TY - JOUR
T1 - Trainee-Led Quality Improvement Project to Improve Fertility Preservation Counseling for Patients With Cancer
AU - Sena, Laura A.
AU - Sedhom, Ramy
AU - Scott, Susan
AU - Kagan, Amanda
AU - Marple, Andrew H.
AU - Canzoniero, Jenna V.
AU - Hsu, Melinda
AU - Hussaini, Syed M.Qasim
AU - Herati, Amin S.
AU - Reschke, Lauren
AU - Antero, Maria Facadio
AU - Christianson, Mindy S.
AU - Binder, Adam F.
AU - Chen, Allen R.
AU - Donehower, Ross C.
AU - Marrone, Kristen A.
AU - Gupta, Arjun
N1 - Publisher Copyright:
© 2021 by American Society of Clinical Oncology.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - PURPOSE Oncofertility counseling regarding the reproductive risks associated with cancer therapy is essential for quality cancer care. We aimed to increase the rate of oncofertility counseling for patients of reproductive age (18- 40 years) with cancer who were initiating systemic therapy at the Johns Hopkins Cancer Center from a baseline rate of 37% (25 of 68, June 2019-January 2020) to 70% by February 2021. METHODS We formed an interprofessional, multidisciplinary team as part of the ASCO Quality Training Program. We obtained data from the electronic medical record and verified data with patients by phone. We surveyed patients, oncologists, and fertility specialists to identify barriers. After considering a prioritization matrix, we implemented Plan-Do-Study-Act (PDSA) cycles. RESULTS We identified the following improvement opportunities: (1) oncologist self-reported lack of knowledge about counseling and local fertility preservation options and (2) lack of a standardized referral mechanism to fertility services. During the first PDSA cycle (February 2020-August 2020, disrupted by COVID-19), we introduced the initiative to increase oncofertility counseling at faculty meetings. From September 2020 to November 2020, we implemented a second PDSA cycle: (1) educating and presenting the initiative at Oncology Grand Rounds, (2) distributing informative pamphlets to oncologists and patients, and (3) implementing an electronic medical record order set. In the third PDSA cycle (December 2020-February 2021), we redesigned the order set to add information (eg, contact information for fertility coordinator) to the patient after-visit summary. Postimplementation (September 2020-February 2021), counseling rates increased from 37% to 81% (38 of 47). CONCLUSION We demonstrate how a trainee-led, patient-centered initiative improved oncofertility care. Ongoing work focuses on ensuring sustainability and assessing the quality of counseling.
AB - PURPOSE Oncofertility counseling regarding the reproductive risks associated with cancer therapy is essential for quality cancer care. We aimed to increase the rate of oncofertility counseling for patients of reproductive age (18- 40 years) with cancer who were initiating systemic therapy at the Johns Hopkins Cancer Center from a baseline rate of 37% (25 of 68, June 2019-January 2020) to 70% by February 2021. METHODS We formed an interprofessional, multidisciplinary team as part of the ASCO Quality Training Program. We obtained data from the electronic medical record and verified data with patients by phone. We surveyed patients, oncologists, and fertility specialists to identify barriers. After considering a prioritization matrix, we implemented Plan-Do-Study-Act (PDSA) cycles. RESULTS We identified the following improvement opportunities: (1) oncologist self-reported lack of knowledge about counseling and local fertility preservation options and (2) lack of a standardized referral mechanism to fertility services. During the first PDSA cycle (February 2020-August 2020, disrupted by COVID-19), we introduced the initiative to increase oncofertility counseling at faculty meetings. From September 2020 to November 2020, we implemented a second PDSA cycle: (1) educating and presenting the initiative at Oncology Grand Rounds, (2) distributing informative pamphlets to oncologists and patients, and (3) implementing an electronic medical record order set. In the third PDSA cycle (December 2020-February 2021), we redesigned the order set to add information (eg, contact information for fertility coordinator) to the patient after-visit summary. Postimplementation (September 2020-February 2021), counseling rates increased from 37% to 81% (38 of 47). CONCLUSION We demonstrate how a trainee-led, patient-centered initiative improved oncofertility care. Ongoing work focuses on ensuring sustainability and assessing the quality of counseling.
UR - http://www.scopus.com/inward/record.url?scp=85126388963&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85126388963&partnerID=8YFLogxK
U2 - 10.1200/OP.21.00479
DO - 10.1200/OP.21.00479
M3 - Article
C2 - 34565170
AN - SCOPUS:85126388963
SN - 2688-1527
VL - 18
SP - E403-E411
JO - JCO Oncology Practice
JF - JCO Oncology Practice
IS - 3
ER -