title: Fighting cancer together: Development and implementation of shared medical appointments to standardize and improve chemotherapy education.
abstract: OBJECTIVE
  Shared medical appointments offer a novel approach to improve efficiency and quality of care consistent with the goals of the Institute of Medicine. Our objective was to develop and implement a shared medical appointment for gynecologic cancer patients initiating chemotherapy.
  
  
  METHODS
  We first assessed the level of interest in shared medical appointments among our patients and providers through qualitative interviews. Both patients and providers identified pre-chemotherapy as an optimal area to pilot shared medical appointments. We subsequently created a multidisciplinary team comprised of physicians, advanced practice providers, nurses, pharmacists, administrators, health education specialists and members of the Quality Improvement Department to establish a Shared Medical Appointment and Readiness Teaching (SMART) program for all gynecologic oncology patients initiating chemotherapy with platinum- and/or taxane-based regimens. We developed a standardized chemotherapy education presentation and provided patients with a tool kit that consisted of chemotherapy drug education, a guide to managing side effects, advance directives, and center contact information.
  
  
  RESULTS
  From May 9, 2014 to June 26, 2015, 144 patients participated in 51 SMART visits. The majority of patients had ovarian cancer and were treated with carboplatin/paclitaxel. Surveyed patients reported being highly satisfied with the group visit and would recommend shared medical appointments to other patients.
  
  
  CONCLUSIONS
  This model of care provides patient education within a framework of social support that empowers patients. Shared medical appointments for oncology patients initiating chemotherapy are both feasible and well accepted.
authors.affiliation: Departments of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States. Electronic address: LSPrescott@mdanderson.org.
authors.forename: Lauren S
authors.initials: LS
authors.lastname: Prescott
authors.affiliation: Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Dickens
authors.affiliation: Departments of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Guerra
authors.affiliation: The Learning Center, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Jila M
authors.initials: JM
authors.lastname: Tanha
authors.affiliation: Patient Education, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Desiree G
authors.initials: DG
authors.lastname: Phillips
authors.affiliation: Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Katherine T
authors.initials: KT
authors.lastname: Patel
authors.affiliation: Clinical Operations, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Katie M
authors.initials: KM
authors.lastname: Umberson
authors.affiliation: Performance Improvement, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Lozano
authors.affiliation: Department of Supportive Medicine, Memorial Hermann Healthcare System, Houston, TX, United States.
authors.forename: Kathryn B
authors.initials: KB
authors.lastname: Lowe
authors.affiliation: Departments of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Alaina J
authors.initials: AJ
authors.lastname: Brown
authors.affiliation: Departments of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Jolyn S
authors.initials: JS
authors.lastname: Taylor
authors.affiliation: Departments of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Pamela T
authors.initials: PT
authors.lastname: Soliman
authors.affiliation: Departments of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Garcia
authors.affiliation: Departments of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Charles F
authors.initials: CF
authors.lastname: Levenback
authors.affiliation: Departments of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Diane C
authors.initials: DC
authors.lastname: Bodurka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001071:Appointments and Schedules; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D010348:Patient Care Team; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction
keywords: Education; Quality improvement; chemotherapy; shared medical appointment