Compliance to select quality measures in a non-QOPI subspecialty academic practice: A pilot quality improvement initiative.

Abstract

261 Background: ASCO’s Quality Oncology Practice Initiative (QOPI) includes core, disease and domain-specific quality measures. QOPI Certification requires an overall score of 72.62% in 24 core and 80% in adjuvant quality measures. There are currently 137 oncology practices with only 10 in New York State having achieved QOPI certification. At Mount Sinai Medical Center (MSMC), the large hematology and oncology practice is subdivided into disease-specific groups functioning semi-autonomously. The practice is not QOPI certified. With no prior measures of quality adherence in the overall or subspecialty groups we aimed to determine the baseline compliance to QOPI disease specific measures. Methods: All colorectal patient charts seen in the GI oncology group at MSMC over a four-month period from February 2012 to May 2012 were retrospectively reviewed. The team included two GI oncology physicians, one physician assistant and one registered nurse. Each member was assigned roles to meet the defined quality measures prior to project initiation. A separate auditor reviewed medical records during the study period. 17 quality measures were evaluated including 10 core and one adjuvant colorectal disease-specific measure. Results: The average compliance with the QOPI measures tested was 96%, 98%, 92%, and 97% (February to May respectively). The measures with the lowest compliance were not required for certification but included for internal review after recent practice changes. Despite the high compliance rate, compliance for an individual patient in all 17 categories was achieved in only 48% of patients. Conclusions: This study highlights that adherence to quality benchmarks in a disease-specific subset of a larger oncology program can be achieved by identifying staff, assigning roles and defining practice structure. The GI Oncology group attained a level of compliance with quality measures that would result in QOPI certification if maintained practice-wide. This study serves as the basis for a larger internal audit of quality measures across other subspecialty disease-specific areas of hematology and oncology at MSMC.