Achieving Excellence in Oncology Care: A Journey to Regional QOPI® Certification

In a noteworthy quality improvement (QI) initiative, Advocate Health and Hospitals Corporation/Advocate Medical Group in Illinois has achieved a regional Quality Oncology Practice Initiative (QOPI®) certification. Launched by the American Society of Clinical Oncology, the QOPI program provides a 3-year certification recognizing high-quality care for outpatient hematology-oncology practices in the United States. Many individual practices pursue this certification; however, it is notably difficult to achieve the standardization necessary for a regional certification as Advocate Medical Group achieved in 2023. All certification requirements were met successfully, and perfect survey scores were obtained across all 22 standards; further, quality standards were surpassed in the areas of electronic medical record (EMR) documentation, chemotherapy dose checks, and management/administration of intrathecal chemotherapy.

Advocate Medical Group’s journey to regional QOPI certification involved 13 distinct practice sites, 9 of which have embedded infusion centers. Whereas sites had individually received previous QOPI certification, Advocate Medical Group aimed to elevate and standardize high-quality cancer care delivery by achieving a regional certification encompassing all 13 clinic sites. Adding to the complexity of this endeavor was the geographical spread of individual clinic sites from inner-city Chicago to the Wisconsin-Illinois state line. The patient populations served by these hematology-oncology practices were extremely diverse and ranged from suburban, middle-class individuals to more rural and socioeconomically disadvantaged populations. Despite these challenges, Advocate Medical Group resolved to standardize care delivery and meet the unique needs of their diverse patient populations. Each patient served by Advocate Medical Group would experience a similar care pathway, receive the same resources for patient/caregiver education, and be documented within the EMR in a standardized, scalable fashion.

Transforming Operational Structure: A Multidisciplinary Effort

Achieving the regional QOPI certification required a complete reorganization of long-standing operational structures. Beginning with the end in mind, collaborative and cross-functional goals included the following:

• Clinic workflows. Streamlining the patient experience in clinic for various visit types required delineation of care steps necessary at the front desk and in rooming patients.
• EMR processes. Standardized documentation for members of the departments of Nursing and Pharmacy and for providers was achieved with the help of dot phrases and other insights from partners in information technology (IT). A 45-page Ambulatory Oncology Quick Start Guide (Epic Systems) was made available to all regional team members.
• Distress management. Patients were screened for psychosocial distress and protocols were put into place to address the unique cognitive, behavioral, social, and spiritual concerns experienced by patients with cancer.
• Policy and procedures. Institutional policies and procedures were standardized across all clinic sites, ensuring alignment with best practices.
• Patient/Caregiver education. Detailed digital and print educational resources were developed for use in the outpatient setting. A 108-page patient education and resource materials book was published covering essential topics such as disease information, chemotherapy expectations, and adverse effect management. The book was also made available to patients via a QR code, increasing accessibility.
• Oral chemotherapy documentation. The clinical workflow necessary for preparation and administration of oral chemotherapy was streamlined. Processes for evaluating and determining adherence were established.
• Chemotherapy consent. A chemotherapy informed consent document meeting all legal, QOPI, and best practice standards was created for universal use across the region. Available in 11 languages, the consent document supported institutional commitment to health equity.
• Pharmacy processes. Workflows tailored for the outpatient hematology-oncology pharmacy were determined, ensuring alignment with best practices.
• Team member education. Interprofessional educational strategies were implemented to ensure that orientation, competence, and educational standards were met for all regional multidisciplinary team members.
• Survey readiness. Preparation for on-site surveyor visits and ongoing EMR chart audits was continuous throughout the initiative.

Keys to Success

When asked what advice she would give to other multisite cancer programs looking to establish regional QOPI certification, Advocate Medical Group’s Connie Kocourek, RN, BSN, OCN, suggested the following:

• Establish a core workgroup. The core workgroup oversees all other workgroups coordinating initiatives at individual sites, providing strategic oversight and deciding where focus should be directed. At Advocate Medical Group, the core workgroup consisted of an operations manager, clinical nursing specialist, pharmacy manager, health care provider lead, clinical informatics/IT specialist, nursing education coordinator, and quality expert.
• Set a regular meeting cadence. For quality improvement initiatives taking place over the course of years, creating and maintaining momentum is critical for success. Setting recurring workgroup meetings allowed the core workgroup to follow up on action items in a timely manner and continue to meaningfully move the needle over time.

Conclusion

As a senior quality improvement coordinator, for Advocate Health, Kocourek joined the core workgroup in gaining consensus and buy-in, communicating the vision for and reasons behind the regional QOPI certification, and ultimately aligning the processes needed to confirm compliance with quality standards and ensure survey readiness. The journey to QOPI certification has set a new regional standard for oncology care; it proves that with dedication, collaboration, and innovation, cancer care programs can attain remarkable quality improvement outcomes for the patients they serve. Eager to share her organization’s success, Kocourek expressed willingness to communicate with other cancer programs looking to pursue QOPI certification. She can be reached at connie.kocourek@aah.org.

Resources:

ACCC Oncology Practice Transformation and Integration Center