Plan-Do-Study-Act (PDSA) cycles
PDSA #1: In March2019, confirmation of a list of new diagnoses (target
list) for which a PPC consult was recommended within 30 days of
diagnosis (TABLE 1 ). This list created by the project team with
input from oncology leaders was presented to all oncology physician
faculty. Consensus and buy-in was obtained resulting in the final target
list.
Information dissemination sessions at three oncology clinician meetings
explained the purpose of the project, background on the evidence for PPC
involvement, survey results, and education on how to introduce PPC to
patients and families.
A standard documentation tool in the electronic medical record was
developed for clinicians to note if PPC consult was considered,
discussed with patient/family, and placed. If a PPC consult was not
placed, the tool included space for documenting why the consult was not
applicable. The tool was designed to help identify barriers to PPC
consultation, including family refusal (Supplemental Figure 1 ).
PDSA #2: Monthly division emails began in July 2019 and incorporated
general updates on the project as well as reminders about the target
list diagnoses and the standard documentation tool.
PDSA# 3: Monthly patient review by members of the project team began in
October 2019. Following review, targeted reminder emails were sent to
the primary oncology team of identified patients regarding the target
list diagnoses, PPC consult expectation, and documentation tool.