Background: The use of oral chemotherapy in cancer patients continues to increase and proper documentation of patient adherence, duration of treatment and side effects while on these medications is important. The Quality Oncology Practice Initiative (QOPI) identified oral chemotherapy documentation as an area in need of improvement.
Methods: We used the QOPI audit to create a quality improvement project with the goal of improving our provider oral chemotherapy documentation including cycle number, adherence and side effects. An existing oral chemotherapy best practice alert template in our electronic medical record had already been created to help our providers document oral chemotherapy administration, and we sought to improve our documentation by increasing our provider compliance in completing this template. We utilized Plan-Do-Study- Act (PDSA) cycles to accomplish our goal. For the first PDSA cycle, we made bypassing the oral chemotherapy documentation template in our electronic medical record more difficult for our providers. Our providers were required to acknowledge the template by either following the link to complete the template or documenting a reason why the template was not completed. Requiring the provider to document a reason why the template was not completed made bypassing the template more difficult.
Results: By making this change to the template, we successfully improved our provider compliance with following the link to complete the template from 38% (83/220) to 71% (121/169). For the second PDSA cycle, we educated our medical oncology providers via email about the importance of utilizing the template to improve our oral chemotherapy documentation. By educating our providers, we improved our provider compliance with following the link to complete the template to 86.5% (155/179).
Conclusion: Our project showed how the QOPI audit can be used to create a quality improvement project. Our project also demonstrated how templates within the electronic medical record can be utilized to complete a successful quality improvement project.
