Excellence, Durham, North Carolina; and American Anesthesiology, Mednax National Medical Group, Sunrise, Florida.
P Kelly
PK
Marcom
From Department of Medicine, Duke School of Medicine and Health System, and Department of Pathology, Duke University Medical Center, Durham, North Carolina; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, Tennessee; The France Foundation, Old Lyme, Connecticut; Duke Medicine, Center For Educational Excellence, Duke Clinical Research Institute, and Duke School of Medicine, Center for Educational Excellence, Durham, North Carolina; and American Anesthesiology, Mednax National Medical Group, Sunrise, Florida.
Neil L
NL
Spector
From Department of Medicine, Duke School of Medicine and Health System, and Department of Pathology, Duke University Medical Center, Durham, North Carolina; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, Tennessee; The France Foundation, Old Lyme, Connecticut; Duke Medicine, Center For Educational Excellence, Duke Clinical Research Institute, and Duke School of Medicine, Center for Educational Excellence, Durham, North Carolina; and American Anesthesiology, Mednax National Medical Group, Sunrise, Florida.
Melanie
M
Watson
From Department of Medicine, Duke School of Medicine and Health System, and Department of Pathology, Duke University Medical Center, Durham, North Carolina; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, Tennessee; The France Foundation, Old Lyme, Connecticut; Duke Medicine, Center For Educational Excellence, Duke Clinical Research Institute, and Duke School of Medicine, Center for Educational Excellence, Durham, North Carolina; and American Anesthesiology, Mednax National Medical Group, Sunrise, Florida.
Daniel U
DU
Rabin
From Department of Medicine, Duke School of Medicine and Health System, and Department of Pathology, Duke University Medical Center, Durham, North Carolina; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, Tennessee; The France Foundation, Old Lyme, Connecticut; Duke Medicine, Center For Educational Excellence, Duke Clinical Research Institute, and Duke School of Medicine, Center for Educational Excellence, Durham, North Carolina; and American Anesthesiology, Mednax National Medical Group, Sunrise, Florida.
Theodore O
TO
Bruno
From Department of Medicine, Duke School of Medicine and Health System, and Department of Pathology, Duke University Medical Center, Durham, North Carolina; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, Tennessee; The France Foundation, Old Lyme, Connecticut; Duke Medicine, Center For Educational Excellence, Duke Clinical Research Institute, and Duke School of Medicine, Center for Educational Excellence, Durham, North Carolina; and American Anesthesiology, Mednax National Medical Group, Sunrise, Florida.
Amanda
A
Noe
From Department of Medicine, Duke School of Medicine and Health System, and Department of Pathology, Duke University Medical Center, Durham, North Carolina; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, Tennessee; The France Foundation, Old Lyme, Connecticut; Duke Medicine, Center For Educational Excellence, Duke Clinical Research Institute, and Duke School of Medicine, Center for Educational Excellence, Durham, North Carolina; and American Anesthesiology, Mednax National Medical Group, Sunrise, Florida.
Stacy
S
Miller
From Department of Medicine, Duke School of Medicine and Health System, and Department of Pathology, Duke University Medical Center, Durham, North Carolina; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, Tennessee; The France Foundation, Old Lyme, Connecticut; Duke Medicine, Center For Educational Excellence, Duke Clinical Research Institute, and Duke School of Medicine, Center for Educational Excellence, Durham, North Carolina; and American Anesthesiology, Mednax National Medical Group, Sunrise, Florida.
Chitra
C
Subramaniam
From Department of Medicine, Duke School of Medicine and Health System, and Department of Pathology, Duke University Medical Center, Durham, North Carolina; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, Tennessee; The France Foundation, Old Lyme, Connecticut; Duke Medicine, Center For Educational Excellence, Duke Clinical Research Institute, and Duke School of Medicine, Center for Educational Excellence, Durham, North Carolina; and American Anesthesiology, Mednax National Medical Group, Sunrise, Florida.
Sherry
S
Layton
From Department of Medicine, Duke School of Medicine and Health System, and Department of Pathology, Duke University Medical Center, Durham, North Carolina; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, Tennessee; The France Foundation, Old Lyme, Connecticut; Duke Medicine, Center For Educational Excellence, Duke Clinical Research Institute, and Duke School of Medicine, Center for Educational Excellence, Durham, North Carolina; and American Anesthesiology, Mednax National Medical Group, Sunrise, Florida.
Katherine
K
Grichnik
D000223:Adaptation, Psychological; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy*; D004502:Education, Medical, Continuing; D005260:Female; D019983:Guideline Adherence; D006282:Health Personnel / Q000193:education / Q000592:standards; D006801:Humans; D055118:Medication Adherence; D058996:Quality Improvement; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism
D018719:Erb-b2 Receptor Tyrosine Kinases