title: Addressing Opioid-Associated Constipation Using Quality Oncology Practice Initiative Scores and Plan-Do-Study-Act Cycles.
abstract: Using the Quality Oncology Practice Initiative, an affiliate program of ASCO, we outlined opioid-associated constipation (OAC) as a subject in need of quality improvement (QI) in our fellowship program at the University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System. We initiated a fellow-led QI project to advance the quality of patient care and provide a valuable avenue for QI training of young physicians. Fellows organized meetings with all stakeholders, addressed the scope of the problem, and devised strategies for OAC management. Monthly meetings were organized using Plan-Do-Study-Act principles. Mandatory check boxes were inserted into our electronic medical record templates to remind all physicians to identify patients on opioid medications and assess and address OAC. Final chart audit and patient satisfaction surveys were performed 6 months after project initiation. Assessment of OAC improved from 52% at baseline to 92% ( P < .003). This improvement corresponded with high patient satisfaction scores, with 90% of surveyed patients reporting adequate management of their constipation. In this QI initiative, we showed that participation in ASCO's Quality Oncology Practice Initiative helps identify areas in need of QI, and such fellow-led QI projects can serve as models for QI training of young physicians.
authors.affiliation: Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences; Central Arkansas Veterans Healthcare System, Little Rock, AR; and British Columbia Cancer Agency, Vancouver Island Cancer Center, Victoria, British Columbia, Canada.
authors.forename: Varinder
authors.initials: V
authors.lastname: Kaur
authors.affiliation: Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences; Central Arkansas Veterans Healthcare System, Little Rock, AR; and British Columbia Cancer Agency, Vancouver Island Cancer Center, Victoria, British Columbia, Canada.
authors.forename: Sajjad
authors.initials: S
authors.lastname: Haider
authors.affiliation: Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences; Central Arkansas Veterans Healthcare System, Little Rock, AR; and British Columbia Cancer Agency, Vancouver Island Cancer Center, Victoria, British Columbia, Canada.
authors.forename: Appalanaidu
authors.initials: A
authors.lastname: Sasapu
authors.affiliation: Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences; Central Arkansas Veterans Healthcare System, Little Rock, AR; and British Columbia Cancer Agency, Vancouver Island Cancer Center, Victoria, British Columbia, Canada.
authors.forename: Paulette
authors.initials: P
authors.lastname: Mehta
authors.affiliation: Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences; Central Arkansas Veterans Healthcare System, Little Rock, AR; and British Columbia Cancer Agency, Vancouver Island Cancer Center, Victoria, British Columbia, Canada.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Arnaoutakis
authors.affiliation: Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences; Central Arkansas Veterans Healthcare System, Little Rock, AR; and British Columbia Cancer Agency, Vancouver Island Cancer Center, Victoria, British Columbia, Canada.
authors.forename: Issam
authors.initials: I
authors.lastname: Makhoul
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects*; D003248:Constipation / Q000139:chemically induced*; D006801:Humans; D017060:Patient Satisfaction; D058996:Quality Improvement / Q000592:standards; D011795:Surveys and Questionnaires
chemical_list: D000701:Analgesics, Opioid