A multiphase continuing education and quality improvement initiative to tailor treatment plans for patients with follicular lymphoma.

Abstract

e18651 Background: Data support the need for increasing shared decision-making (SDM) conversations to align treatment decisions with patient values and preferences (Kehl KL et al. JAMA Oncol. 2015). Combining certified interprofessional continuing education and quality improvement (QI) methods may accelerate how cancer clinicians translate evidence into real-world clinical practice when diagnosing and treating patients with follicular lymphoma (FL). This initiative was supported by educational grants from Genentech, a member of the Roche Group and Bristol Myers Squibb and managed by AXIS Medical Education and Q Synthesis. Methods: The project collaborators invited three community hospital-based cancer centers to participate in this 18-month longitudinal, multiphase CME/CE and QI initiative. Each cancer center performed a baseline assessment by reviewing how their clinicians diagnosed and treated patients with FL. This process involved chart reviews, focus group discussions, and online surveys. Each cancer center developed problem statements, aim statements, and implemented improvement projects around prognostic scoring, the use of molecular diagnostics, SDM, and treatment planning. Clinicians also participated in two live virtual continuing education interventions, co-moderated by an academic clinician with a focus in lymphoma (T.F.), as well as the medical director of the activity (J.K.) and received reinforcement messages following those activities. Results: Members of the multidisciplinary cancer care team from three cancer centers in AZ, TN, and VA participated in this initiative. Across all three cancer centers, the following educational outcomes were observed: 61% increase in knowledge about the concept of POD24 (early disease progression within 24 months of initiating therapy); 50% increase in knowledge and practice skills regarding tailored treatment planning based on patient risk factors and prognostic scores; 33% increase in knowledge around the benefits of incorporating SDM when developing treatment plans, and an 18% increase in knowledge about risk-based treatment plans. The QI projects resulted in a 56% improvement in prognostic scoring (incorporating tumor grade and stage), a 25% increase in documenting tumor burden, and a 22% increase in the use of molecular diagnostics. Conclusions: This multiphase education and QI program enabled cancer clinicians to improve monitoring patients for POD24 and risk assessment, incorporate molecular testing, engage in SDM conversations with patients, and formulate tailored treatment plans for patients with FL.