Got Stage Fright? A Fellow-Led Initiative to Improve Cancer Staging Documentation

INTRODUCTION Accurate cancer staging is essential for determining prognosis and treatment. However, only 6.1% of new patient visits (NPV) at our Comprehensive Cancer Center (CCC) were staged baseline using electronic health record tool (EST). We used Quality Improvement (QI) methods, targeting oncology fellows, to improve fellow-seen NPV rates by the end 2018-19 academic year. METHODS aimed increase fellow monthly EST usage rate solid tumor NPVs 70% June 2019. In first Plan-Do-Study-Act (PDSA) cycle, we moved into visit navigator that unifies all components needed complete an encounter. second PDSA specifically engaged fellows with reminder emails, periodic surveys, individualized outreach low performers. tracked rates, and, statistical process control charting, CCC-wide rates. RESULTS Monthly rose from 47% in July 2018 a mean 75% during 1 2. 16% 13% Staging decreased arrival fellows. DISCUSSION Our initiative improved timely NPVs. Although see minority CCC, found fellow-oriented QI appeared as well (in absence any comparable initiatives). Future steps include development note templates embedded tools promote sustainability.