Addressing Opioid-Associated Constipation Using Quality Oncology Practice Initiative Scores and Plan-Do-Study-Act...

Area of Science:

• Oncology
• Quality Improvement
• Medical Education

Background:

• Opioid-associated constipation (OAC) is a significant challenge in cancer care requiring quality improvement (QI).
• Fellowship programs offer opportunities for physician training in QI methodologies.
• The Quality Oncology Practice Initiative (QIPI) provides a framework for identifying areas needing improvement.

Purpose of the Study:

• To implement and evaluate a fellow-led QI project focused on improving OAC management.
• To enhance the quality of patient care for individuals experiencing OAC.
• To provide practical QI training for young physicians within an oncology fellowship.

Main Methods:

• A fellow-led QI project was initiated within an oncology fellowship program.
• Plan-Do-Study-Act (PDSA) principles guided monthly improvement meetings.
• Mandatory electronic medical record (EMR) checkboxes were implemented to prompt OAC assessment and management.

Main Results:

• Assessment of OAC improved from 52% at baseline to 92% (P < .003).
• Patient satisfaction scores were high, with 90% reporting adequate constipation management.
• The QI project successfully integrated OAC assessment into routine clinical practice.

Conclusions:

• Fellow-led QI projects, supported by initiatives like QIPI, are effective in addressing clinical challenges such as OAC.
• This model demonstrates a successful approach to QI training for physicians.
• Improved OAC management leads to enhanced patient satisfaction and quality of care in oncology settings.