Trainee-Led Quality Improvement Project to Improve Fertility Preservation Counseling for Patients With Cancer

Area of Science:

• Oncology
• Reproductive Medicine
• Healthcare Quality Improvement

Background:

• Oncofertility counseling is crucial for patients undergoing cancer therapy.
• Reproductive risks associated with cancer treatments necessitate informed patient discussions.
• Baseline oncofertility counseling rates at Johns Hopkins Cancer Center were 37%.

Purpose of the Study:

• To increase oncofertility counseling rates for reproductive-aged cancer patients initiating systemic therapy.
• The target was to raise counseling rates from 37% to 70% by February 2021.

Main Methods:

• An interprofessional team utilized Plan-Do-Study-Act (PDSA) cycles for quality improvement.
• Data were collected via electronic medical records and patient phone verification.
• Barriers were identified through surveys of patients, oncologists, and fertility specialists.

Main Results:

• Key barriers included lack of oncologist knowledge and a non-standardized referral process.
• Interventions involved educational sessions, patient pamphlets, and an electronic medical record order set.
• Post-implementation, counseling rates significantly increased to 81%.

Conclusions:

• A trainee-led, patient-centered initiative effectively enhanced oncofertility care.
• Future efforts will focus on sustaining these improvements and evaluating counseling quality.