A pillar of safety: Standardizing oral chemotherapy protocols.

Abstract

e23323 Background: Standardizing protocols for oral chemotherapy treatment and delivery is a critical quality improvement initiative to reduce variability and enhance reliability in oncologic care. Oral anticancer agents introduce complex workflows involving prescribing, education, monitoring, and adherence. Each of which is vulnerable to process gaps and errors. Inconsistent practices across providers can lead to delayed treatment, suboptimal monitoring, and preventable adverse events. A standardized approach enables the use of clear process measures, supports multidisciplinary coordination, and facilitates timely identification of deviations from best practice. Protocol-driven workflows improve patient education, documentation, and follow-up, allowing for consistent measurement of outcomes and continuous performance improvement. Here, we present our data on oral chemotherapy delivery after implementing a standardized protocol across the clinic amongst all providers to improve safety and efficiency. Methods: Oral chemotherapy was set up and ordered in the following manner, Step 1: Primary Oncologist obtained consent, wrote communication order, and chemotherapy orders. Step 2: A secure chart message was sent to the Oral Chemotherapy Pharmacy Pool with the starting time frame. Step 3: An appointment is scheduled with an advanced practitioner for chemotherapy teaching and pill pick up. The first four appointments for pill pickup dates will also be scheduled concurrently. Patients are scheduled for toxicity checks and follow-ups at the discretion of the primary Oncologist as stated in the communication order. Step 4: Physician orders are placed through administrative appointment slots on the Thursday of each week prior to the planned cycle. At each medication pick-up, patients complete an anonymous survey that assesses patient’s safety and understanding of their medication. The survey also identified information on any delays in treatment due to staffing, scheduling availability, delayed lab results, and/or logistic confusion. Data was collected over 4 months and evaluated for improvements in quality of care based on frequency of treatment delays not related to toxic side effects and patient satisfaction. Results: We found at least a 20% decrease in treatment delays due to missing lab results, chemotherapy orders, and appropriate scheduling of cycles. Patient satisfaction improved from an average score of 2.5 out of 5 to 3.5 out of 5. Conclusions: Implementing a standardized protocol for oral chemotherapy decreased treatment delays due to missing lab results, delay in chemotherapy orders, and appropriate scheduling of cycles. We also saw an increase in patient satisfaction in the pill-pick up process.