JL305. Bringing Quality Into Your Practice
Laura Mulka, APRN, AOCN, ACHPN, Connecticut Multispecialty Group, Wethersfield, CT
As professionals, we pride ourselves on delivering high quality care. However, until five years ago, there was no method of demonstrating a practice’s level of excellence distinction from competing practices. In 2010, the Quality Oncology Practice Initiative (QOPI) was launched. QOPI recognizes practices that deliver the highest quality of care by reviewing twenty standards including over one hundred quality measures. In addition, there is an onsite review to observe nursing procedures and examine policies and processes. Over the past five years, not only have the standards changed, but the bar has been raised to attain these goals. The Quality Oncology Practice Initiative is a preview of impending changes. The Oncology Care Model (OCM) was developed by the Center for Medicare and Medicaid Innovation. This is a new payment and delivery system, which is based on quality of care. In the near future, practices that demonstrate a commitment to improve care and lower costs for their patients will receive financial incentives. It is predicted that the private pay insurance companies will follow this lead. Demonstrating excellence in care is not only essential for our patients, but will soon become crucial in the financial survival of practices. The QOPI site review involves twenty standards, with multiple subsections. The major areas include: treatment planning, staff training and education, chemotherapy orders and drug preparation, patient consent and education, safe chemotherapy administration, and monitoring and assessment of patient well being. This poster will highlight the oral chemotherapy standard and the assessment of the patient’s psychosocial standard. These are considered the most challenging criteria to meet. The oral chemotherapy standard requires an extremely detailed process. The measure entails education regarding the agent, including side effects and schedule of the medication. It also necessitates the creation of a formal process in the office. This is to assure that the patient obtains the prescription, is compliant taking the medication, has regular follow up visits, and has interventions for side effects. Documentation has to be extremely specific in this category. Assessing the patient’s psychosocial well being is also a very challenging standard. The requirements include an evaluation with each chemotherapy treatment, either by the provider or nurse, to assess the physical, social, spiritual and psychological well being of the patient. If the patient has concerns, interventions must be documented. This includes referrals to allied health professionals, supportive services or other interventions. The Advanced Practice Provider must be aware of not only the changes and implementation in the demand for high standards, but also the financial implications of their documentation. Advanced Practice Providers take on the principle role in not only providing direct patient care, but also in creating policies and processes to ensure that the highest quality of care is accessible for their patients. The paradigm of quality monitoring and improvement is now shifting to the outpatient setting. We need to be prepared to undertake this challenge and lead the way for excellence in the office.
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