Nupur Bhatt1, Zahrah Taufique2, Emily Kamen2, Binhuan Wang3, Catherine Concert4, Zujun Li5, Kenneth Hu4, Babak Givi2. 1. New York University Grossman School of Medicine, New York, New York. 2. Department of Otolaryngology-Head & Neck Surgery, New York University Langone Health, New York, New York, U.S.A. 3. Department of Population Health, New York University Langone Health, New York, New York, U.S.A. 4. Department of Radiation Oncology, New York University Langone Health, New York, New York, U.S.A. 5. Department of Medicine, New York University Langone Health, New York, New York, U.S.A.
Abstract
OBJECTIVE: To investigate and improve compliance of thyroid function monitoring in head and neck cancer patients who received radiotherapy to the cervical region before and after instituting quality improvement interventions. METHODS: Using the Plan, Do, Study, Act (PDSA) methodology, patients with head and neck malignancies who received radiotherapy to the cervical region from 2013-2015 were identified at a tertiary medical center. The status of the patients' thyroid monitoring and related characteristics were recorded. A quality improvement project was subsequently implemented by data sharing and providing feedback to practitioners involved in head and neck cancer care and creating a tracking database for all patients who received radiotherapy to the neck. After implementation of these interventions, data was collected on patients meeting the inclusion criteria from 2015-2017. RESULTS: One hundred fifty-six patients met criteria pre-intervention and ninety-eight patients met criteria post-intervention. Compliance of thyroid monitoring went up from 34% to 80% after interventions (P < .0001). There was a significant increase in thyroid testing performed by radiation oncologists after interventions from 2% to 21%, while medical oncologists and otolaryngologists remained consistent in their compliance rates. CONCLUSION: It is possible to improve compliance with evidence-based recommendations and improve the quality-of-care for head and neck cancer survivors through simple, cost effective interventions. LEVEL OF EVIDENCE: 2 Laryngoscope, 130:E573-E579, 2020.
OBJECTIVE: To investigate and improve compliance of thyroid function monitoring in head and neck cancerpatients who received radiotherapy to the cervical region before and after instituting quality improvement interventions. METHODS: Using the Plan, Do, Study, Act (PDSA) methodology, patients with head and neck malignancies who received radiotherapy to the cervical region from 2013-2015 were identified at a tertiary medical center. The status of the patients' thyroid monitoring and related characteristics were recorded. A quality improvement project was subsequently implemented by data sharing and providing feedback to practitioners involved in head and neck cancer care and creating a tracking database for all patients who received radiotherapy to the neck. After implementation of these interventions, data was collected on patients meeting the inclusion criteria from 2015-2017. RESULTS: One hundred fifty-six patients met criteria pre-intervention and ninety-eight patients met criteria post-intervention. Compliance of thyroid monitoring went up from 34% to 80% after interventions (P < .0001). There was a significant increase in thyroid testing performed by radiation oncologists after interventions from 2% to 21%, while medical oncologists and otolaryngologists remained consistent in their compliance rates. CONCLUSION: It is possible to improve compliance with evidence-based recommendations and improve the quality-of-care for head and neck cancer survivors through simple, cost effective interventions. LEVEL OF EVIDENCE: 2 Laryngoscope, 130:E573-E579, 2020.
Authors: Alexander Augustyn; Valerie I Reed; Neelofur Ahmad; Manoop S Bhutani; Elizabeth S Bloom; John R Bowers; Gregory M Chronowski; Prajnan Das; Emma B Holliday; Marc E Delclos; Ryan W Huey; Eugene J Koay; Sunyoung S Lee; Christopher L Nelson; Cullen M Taniguchi; Albert C Koong; Stephen G Chun Journal: Clin Transl Radiat Oncol Date: 2021-02-12