263 Background: Barriers to safe delivery of oral chemotherapy in a safety net hospital population include lack of health insurance, delays in medication delivery, and language barriers. Baseline chart review at the Lyndon B. Johnson Hospital oncology clinic revealed sparse documentation of oral chemotherapy education and compliance. Our team conducted the present quality improvement project to improve documentation of toxicity assessment, patient education, and compliance with the oral chemotherapy agents capecitabine, palbociclib, and sorafenib by 25% from October through December 2020. Methods: A set of standardized questions designed to assess for the above domains were generated in the form of an auto-populated electronic medical record phrase ("dot phrase," see Figure 1). Using weekly timed email notifications, physicians were reminded to incorporate these questions in their documentation during clinic visits. Chart review was performed to assess usage frequency of the dot phrase. A post-intervention survey was administered to assess providers' experience with use of the dot phrase, and assess barriers to consistent documentation. Results: 41 patients over 3 months were identified as taking the oral chemotherapy drugs capecitabine (68%), palbociclib (29%) or sorafenib (3%). 63% were non-English speakers. 49% had breast cancer, 39% GI cancers, and 12% other cancers. 12% of clinic visits correctly incorporated use of the dot phrase. Education on the dosing and schedule for oral chemo was addressed for 48% of patients, documentation of adverse effects was performed for 34% of patients, and assessment of medication adherence was documented for 22% of patients. While 73% of providers felt that documentation of oral chemotherapy compliance is important, 70% cited failure to remember to incorporate the dot phrase in real time as the primary reason for failure to use the dot phrase for oral chemotherapy documentation. Conclusions: Despite providers' view of documentation of oral chemotherapy toxicities and compliance as important, low uptake of the dot phrase was observed. The main barrier to use of the dot phrase was providers' forgetting to incorporate the dot phrase prior to and during their clinic charting. Future efforts should focus on automated reminders and regular assessments to increase compliance to this important quality domain. [Table: see text]

e18750 Background: Single-day multidisciplinary cancer clinics began in the 1960s, but have been difficult to institutionalize due to a lack of literature demonstrating the benefits for patients and the high cost of implementation1. Other institutions have shown that patients are seen by specialists sooner, receive treatment earlier, and have reduced stress when care is delivered in this model 1-6. MDA sought to improve breast cancer patient’s access by implementing a single-day multidisciplinary clinic in 2013. Methods: We identified local patients (within 150 miles) who were treated at MD Anderson Cancer Center Main for breast cancer from March 2016 to March 2022. Patients were either seen in the single-day multiteam (MT) model (Table 1) with coordination between surgical oncology, radiation oncology, and medical oncology or by specialists in the traditional model. Time from referral to first completed provider appointment was analyzed. Results: A total of 4,999 patient records were reviewed. 2,288 were seen in MT and 2,711 were seen in the traditional model. Median number of work days from referral to first appointment completion was 8 days vs 14 days respectively (p-value < 0.0001). Conclusions: A single-day MT visit is associated with reduced time from referral to first appointment completion. Further studies are warranted to determine if this shorter interval can improve patient outcomes and experience. Multiteam Protocol Plan Time frame Prior to clinic visit Nurse Patient Access Coordinator obtains pertinent medical information for initial encounter Multiple days prior to visit Clinic Day PA meets with patient to perform H&P, review acquired imaging and pathology, describe multiteam goals, and briefly discuss treatment options 11:00-11:30 PA presents patient cases to surgical oncologist, medical oncologist, and radiation oncologist. Treatment options are discussed. 2:00-2:30 Entire team meets the patient and performs an exam. 2:30 Encounter with medical oncology to discuss systemic treatment options. 2:45 Encounter with surgical oncology to discuss surgical treatment options. If necessary, patient consents for surgery. 3:15 Encounter with radiation oncology to discuss radiation therapy. 3:45 Nurse wraps clinic day with necessary patient teaching and assistance with scheduling any required further work up. 4:15.