For a private practice like six-physician New England Hematology Associates, garnering Quality Oncology Practice Initiative (QOPI®) Certification can really signal to patients that the care provided there is among the best available—not just in the local market, but nationwide, said Deborah Davis, RN, MS, the practice’s clinical nursing leader.
“Achieving certification says your practice was evaluated against extremely high standards and we met them all,” she explained. “It signals our strong commitment of quality to patients, referring physicians, and the community.”
Davis added that this is especially important when competing with large academic medical centers and hospital-based programs, which Newton, Massachusetts–based New England Hematology Associates does. It’s one of few private practices in the area with an infusion clinic. After starting the process in September of last year, New England Hematology got its QOPI Certification in February.
Rigorous Standards Apply
The first program of its kind in the United States, the QOPI Certification program, launched in January 2010, gives oncology practices the opportunity to go a step beyond ASCO’s QOPI program. In the QOPI program, practices submit data that lets them compare performance with other practices across the country. Certification recognizes outpatient oncology practices that consistently provide the very highest standards of care. Of the more than 650 practices participating in QOPI, 110 have applied to go through the months-long process to gain certification, and 65 have made it through and received the coveted certification plaque.
The certification lasts for 3 years and indicates that the practice scored above expected levels in treatment planning, staff training and education, chemotherapy orders and drug preparation, patient consent and education, safe chemotherapy administration, and monitoring and assessment of patient well-being.
The process starts with QOPI data collection. If a practice gets the required scores on QOPI quality measures and believes it can demonstrate compliance with chemotherapy safety standards, it can then apply for certification. The practice submits a Site Assessment Questionnaire, supportive documentation for five randomly selected chemotherapy safety standards, and three randomly selected medical records. QOPI Certification staff and QOPI Steering Group reviewers evaluate the submitted materials.
A random selection of applicants receives an onsite audit. If a practice is selected, an advanced practice oncology nurse makes a day-long visit to the practice, reviewing charts and following two patients through their entire visit that day. These are some of the aspects of care reviewed on site:
- Written policies, procedures, or guidelines for verification of training and continuing education for clinical staff
- Orders for parenteral and oral chemotherapy that are written and signed by licensed independent practitioners who are determined to be qualified by the practice according to the practice’s written policies
- Preparation of chemotherapy drugs (oral or parenteral) by a pharmacist, pharmacy technician, or nurse who is qualified according to the practice’s policies
- Chemotherapy administration only by qualified physicians, physician assistants, advanced practices nurses, or registered nurses
- A comprehensive education program for new staff administering chemotherapy, including a competency assessment—or the use of an off-site educational program regarding chemotherapy administration that includes competency assessment
- Chemotherapy administration education that includes all routes of administration used in the practice site, such as parenteral, oral, intrathecal, intraperitoneal, and intravesicular
- A standard mechanism for monitoring chemotherapy administration competency at specified intervals
- Maintenance of basic life support certification by all clinical staff
Certification Process Also Benefits Practice Staff
Jockeying to attain the certification can be a rigorous undertaking, but the process itself can have significant upsides, said Kathleen A. Cooney, MD, Frances and Victor Ginsberg Professor of Hematology/Oncology, Chief of the Division of Hematology, and Interim Director at University of Michigan Cancer Center, which has 180 physicians who handle 100,000 clinic visits and 45,000 infusion visits per year.
“In big organizations like ours, you can prioritize activities you think might be important, but you may be overlooking things,” said Cooney. “The certification process provided a really nice opportunity to have external reviews of our own procedures, along with getting all of our staff members on the same page. That was very positive, and allowed us to improve the way we work together.”
Once certification is attained, practices can include their certification status in marketing materials to show that their organization is among the upper echelon of outpatient oncology practices. But it’s not just for marketing; QOPI Certification is also beginning to be recognized by major national insurers as a reliable way to identify and compensate high-performing practices. ■
