A review of practice-level systems indicated opportunities for quality improvement efforts for the safe management of chemotherapy, defining the treatment gap targeted here. Another study showed that patients treated by physicians who attend weekly tumor boards are significantly more likely to be enrolled in clinical trials for various cancers, and patient survival is better when physicians attend a specialized tumor board as compared to a general oncology tumor board. There is no requirement that all measures be used by a provider or hospital. Education and active consent obtained for same chemotherapy prescription in the past 12-month period. It is anticipated that by measuring performance, a treatment gap will be confirmed and further opportunities for improvement will be identified. Patients with tissue insufficient for molecular testing. The most frequently used chemotherapies in neuro-oncology are oral, including temozolomide, lomustine, and procarbazine, and errors in the home administration of oral chemotherapy are associated with a high likelihood of harm.
After collecting data, providers are encouraged to use data to drive performance improvement in practice. Opportunities for Improvement Following a thorough literature search, the work group identified five areas in need of quality improvement. In the end, the group delineated five areas that were feasible for measure development, as they had support from scientific literature and evidence of gaps in care. As you know, Neuro Oncology is a field in constant evolution with novel diagnostic strategies, therapeutics, and prognostic factors being discovered each year. Ultimately these measures were not developed for a variety of reasons, including difficulty capturing data due to current electronic medical records practices, lack of evidence, lack of a known gap in care practice, and development of similar measures by others in related fields. Supplementary Material Supplementary data are available at Neuro-Oncology online.
Our goal is to train future leaders in the field of academic Neuro Oncology. Consultations and compassionate care for general neurology including headaches, migraine, stroke, memory problems, vertigo, neuropathy, concussions, seizures and epilepsy. One study of brain tumor board discussions revealed that 91% of 1516 clinical recommendations were implemented, and that nearly half of those were recommendations for conservative management, demonstrating the utility of multidisciplinary input in neuro-oncology cases and in optimizing patient centered outcomes. The work group explored multiple alternate measure topics addressing various other practice patterns and clinical processes. Hospice and Palliative Care — Treatment Preferences. Canadian participants can claim credit for each interview by listening to the interview, completing the posttest and evaluation, and reporting the activity in. We treat Parkinson's disease and Alzheimer dementia.
Our Neuro Oncology fellows are chosen from among the best applicants in the country to further their academic career with clinical training, trial research, and scientific investigations. Measures will be periodically evaluated every three years and updated as necessary to reflect continued utility in quality neuro-oncology care. Subsequent to this preliminary work group approval, a 21-day public comment period resulted in input from 22 individuals, a similar number to public input for previous measure development efforts. The work group declined to create a new measure, and encourages providers to identify a measure to meet their population needs. These concepts will be retained for future measurement set updates, as more evidence may support development at that time. Credit cannot be claimed for issues prior to June 2018.
Molecular Brain Tumor Testing Recent advances in molecular characterization of brain tumors have improved the understanding of disease pathophysiology and prognosis, and have provided new therapeutic opportunities. Fellowship Overview Neuro-Oncology is a growing subspecialty that is in constant evolution as novel diagnostic strategies, therapeutics, and prognostic factors are being discovered. However, perfection is not anticipated for any measure; instead, performance data should serve as an internal benchmark for provider, practice, and hospital quality improvement opportunities. The inclusion of an outcome measure in this set creates an opportunity for improvement even for high-volume neuro-oncology institutions that might otherwise achieve the named process measures nearly perfectly. There continues to be a great need for physicians who have an interest in research as well as clinical practice. The first year of our fellowship focuses primarily on the clinical training. Results The workflow of group measure proposal, evaluation, and development is shown in.
Patients 18 years and older with a diagnosis of brain tumor who were prescribed chemotherapy outside of a clinical trial. Future measures from this group may also include the provision of patient reported outcomes in routine clinical practice, which may inform better decisions by patients and providers. Mohile has received consulting fees from Novocure. Then, a second literature review focused on level of evidence for the remaining proposed measures, and four additional measures were omitted for insufficient evidence. The work group focused their efforts on measures that arose from known treatment gaps allowing for opportunity to improve with evidence or guideline statements to support existing standards of care, had high face validity, and were feasible to collect. Sanders serves as a member of the National Quality Forum Palliative and End-of-Life Standing Committee.
We also perform Botox injections and nerve blocks for severe headache management. Since approval of the measure specifications, Senders et al. The specific topics and rationale for each are described below. Education of patients and caregivers to reduce the risk of error is vital, as well as to empower them to speak up if an error occurs. Thus, a treatment gap does exist. Multidisciplinary Care Plan Development Multidisciplinary tumor board discussions for care plan determination have been associated with improved quality and coordination of care in various cancers, and are a well-established quality indicator in oncology care, both domestically and internationally. In fact, implementation of all measures at one time would likely not be feasible for providers.
Our goal is to train future leaders in the field of academic neuro-oncology. It is hoped that the use of integrated diagnoses will facilitate further progress in research and therapeutic efficacy for brain tumor patients. Written documentation of consent is stressed among oncology quality best practices, which may be either in the form of documentation by the clinician or a document signed by the patient or proxy. Fellows are also encouraged to pursue their research interests concurrent with their clinical training or to complete a second year of training to focus specifically on research. Candidate measure concepts were extensively reviewed and edited prior to a work group vote to approve, reject, or abstain on each measure during teleconference meetings. Toward this end, several authors have published work on quality-based practice and on the inclusion of patient reported outcomes in brain tumor care. Should performance rates near perfect compliance, the work group will evaluate the continued need for these measures during the next scheduled update.
Only Continuum Audio courses published after May 31, 2018 are designated as Section 3 Self-Assessment Programs. The fund will also help to further their learning by subsidizing their expenses to present their research findings at national scientific meetings, sit for subspecialty board examinations, and have the necessary educational materials to aide their academic training. Disclaimer: This article is published simultaneously in Neuro-Oncology and Neurology. Based on measurement set approval by two professional societies with a marked decrease in turnaround time, similar number of measures developed, and similar amount of public commentary, the work group determined the expedited, virtual measure development process to be an appropriate surrogate for previously published processes. The final work group comprised nine members representing multi-stakeholder interests for patients with neuro-oncology conditions. Population-based studies have shown that socioeconomic disparities are present within the neuro-oncology community, highlighting the need for a unified system of quality metrics in this growing field.