학술논문
An initiative to implement a triage and referral system to make exercise and rehabilitation referrals standard of care in oncology.
Document Type
Academic Journal
Author
Schmitz KH; Division of Hematology and Oncology, School of Medicine, UPMC Hillman Cancer Center, University of Pittsburgh, 580 S. Aiken Ave, Suite 610, Pittsburgh, PA, 15232, USA. schmitzk@upmc.edu.; Chongaway A; Division of Hematology and Oncology, School of Medicine, UPMC Hillman Cancer Center, University of Pittsburgh, 580 S. Aiken Ave, Suite 610, Pittsburgh, PA, 15232, USA.; Saeed A; Division of Hematology and Oncology, School of Medicine, UPMC Hillman Cancer Center, University of Pittsburgh, 580 S. Aiken Ave, Suite 610, Pittsburgh, PA, 15232, USA.; Fontana T; Division of Hematology and Oncology, School of Medicine, UPMC Hillman Cancer Center, University of Pittsburgh, 580 S. Aiken Ave, Suite 610, Pittsburgh, PA, 15232, USA.; Wood K; ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA, USA.; Gibson S; Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.; Trilk J; Department of Biomedical Sciences, University of South Carolina School of Medicine, Greenville, SC, USA.; Adsul P; Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, USA.; Comprehensive Cancer Center, Cancer Control and Population Sciences Research Program, University of New Mexico, Albuquerque, NM, USA.; Baker S; Division of Hematology and Oncology, School of Medicine, UPMC Hillman Cancer Center, University of Pittsburgh, 580 S. Aiken Ave, Suite 610, Pittsburgh, PA, 15232, USA.
Source
Publisher: Springer International Country of Publication: Germany NLM ID: 9302957 Publication Model: Electronic Cited Medium: Internet ISSN: 1433-7339 (Electronic) Linking ISSN: 09414355 NLM ISO Abbreviation: Support Care Cancer Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Clinical guidelines suggest that patients should be referred to exercise while undergoing cancer treatment. Oncology clinicians report being supportive of exercise referrals but not having the time to make referrals. Toward the goal of making exercise referrals standard of care, we implemented and evaluated a novel clinical workflow.
Methods: For this QI project, a rehabilitation navigator was inserted in chemotherapy infusion clinics. Patients were offered a validated electronic triage survey. Exercise or rehabilitation recommendations were communicated to patients during a brief counseling visit by the rehabilitation navigator. The implementation approach was guided by the EPIS framework. Acceptability and feasibility were assessed.
Results: Initial meetings with nursing and cancer center leadership ensured buy-in (exploration). The education of medical assistants contributed to the adoption of the triage process (preparation). Audit and feedback ensured leadership was aware of medical assistants' performance (implementation). 100% of medical assistants participated in implementing the triage tool. A total of 587 patients visited the infusion clinics during the 6-month period when this QI project was conducted. Of these, 501 (85.3%) were offered the triage survey and 391 (78%) completed the survey (acceptability). A total of 176 (45%) of triaged patients accepted a referral to exercise or rehabilitation interventions (feasibility).
Conclusions: Implementation of a validated triage tool by medical assistants and brief counseling by a rehabilitation navigator resulted in 45% of infusion patients accepting a referral to exercise or rehabilitation. The triage process showed promise for making exercise referrals standard of care for patients undergoing cancer treatment.
(© 2024. The Author(s).)
Methods: For this QI project, a rehabilitation navigator was inserted in chemotherapy infusion clinics. Patients were offered a validated electronic triage survey. Exercise or rehabilitation recommendations were communicated to patients during a brief counseling visit by the rehabilitation navigator. The implementation approach was guided by the EPIS framework. Acceptability and feasibility were assessed.
Results: Initial meetings with nursing and cancer center leadership ensured buy-in (exploration). The education of medical assistants contributed to the adoption of the triage process (preparation). Audit and feedback ensured leadership was aware of medical assistants' performance (implementation). 100% of medical assistants participated in implementing the triage tool. A total of 587 patients visited the infusion clinics during the 6-month period when this QI project was conducted. Of these, 501 (85.3%) were offered the triage survey and 391 (78%) completed the survey (acceptability). A total of 176 (45%) of triaged patients accepted a referral to exercise or rehabilitation interventions (feasibility).
Conclusions: Implementation of a validated triage tool by medical assistants and brief counseling by a rehabilitation navigator resulted in 45% of infusion patients accepting a referral to exercise or rehabilitation. The triage process showed promise for making exercise referrals standard of care for patients undergoing cancer treatment.
(© 2024. The Author(s).)