Methodology

In 2008-2009, the American Society of Clinical Oncology (ASCO) and the Oncology Nursing Society (ONS) initiated a consensus-based process to develop standards for safe administration of chemotherapy to adult patients in the outpatient setting.

After reviewing existing literature, a group of 40 multidisciplinary oncology professionals, representing diverse practice settings, including oncologists, nurses, pharmacists, social workers, practice administrators and patient advocates was convened. The goal of this workshop was to establish a set of standards focused on patient safety. The result was a draft of 34 safety standards which were made available for public comment.

In January 2011, another workshop was convened to review feedback received and further refine the standards as needed. An overwhelming number of responses suggested that the standards should encompass the inpatient setting as well. 

After reviewing each standard in the context of an inpatient environment, the group determined that the same standards for chemotherapy administration safety should apply in all settings.

A panel of experts was convened in December, 2011 to examine standards specific to Oral Chemotherapy.  From this meeting, a set of standards was created for the purpose of addressing safety in administering oral chemotherapy to patients. 

Initial ASCO/ONS Safety Standards (2010)

The ASCO/ONS chemotherapy safety standards development process was initiated with a review of the literature and convening of a workshop of 40 multidisciplinary oncology professionals, representing diverse practice settings, including oncologists, nurses, pharmacists, social workers, practice administrators and patient advocates. [See the complete list of workshop participants]

Workshop participants used a structured consensus building and voting process that culminated in a draft of 34 safety standards. The draft standards were then posted for public comment, which was used to select and refine the final standards set.

Read the JCO article fully describing the ASCO/ONS chemotherapy safety standards process for development, consensus and refinement, and a discussion of the standards and results. 

Refinement and Expansion of the ASCO/ONS Safety Standards to Inpatient Setting (2011)

In January 2011, a workgroup consisting of ASCO and ONS members was convened to review feedback received since publication of the ASCO/ONS Standards for Safe Chemotherapy Administration and to clarify the Standards as needed. The most significant change to the Standards is to extend their scope to the inpatient setting.

The ASCO/ONS workgroup concluded that these patient safety standards should apply whether chemotherapy is administered in the outpatient or inpatient setting. They reviewed each standard in the context of an inpatient environment and determined such expansion of scope was feasible and appropriate.

Widening the Scope of Standards to Include Oral Chemotherapy (2013)

The process for developing the oral chemotherapy administration standards replicated the methodology previously used by ASCO and ONS in the initial 2010 standards set. 

 The workshop was convened in December 2011, with 38 participants, including oncologists, nurses, pharmacists, social workers, practice administrators, and patient advocates. Standards were discussed, reviewed, and revised by the workshop participants in small breakout sessions. Resulting standards were reviewed by the full group for redundancy and gaps. Finally, workshop participants voted on the draft standards immediately after the meeting. Voting results and subsequent review by the Steering Group yielded the set of standards released for public comment.

Public comments were reviewed by Steering Group members, and used to select which standards to retain and to inform edits for clarity. Final standards were approved by the ASCO and ONS Boards of Directors in October 2012.

Read the JOP article for more details and the complete, updated safety standards.