Improving the Delivery of Cancer Care in Medically Underserved Communities

Supported by the Stavros Niarchos Foundation  

Program Background       

Assuring high quality care for every American is an important goal of health reform efforts. The Obama Administration’s triple aims—better population health, higher quality of care, and lower health care costs—are at the center of new and emerging strategies intended to produce more cost effective health services across the United States. As new health care delivery models develop, there remains a real and pressing need to address the needs of vulnerable populations. Nowhere is this more critical than in cancer care. 

To address this need, ASCO is developing a new program designed to bring the Quality Oncology Practice Initiative (QOPI) to oncology practices that serve a high proportion of racial minorities and/or patients of low socioeconomic status. Many of the providers in these practices may be unaware of, or isolated from, effective quality improvement programs. As a result, current uptake of quality improvement efforts is uneven, and many patients may be treated by physicians lacking the resources necessary to deliver good outcomes and quality improvement.

Learn more about ASCO’s Commitment to High Quality Cancer Care for All Individuals.

Program Goals & Objectives

The goal of this program is to improve the delivery of cancer care in medically underserved communities by improving the ability of practices serving these communities to engage in quality improvement. To achieve this goal, each participating practice will engage in an individualized, structured quality improvement plan. The program takes place over a two-year period.  

Four practices that have been participating in the program since January 2016. Since the start of the program, ASCO has been helping these participating practices to:

Assess:

  • The quality of care
  • Specific quality improvement goals
  • Challenges/barriers to providing high quality care

Implement a quality program (based on the findings of the assessment), to be carried out through:

  • In-person training
  • Web-based training
  • Collaborative learning activities

Evaluate

  • The intervention's impact on participants’ ability to achieve individual quality improvement goals
  • Participants’ satisfaction with the intervention
  • Program outcomes

View a Sample Timeline of Activities for the Quality Improvement Grant.

Program Design

Each participating practice will begin an intensive quality assessment and improvement journey with the support of ASCO. The process will begin with a comprehensive assessment of the practice’s cultural and structural readiness to carry out quality improvement and a baseline assessment of QOPI measures to evaluate current performance.

Based upon this initial assessment, ASCO will prepare a formal report of findings and recommendations. This report includes:

  • Potential areas for improvement
  • Suggestions for improvement strategies
  • Recommended priorities for action

ASCO will then provide in-depth training for staff at participating practices and institutions. Training will focus on quality improvement, including how to perform QOPI data abstraction.

Pairing With a Mentor Practice

ASCO has the privilege of being able to draw on one of the largest networks of clinical oncology experts. This allows the Society to pair each practice with selected specialists to tailor a quality improvement plan that fits the specific needs of the practice. Then, ASCO works with practices to determine the area(s) of high priority for practice change (such as end-of-life care, chemotherapy administration safety, etc.) and pairs the practices with other practices that have successfully implemented quality change in these same priority areas.  

Taken together, these efforts will:

  • Highlight areas for potential improvements based on practice characteristics
  • Prepare each practice’s/institution’s staff for ongoing full participation in “live” QOPI rounds
  • Form the basis for a targeted quality improvement toolkit (including continued monitoring of quality of care data)
  • Provide ongoing quality performance information

Once the practice is fully engaged with and benefiting from ASCO’s training and quality improvement tools, the practice may reach a point when it is ready to apply for QOPI Certification; participation in the Quality Improvement Grant alone does not assure certification (the regular standards and process will apply), QOPI participation is a necessary first step.

Program Benefits 

Participating practices will receive:

  • On-site assessment, including “test” QOPI data abstraction
  • A report that includes findings and suggestions for achievable improvements
  • Hands-on quality improvement assistance, including participation in four onsite training sessions for ASCO’s Quality Training Program
  • Collaborative support during the project duration, including pairing with a mentor practice. 

Current Participating Practices

Currently, four practices are participating in the program.

  • Georgia Cancer Center for Excellence at Grady Health System — Atlanta, GA
  • John Peter Smith Health Network Center for Cancer Care — Fort Worth, TX
  • Parkland Hospital Health System — Dallas, TX
  • Ralph Lauren Center for Cancer Care — New York City, NY

Additional details on those practices may be accessed here.