Comfort, Care, and Collaboration for the Oncology Patient in the Ambulatory Setting

Background of the problem: The Center for Medicare and Medicaid Innovation recognized the need for a new payment and delivery model to provide higher quality, coordinated oncology care and to lower cost to Medicare. This new model would target patients receiving chemotherapy for a 6-month period following the initiation of treatment.

Objectives/purpose: One key objective would decrease preventable patient admissions and readmissions. Another goal would be to keep patients in our network in the appropriate settings. Lastly, patient satisfaction and engagement would be increased in the ambulatory oncology setting.

Methods: A multidisciplinary team of physicians, nurses, care coordinators, pharmacy, social work, and most importantly, the patient, was created to reach the objectives. A clinician also provides patients with 24/7 access to their medical records. A care plan is documented with 13 key components from the Institute of Medicine Care Management. Therapy is directed by nationally recognized clinical guidelines. This plan addresses the patient’s physical and psychosocial, legal, and financial needs. These measures are reported quarterly, with the first report upcoming in May of this year.

Outcomes: The data reporting period began in September 2017. 3,300 patients will be impacted per quarter, system-wide. Reimbursements from the oncology care model are dependent on bi-annual data reporting periods in March and September. The team is in the process of measuring post intervention data.

Conclusion/implications for nursing practice: Data will be interpreted quarterly. This will be an ongoing process for approximately 4 years. Other units will eventually use this model to participate in value-based care. Information will be used to change policies that will benefit nursing practice and foster better patient care.

Data collection
• Do/will you have outcomes that include 1 pre-intervention and 3 or more post-intervention data points? YES
• Do/will you have outcomes that use nurse satisfaction data (Press-Ganey), or other data that is only available yearly? YES, aligning employees around patient experience goals and business strategies are critical to achieve sustainable improvements in the safety, cost, and quality of care.
• Do/will you have outcomes based on a survey that you created? NO