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October 2014, Supplement to Volume 18, Number 5
Quality Measures: A Call to Action
Susan L. Beck, PhD, APRN, FAAN, AOCN®
This supplement to the Clinical Journal of Oncology Nursing (CJON) marks a significant milestone in the sustained efforts of the Oncology Nursing Society (ONS) to improve the quality of cancer care—a core component of the ONS mission. The lead article by Fessele, Yendro, and Mallory on pages 7–11 of this supplement summarizes the ONS Foundation–supported Breast Cancer Care (BCC) and Breast Cancer Survivorship (BCS) Quality Measures project. ONS leaders recognized that efforts to improve performance and patient outcomes were limited by the lack of a core set of reliable and valid patient-centered measures. A grant from the Breast Cancer Fund of the National Philanthropic Trust to the ONS Foundation supported a partnership with the Joint Commission and the development of two sets of measures for patients with breast cancer. These patient-centered measures span the treatment and the survivorship phases of cancer care, and are sensitive to nursing practice. This pioneering work is a direct outcome of ONS’s strategic initiatives related to quality and builds on the extensive foundation for promoting evidence-based practice through the Putting Evidence Into Practice (PEP) initiative.
The numerous contributions to this supplement are a testament to one of the key factors contributing to the impact of the BCC and BCS Measures project—the enthusiastic engagement of oncology nurse volunteers from 67 ambulatory care practices across the United States that participated in the pilot testing. About half of these joined a quality collaborative to share ideas and support each other in the change process, and several nurse leaders further committed to repeating the measures to evaluate their practice improvements. The case studies within this supplement exemplify how data on quality performance can stimulate creative solutions to improve cancer care. The examples include novel and systematic approaches to assessment, screening, and interventions that can be adopted by others, as well as tools, algorithms, protocols, action plans, and innovative programs to address gaps in care.
This supplement is a call to action. The results of the analyses indicate that there is indeed room to improve the quality of cancer care. The performance gaps include lack of systematic assessment and screening—prerequisites for individualized care—as well as a minimal level of adoption of evidence-based practices for symptom management. The data should spur other improvement efforts at the national and local levels.
A major goal put forth in the 2012–2016 ONS Strategic Plan’s Quality Pillar is to develop a culture of quality in daily practice among nurses caring for patients with cancer or at risk for cancer. ONS launched the first phase in a national quality campaign at the 39th annual ONS Congress in May 2014. The Get Up, Get Moving campaign is designed to improve care quality by engaging students, nurses, and organizations to improve the physical activity of individuals with cancer. ONS members, cancer practices and healthcare institutions, universities, and other nursing and cancer care organizations should anticipate numerous opportunities to participate as the campaign unfolds. These next steps to advance the quality of cancer care will build on the processes, infrastructures, and knowledge gained from the first wave of initiatives reported in this supplement to CJON.
Susan L. Beck, PhD, APRN, FAAN, AOCN®, is a professor and the Robert S. and Beth M. Carter Endowed Chair in the College of Nursing at the University of Utah in Salt Lake City. The author takes full responsibility for the content of the article. No financial relationships relevant to the content of this article have been disclosed by the author or editorial staff. Beck can be reached at firstname.lastname@example.org, with copy to editor at CJONEditor@ons.org.
Key words: quality; breast cancer; patient care