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100th U.S. Practice Receives QOPI® Certification

Feb 21, 2012

Less than two years after launching the first national program to help oncology practices deliver the highest quality of cancer care, ASCO and its affiliate, the Quality Oncology Practice Initiative (QOPI) Certification Program (QCP), announced that more than 100 practices have achieved QOPI certification. “We are delighted that more than 100 oncology practices in the United States have already taken steps to ensure that the cancer care they provide is consistent with the highest national quality standards,” said Allen S. Lichter, MD, CEO of ASCO and President of the QOPI Certification Program.

QOPI enables practices to examine the quality of care they provide to patients based on evidence-based guidelines and established quality measures. Practices that participate receive detailed reports that indicate their performance on these quality metrics and offer insights into specific areas for improvement.

A practice must achieve a scoring threshold on QOPI measures to be able to apply for QOPI certification. Accordingly, a certified practice means it has taken an extra step to ensure that it meets the rigorous safety standards that are the framework of the QCP. More specifically, the practice has proven its providers and staff excel at following written standards to ensure treatment planning, excellence in staff training and education, chemotherapy orders and drug preparation, patient consent and education, safe chemotherapy administration, and monitoring and assessment of patient well-being. To view a complete list of certified practices, visit qopi.asco.org/certification.

In the following interview, William S. Loui, MD, FACP, of OnCare Hawaii, discusses with ASCO Connection his practice’s recent QOPI certification.

 
(Left to right): Dr. William Loui,Tina Navarez, Shauna Sanborn, and Sherrie Mau of OnCare Hawaii. Photo courtesy of Dr. Loui.
AC: What prompted your practiceto seek QOPI certification?
Dr. Loui:
Quality has always been a high priority; it is just difficult to measure and benchmark. There are some doctors who questioned if it could be done at all. Some assumed that they were doing a good job but just couldn’t prove it. We had done well with the information provided by the American College of Surgeons (ACS) Commission on Cancer (COC) and the National Cancer Data Base (NCDB) data. However, we lacked specific medical oncology quality indicators.

When I was the President of the Hawaii Society of Clinical Oncology [HSCO—an ASCO state affiliate], we invited Dr. Joseph Simone, the founder of QOPI, to talk about quality, and this prompted us to look at QOPI for an honest appraisal of our efforts. As “pay for performance” was getting discussed nationally, we asked ourselves how we could get a good self-assessment. QOPI is like holding up a mirror, taking a look, and asking yourself, “Are you reaching for excellence?” I remember my old coach saying, “If you lick at the lollipop of mediocrity, you’ll suck forever.”

What we needed was a specialty-specific process to help us find our weak areas. Getting national benchmarks through QOPI had great appeal.

AC: When did you begin the process of certification and how long didit take?
Dr. Loui:
In 2009, we entered the data. It took a month of extracting data from paper charts and our new EMR, double-checking data, and submitting reports. We had a nurse champion (really important!) and asked for volunteers. It was very labor intensive. When we received the confidential report, we were happy to see that we scored in the top 15% overall. We shared the information with our team as constructive feedback. There were no punitive actions. Rather, we asked people “to aim high” in their goals.

There were areas that clearly needed improvement. For example, we made everyone [the complete staff] take and pass the Basic Life Support course for CPR. In 2010, we targeted two Performance Improvement (PI) projects for the year. We set a goal for 100% pain assessment and initiated a Survivors Clinic using ASCO and Livestrong resource material.

In the fall of 2010, the data submission process went much faster since our EMR had been fully adopted and our team had done it the previous year. In March 2011, we were audited by an experienced oncology nurse from ASCO who gave really good suggestions on improving our safety protocols (for example, intrathecal chemotherapy). Then, in November 2011, we got the great news regarding certification.

AC: What was the most challenging aspect of the process?
Dr. Loui:
It was and is a very labor-intensive process. Giving the feedback to the individual doctors sometimes required a lot of tact and diplomacy.

AC: What was the most gratifying aspect of the process?
Dr. Loui:
This reaffirms to others that the quality of care we provide is excellent, even in our small state two thousand miles from the rest of the United States. The process will also help us continually improve what we do. It means a “race to the top,” rather meeting minimal requirements.

Quality pays for itself. As we negotiate with our Blue Cross Blue Shield (BCBS) carrier, we can envision that it will help in the future with “pay for performance.” The BCBS organization is revising quality evaluation programs, and the medical directors have been open to copying the Michigan BCBS program to use QOPI for measuring quality for medical oncology. They were impressed by the presentations about QOPI as an independent, evidence-based program with national benchmarks.

Furthermore, our efforts to improve quality have paid off in other ways in our community. The American College of Surgeons Commission on Cancer graded two of the oncology programs at two local medical centers as Level 1 with commendation and Level 1 with outstanding achievement (the top score).

AC: Do you have any advice for other practices considering pursuing QOPI certification?
Dr. Loui:
  • No one can do this alone.
  • Form a team because it is a lotof work.
  • Find a champion (one doctor andone nurse).
  • Use nurses with good computer skills.
  • Give honest feedback to doctorswho will want to see their own scores in relationship to the group and national benchmarks.
  • Break it down to smaller tasks.
  • See the process as opportunities for improvement rather thancharacter deficiencies.
  • Fix problems; do not fix blameon others.
  • Reward with chocolate.
Dr. Loui is a medical oncologist with OnCare Hawaii and Chief of the Oncology Department at the Queen’s Medical Center,Honolulu. He is Past President of the Hawaii Society of Clinical Oncology and a member of ASCO’s Health Disparities Advisory Group. Look for Dr. Loui’s Expert Editorial in ASCO Daily News.

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