Improving documentation of oral chemotherapy at a community cancer center

Safe administration of oral chemotherapy is a complex process that represents a potential threat to patient safety. Clear documentation of the plan of care for patients receiving oral chemotherapy can improve patient safety by ensuring complete health information is available to the health care team.

We undertook a rapid-cycle improvement project to improve documentation of oral chemotherapy by increasing the number of components of an oral chemotherapy care plan (as outlined by American Society of Clinical Oncology and Oncology Nursing Society) documented in the medical record before starting a new oral chemotherapy drug. Three improvement cycles were implemented, including: introduction of a standardized nursing flow sheet, use of computerized physician order entry for oral chemotherapy prescribing, and a review of computerized physician order entry to ensure all oral chemotherapy regimens were included.

Our intervention resulted in a meaningful and sustained improvement in the number of components of oral chemotherapy care plans documented in the medical record, from a mean of 67% (eight of 12 components) to a mean of 92% (11 of 12).

We are hopeful that this improvement project will enhance patient safety by improving communication within the health care team regarding the details of the chemotherapy care plan.