HOPA’s Successful Inaugural Quality Improvement Workshop

Emily Mackler, PharmD BCOP
Director of Clinical Quality Initiatives
Michigan Oncology Quality Consortium
Ann Arbor, MI

HOPA’s Quality Oversight Committee (QOC) hosted the association’s inaugural “Introduction to Quality Improvement” workshop, held on September 12, 2019, and led by the American Society of Clinical Oncology’s (ASCO) Quality Training Program (QTP) faculty. HOPA brought this workshop to its members after the 2018 Quality Oversight Task Force’s baseline survey of HOPA Committee leaders and external liaisons indicated that HOPA members desired more education, greater access to quality and value-based tools, and more partnerships with leaders in oncology quality.

ASCO created its QTP to help prepare interdisciplinary oncology teams to design, implement, and lead successful quality improvement activities in their practice settings.¹ The program spans 6 months and includes 5 days of in-person learning in three sessions. Although many teams focus on projects that involve medication management issues, most have not had pharmacists participate as core members of the team. When they have, the pharmacists involved have found the experience valuable. Notably, HOPA QOC member George Carro, RPh MS BCOP, participated in a 2016 session that addressed financial toxicity in ambulatory oncology practice. With the skills learned from the ASCO QTP, his project team was able to increase the percentage of patients receiving information about financial risk and financial support services from 0% to 54% and increased the proportion of patients starting treatment after prior authorization from 50% to 94%.² ASCO QTP’s focus on oncology care, the prior successful involvement of HOPA members in the program, and ASCO’s willingness to bring HOPA a tailored 1-day program was the impetus for HOPA to partner with ASCO in this workshop.

The HOPA-supported “Introduction to Quality Improvement” workshop, held in Charlotte, NC, before the 2019 Practice Management program, accommodated 30 attendees who had applied to participate. Participants were asked to complete a baseline assessment prior to the workshop; the response rate was 83% (25 of 30). The majority of workshop attendees have been in practice for more than 8 years, with 40% having 15 or more years of experience. The primary reasons given for participation were to lead multidisciplinary oncology initiatives within their organization and to increase their skills to complete quality improvement projects. Interestingly, more than half of the attendees indicated that their job responsibilities relating specifically to quality improvement were increasing. Participants’ answers to questions related to knowledge and applications of program content will be assessed by HOPA’s QOC and ASCO’s QTP faculty.

Three ASCO members led the workshop: Michael Keng, MD, of the University of Virginia; Vedner Guerrier, MBA LSSBB, of Memorial Healthcare; and Amy Morris, PharmD, of the University of Virginia. All are alumni of ASCO’s QTP, and Dr. Morris is the first pharmacist to be named a QTP coach. The extensive agenda covered these topics: quality improvement (QI) overview, problem and aim statements, tools for QI, project charters, understanding data, psychology and team effectiveness, theory and knowledge of the Plan-Do-Study-Act method, metrics for practice, and sustaining gains, along with an example of a pharmacy QI project and reflections on the day. Although the day was long and the schedule full, attendees engaged energetically in the multiple hands-on exercises offered during the workshop.

The workshop leaders discussed several ideas with the participants, with a focus on providing additional education and resources for HOPA members and incorporating quality training into postgraduate year 2 (PGY-2) oncology residency experiences. Both topics will be discussed by HOPA’s QOC for follow-up.

The University of Virginia (UVA) offered an example of a recent success related to PGY-2 oncology residency training. In 2018, residency program director and quality improvement workshop attendee Kathy DeGregory, PharmD BCOP, sent her resident, Meredith Mort, PharmD, along with a UVA oncology fellow and other team members, to ASCO’s QTP. The team gained skills related to oncology QI, and their quality project, evaluating cardiomyopathy in patients with acute myeloid leukemia, was recently published in the Journal of Oncology Pharmacy Practice.³

Oncology pharmacists are well equipped to have a positive impact on patients with cancer through leadership in QI activities, involvement in interdisciplinary oncology quality research, and education and mentorship provided to those interested in oncology. HOPA’s support of this 1-day workshop brings oncology pharmacists one step closer to being leaders in the area of oncology quality improvement. 

References

1. American Society of Clinical Oncology. ASCO Quality Training Program. 2019. Available at https://practice.asco.org/quality-improvement/quality-programs/quality-training-program. Accessed September 19, 2019.
2. American Society of Clinical Oncology Quality Training Program. Quality Improvement Library. Kellogg Cancer Center project: “Decreasing the Risk of Financial Toxicity in an Ambulatory Oncology Practice.” 2016. Available at https://asco.org/sites/new-www.asco.org/files/content-files/training-and-education/documents/2016-Kellogg-Cancer-Center-QTP.pdf. Accessed September 19, 2019.
3. Mort MK, Sen JM, Morris AL, et al. Evaluation of cardiomyopathy in acute myeloid leukemia patients treated with anthracyclines. J Oncol Pharm Pract. 2019 September 9: 1078155219873014 [Epub ahead of print].