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QOPI is an oncologist-led quality assessment and reporting program offered free of charge as an ASCO member benefit. Up to twice per year during an eight-week open collection period, fellows at outpatient hematology-oncology programs abstract pre-defined data from patient medical records and manually enter them into a web-based data collection tool sponsored by ASCO. After the collection round, comparative reports are provided that show how the program performed on a series of quality measures compared to aggregate scores for other participating fellowship programs and the QOPI National average.
ACGME Common Program Requirements (page 12 IV A.5.c) for Practice Based Learning and Improvement for Graduate Medical Education in Hematology and Oncology state:
Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life-long learning. (Outcome) Residents are expected to develop skills and habits to be able to meet the following goals:
IV.A.5.c).(1) identify strengths, deficiencies, and limits in one’s knowledge and expertise; (Outcome)
IV.A.5.c).(2) set learning and improvement goals; (Outcome)
IV.A.5.c).(3) identify and perform appropriate learning activities; (Outcome)
IV.A.5.c).(4) systematically analyze practice using quality improvement methods, and implement changes with the goal of practice improvement; (Outcome)
IV.A.5.c).(5) incorporate formative evaluation feedback into daily practice; (Outcome)
IV.A.5.c).(6) locate, appraise, and assimilate evidence from scientific studies related to their patients’ health problems; (Outcome)
IV.A.5.c).(7) use information technology to optimize learning; and, (Outcome)
IV.A.5.c).(8) participate in the education of patients, families, students, residents and other health professionals. (Outcome)
Additionally, under the Professionalism, Personal Responsibility and Patient Safety Regulations (VI.A.3), it states that: The program director must ensure that residents are integrated and actively participate in interdisciplinary clinical quality improvement and patient safety programs.
Participation in QOPI may help to fulfill the following ACGME requirements:
- Review and improve patient care through application of quality indicators.
- Apply current medical knowledge to patient care through selection, discussion and updating quality indicators.
- Use interpersonal and communication skills in peer review discussion.
- Assess and demonstrate professional ethical behavior, through peer review and concern for patients.
- Assess and demonstrate awareness of systems-based practice as manifested by knowledge and development of quality indicators and application of uniform standards.
- Demonstrate practice-based improvement through initial chart review, review of QOPI data, improvement of challenging areas, and follow-up on QOPI data.
To facilitate fellowship program participation, the ASCO Oncology Training Programs (OTP) Subcommittee has recommended the following participation guidelines:
- Frequency/Timing of Participation: Fellowship programs should participate at least once per year, during the spring collection round (March – May), if possible. Synchronized program participation during the same collection round provides more robust fellowship aggregate for performance benchmarking and data upon which to base quality improvement initiatives across programs. Programs may choose to participate in both spring and fall collection rounds.
- Participation Requirement: QOPI measures are grouped into categories (modules). The minimum module requirement for fellowship program participation is one module plus the set of core QOPI measures.
QOPI provides a chart selection methodology which targets newly diagnosed patients, seen recently in the clinic.
The OTP Subcommittee has suggested that in addition to the core measures the fellowship programs may find the symptom/toxicity management module or the care at end of life module useful for evaluation as they apply to all types of cancer and more conducive to fellow case load. Additionally, if these two modules are predominately selected by fellowship programs there will be more robust measure results for comparison of scores across programs.
A complete list of QOPI measures and modules is available here.
Chart Requirements (Number of Charts): ensure adequate participation by each fellow within the program. ASCO recommends that fellows abstract data from charts other than their own to facilitate un-biased abstraction.
Decide how much time the trainees can commit to QOPI
Schedule specific time for QOPI
Excuse the fellows from other activities
- Select Modules
Choose a category of measures most applicable to the patients treated by the fellows.
Choose a category that may offer opportunities for an improvement activity and reassessment in
subsequent rounds to evaluate effectiveness
Consider the care at end of life or symptom/toxicity management module for first time
- Get Trained
QOPI Help Desk staff can walk you through the process.
Understand the data that will need to be submitted for the module selected – the QOPI Help Desk staff can review with you, as needed
- Train Fellows
Build in a 20 to 30 min session in the fellowship programs didactic/ teaching sessions to review QOPI with the fellows before the fellows actually review the charts.
This lecture gets the topic on everyone’s radar and prompts people to make sure that the data abstraction date is on their calendars.