Reinventing the Clinical Audit in a Pediatric Oncology Network

Area of Science:

• Pediatric Oncology
• Healthcare Quality Improvement
• Clinical Trial Management

Background:

• The St. Jude Affiliate Program aims to provide equitable pediatric cancer care access.
• Affiliate clinics in 9 states support St. Jude clinical trials and care extension.
• Initial on-site audits did not improve key clinical outcomes.

Purpose of the Study:

• To assess the impact of a comprehensive clinical audit on pediatric cancer care quality.
• To identify effective strategies for improving clinical outcomes in affiliate settings.

Main Methods:

• Implemented a comprehensive clinical audit involving staff self-reflection and transparent data sharing.
• Engaged local quality champions and senior leadership.
• Monitored specific clinical outcomes before and after the intervention.

Main Results:

• The comprehensive audit significantly improved time to antibiotics for febrile immunocompromised patients.
• Enhanced consistency in hand-off communication and oral chemotherapy documentation.
• Increased adherence to the central line bundle in the ambulatory setting.

Conclusions:

• A comprehensive, multi-faceted audit approach is more effective than basic on-site audits for improving pediatric cancer care quality.
• Engaging staff, leaders, and utilizing transparent data are crucial for successful quality improvement initiatives.
• This model can be applied to extend high-quality cancer care to geographically diverse patient populations.