Oct 24, 2018
In August 2018, the Georgia Cancer Center for Excellence (GCCE) at Grady Memorial Hospital in Atlanta became the first recipient of the Improving the Delivery of Cancer Care in Medically Underserved Communities Grant Program, made possible by the Stavros Niarchos Foundation, to receive QOPI® Certification.
GCCE was one of four oncology practices that received grant funding to participate in the program, launched in January 2016 to improve the delivery of cancer care in medically underserved communities. As part of the program, the GCCE completed ASCO’s Quality Training Program (QTP), participated in Quality Oncology Practice Initiative (QOPI®) reporting rounds, and engaged in an individualized, structured, two-year quality improvement plan. Leon Bernal-Mizrachi, MD, led the GCCE team through the grant program activity and now serves on the ASCO Health Equity Committee.
“The success that GCCE has achieved serves as an example of the outcomes we hope to see toward the goal of high-quality cancer care for all patients,” said William D. Tap, MD, Health Equity Committee chair. “By spearheading this grant opportunity and fostering process improvement at practices caring for patients in underserved communities, ASCO has made a tangible difference for the medical staff, patients, and caregivers who serve and access GCCE and similar practices.”
ASCO’s QTP prepares physician-led oncology teams to design, implement, and lead successful quality improvement activities in their practice settings. Specifically, the program empowers practice teams to improve clinical care and operational performance and teaches them how to balance quality improvement projects with demanding schedules and competing priorities. Through participation in the QTP program, Dr. Bernal-Mitzrachi and his colleagues at GCCE worked to boost patients’ adherence to oral anticancer medications by 30%. The results of the project demonstrated that a pharmacist-led adherence program combined with low-cost adherence measures meeting patient needs exceeded the goal of a 30% increase in adherence.
As part of the process, GCCE also participated in QOPI, a voluntary, self-assessment and improvement program to help hematology oncology and medical oncology practices assess the quality of the care they provide to patients. QOPI analyzes individual practice data and compares it to more than 100 quality measures. The information is then provided in reports to participating practices, and they can compare their performance to that of other practices across the country. Over four rounds of QOPI Core module measurement, GCCE improved their average score from 2.8% below the QOPI aggregate to 6.5% above the QOPI aggregate.
GCCE then took the further step of applying for and ultimately achieving QOPI Certification, meaning that the practice met or exceeded a benchmark score on measures that compared the quality of their care against national standards. To obtain certification, the practice underwent an on-site review and peer review by a select team of oncology professionals who evaluated its performance in areas that affect patient care and safety, including:
- Qualifications of practice staff
- Chart documentation
- Chemotherapy preparation and administration
- Patient monitoring and assessment
- Preparedness for emergency situations.
GCCE, along with nearly 300 other certified practices nationwide, scored well on these and other QOPI® quality measures and have met chemotherapy safety standards established by ASCO and the Oncology Nursing Society.
The idea for the Improving the Delivery of Cancer Care in Medically Underserved Communities Grant Program was developed by ASCO’s Health Equity Committee, charged by the ASCO Board of Directors to lead ASCO’s health equity initiatives, guiding the Society on a long-term strategy to effectively address healthcare disparities and improve healthcare equity across the cancer care continuum from prevention to end-of-life care.
As a public safety-net hospital, Grady Memorial and its cancer center are committed to providing high-quality care to residents of metro Atlanta, as well as underserved populations of Fulton and DeKalb counties. Grady Memorial also serves as a teaching hospital for the Emory University and Morehouse College schools of medicine. Being such a large institution and serving such a large and diverse population, it was important to GCCE to optimize its processes, making the necessary changes to raise even further its standard of care and sustain this new level of excellence. GCCE so enthusiastic about the QTP that this year they sent a second GCCE team to participate in the QTP, this one focusing on reducing the time to first infusion for infusion center patients.
“This is the type of practice for which the grant was intended—one that provides cancer care to an underserved community and one that aspires to provide the highest quality of care,” said Joseph O. Jacobson, MD, MSc, Stavros Niarchos Foundation Grant Steering Group chair. “We look forward to watching them apply their new QI skills to sustain the gains that they have achieved, to tackling new projects, and to sharing their learning with others.”