Regional Oncology Standardization - A SOAR-ing Systematic Approach

Purpose: Cancer services at a large academic medical center began offering regional non-hospital license services in 2019. Rapid growth, including the addition of three multi-specialty oncology/hematology clinics, two infusion centers, an onsite pharmacy, expansion of service lines, and plans for additional facilities highlighted the demand for community access to high-quality cancer care.

Learning objective: To understand a comprehensive method to address the unique regulatory, quality, and safety needs at off-license ambulatory care clinical sites. To evaluate and verify consistent, quality care across sites, the satellite oncology annual review team, or SOAR team, was created. The SOAR team provides annual and ongoing standardized support to ambulatory care cancer teams, ensuring they meet the same exacting quality standards and safety measures and goals as the on-license sites.

Evaluation: To ensure quality of care is maintained in unique off-license ambulatory care settings, the SOAR team conducts onsite assessments of the following, according to the organization’s standards: Joint Commission ambulatory care survey and tracers, laboratory environment and practices, pharmacy environment and practices, workplace violence prevention, environment health and safety, and hand hygiene audits.

Coordination with organizational regulatory services, nursing education, facilities, and onsite leadership to ensure organizational consistency. SOAR team experts, including pharmacy, quality, nursing, and operations conduct an annual inspection and evaluation of each site, and provide findings within one week of evaluation. Clinical leadership at each site is provided a compliance report and 90-days to resolve non-compliant tracers. 605 assessment points were reviewed. 78 previously unidentified addressable findings were found. Over 30 have been resolved, including creation of unique contacts for emergencies in the different geographic locations and implementation of updates to onsite emergency signage and resources with the local information – a SOAR team dashboard created with all survey results, providing updates for site leaders and senior leadership to review, access, and make decision; and coordination of management services agreements for sites’ unique needs.

Outcome: Through systematic evaluation by internal experts, quality of care at these sites can be analyzed and adjusted, maintaining reputational, cultural, and clinical consistency across the enterprise. The team is also prepared to evaluate acquisitions, co-brand sites and joint ventures, and open new locations with baseline evaluations and scheduled reviews. The SOAR team dashboard provides documented compliance and resolution for informed decision-making and continuous quality improvement, creating higher confidence in the quality and safety of these regional sites.