title: Improving Communication on Intent of Chemotherapy Using QOPI Scores and PDSA Cycles.
abstract: Using the standardized ASCO Quality Oncology Practice Initiative (QOPI) guidelines for assessing quality cancer care, we identified communication about intent of chemotherapy as an area needing improvement in our program at the University of Arkansas for Medical Sciences (UAMS) and the Central Arkansas Veterans Healthcare System (CAVHS). We organized training in communications on intent of treatment (palliative vs curative) and added optional checkboxes to our electronic templates for progress notes. Afterwards, we conducted a retrospective review of electronic medical records of initially often randomly selected patient charts. The first 10 patient charts after 1 month of implementation showed intent of treatment in 80 % of charts compared to 74 % at baseline. We then changed checkboxes from mandatory to optional and reviewed 30 randomly selected patient charts. Intent of treatment was documented in 96.7 % of cases compared to 74 % at baseline. We also assessed patient satisfaction through surveys distributed in clinic. Patient satisfaction scores were close to 100 % for receiving clear information, understanding the reason for which they were receiving chemotherapy, and willingness of oncologists to listen carefully, to take time to answer questions, to explain things clearly, and to spend adequate time with them. In this study, we showed that training in communication of intent of chemotherapy and use of checkboxes in progress note templates could improve competency in communication of intent of therapy in cancer patients.
authors.affiliation: Division of Hematology and Oncology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.|Division of Hematology and Oncology, Central Arkansas Veterans Healthcare System, Little Rock, AR, USA.
authors.forename: Meghana
authors.initials: M
authors.lastname: Bansal
authors.affiliation: Division of Hematology and Oncology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA. aaabdallah@uams.edu.|Division of Hematology and Oncology, Central Arkansas Veterans Healthcare System, Little Rock, AR, USA. aaabdallah@uams.edu.
authors.forename: Al-Ola
authors.initials: AO
authors.lastname: Abdallah
authors.affiliation: Division of Hematology and Oncology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.|Division of Hematology and Oncology, Central Arkansas Veterans Healthcare System, Little Rock, AR, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Pennisi
authors.affiliation: Division of Hematology and Oncology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Arnaoutakis
authors.affiliation: Division of Hematology and Oncology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Issam
authors.initials: I
authors.lastname: Makhoul
authors.affiliation: Division of Hematology and Oncology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.|Division of Hematology and Oncology, Central Arkansas Veterans Healthcare System, Little Rock, AR, USA.
authors.forename: Paulette
authors.initials: P
authors.lastname: Mehta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000517:prevention & control*; D017060:Patient Satisfaction; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000592:standards*; D058996:Quality Improvement / Q000458:organization & administration* / Q000592:standards; D011787:Quality of Health Care / Q000592:standards*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
keywords: Intent of chemotherapy; Quality Oncology Practice Initiative