In response to the IOM report that identified major gaps in both quality and safety of patient care, the American Society of Clinical Oncology (ASCO) created the Quality Oncology Practice Initiative (QOPI), which was launched in 2006. Developed under the guidance of an expert panel of oncologists, the program provides a process for standardized assessment of care and reliable information to help focus improvement activities. Currently, approximately 1,000 U.S.-based oncology practices are registered in QOPI of which just over 300 are certified. All CTCA® hospitals have achieved and maintain QOPI certification.
Oncology practices that wish to achieve a three-year certification from QOPI must meet stringent criteria. This begins with an assessment of performance against a set number of scored quality metrics, calculating a composite overall score and submitting data on approximately 150 measures. To achieve QOPI certification, a practice must achieve an overall quality score of 75% or higher and comply with 26 safety standards. QOPI measures fall into the following categories: core, disease-specific and domain-specific. Core measures include areas such as staging, pathology testing and pain. Domain-specific measures include symptom management and care at the end of life. Disease-specific modules include breast, colorectal and non-small cell lung cancer. The following graph reflects performance for the most current data submission period, according to certification and maintenance requirements.
The scored quality metrics below reflect the performance of CTCA hospitals in aggregate and how these scores compare to the QOPI aggregate.1 Directional arrows are used to reflect where CTCA is higher, the same as, or lower than the QOPI norm.
| Key | Description |
|---|---|
| a | Height, weight and BSA documented prior to chemotherapy |
| b | Action taken to address problems with emotional well-being by the second office visit |
| c | Patient emotional well-being assessed by the second office visit |
| d | Smoking status/tobacco use documented in past year |
| e | Patient consent for chemotherapy |
| f | Documented plan for oral chemotherapy: administration schedule (start day, days of treatment, rest and planned duration) |
| g | Documented plan for oral chemotherapy: dose |
| h | Chemotherapy intent discussion with patient documented |
| i | Chemotherapy intent (curative vs. noncurative) documented before or within two weeks after administration |
| j | Documented plan for chemotherapy, including doses, route, and time intervals |
| k | Pain assessed on either of the two most recent office visits |
| l | Pain addressed appropriately (defect-free measure 3, 4a, and 5) |
| m | Staging documented within one month of first office visit |
| n | Pathology report confirming malignancy |
| o | Patients with Stage IV NSCLC with adenocarcinoma histology with an activating EGFR mutation or ALK gene rearrangement who received first-line EGFR tyrosine kinase inhibitor or other targeted therapy |
| p | Performance status documented for patients with initial AJCC Stage IV or distant metastatic NSCLC |
| q | RAS (KRAS and NRAS) testing for patients with metastatic colorectal cancer who received anti-EGFR MoAb therapy |
| r | Colonoscopy before or within 6 months of curative colorectal resection or completion of primary adjuvant chemotherapy |
| s | Adjuvant chemotherapy received within 2 months of diagnosis by patients with AJCC Stage III colon cancer |
| t | CEA within 4 months of curative resection for colorectal cancer |
| u | Tamoxifen or AI received within 1 year of diagnosis by patents with AJCC Stage IA (T1c) and IB to III ER or PR positive breast cancer |
| v | Test for Her-2/neu overexpression or gene amplification |
| w | Combination chemotherapy received within 4 months of diagnosis by women under 70 with AJCC Stage IA (T1c) and IB - III ER/PR negative breast cancer |
1CTCA performance is shown relative to the QOPI Spring 2019 aggregate in terms of being higher or lower than the QOPI aggregate with a higher score preferred. At this time, ASCO limits the public release of the QOPI aggregate data or benchmarks.