Quality Resources and Improvement Activities

Quality Resources to Support Evidence-based Practice (EBP) and Quality Improvement

Nursing plays a critical role to identify and eliminate waste while actively improving systems and care delivery, all resulting in improved patient experiences and outcomes. ONS offers resources to inform healthcare professionals about quality reporting with an emphasis on improvement.

Evidence-based practice is a problem-solving approach to clinical practice that integrates the conscientious use of best research evidence in combination with clinician expertise as well as patient preferences and values to make decisions for care that will promote the optimal outcome.

Quality improvement (QI) is a method of improving clinical processes through the use of quality tools and methods with the goals of the activity depending on the practice gap identified in the performance data.

LEAN Healthcare – QI tools that help identify sources of waste in a clinical process and replace those non-value adding activities with those value adding practices that improve outputs and clinical outcomes.
Six Sigma – QI tool that aims to reduce impractical variation in processes and clinical practice between clinicians. Variation increases costs and often indicates lack of EBP utilization on the part of clinicians.
Model for Improvement – QI tools that utilize testing of ideas and hypothesis about what we might change to achieve EBP and improved outcomes using small tests of change often called PDSA cycles.

Data-Driven Quality Improvement refers to the use of scientifically tested quality metric to measure nursing sensitive and patient centered key performance metric to identify gaps in practice and variations between clinician and practice sites. These data are needed to determine greatest opportunities for improvement in practice to prioritize improvement activities.

ONS maintains a portfolio of scientifically tested quality measures. These measures are both process focused and outcome focused. Both process and outcome measures are important for use in a well-designed clinical quality program in oncology care.

ONS Custom Quality Measures

Goal Setting and Attainment for Cancer Survivors
Fatigue Improvement
Exercise Recommendation to Adult Cancer Survivors
PCR Test with MR2 or great result (BCR-ABL1 < 1% [IS]) for patients receiving TKI for at least 6 months for Chronic Myelogenous Leukemia
Patient Reported Health-Related Quality of Life during Treatment for Advanced Cancer
Assessment and Management of Immune-Related Adverse Events during Cancer Treatment with Checkpoint Inhibitors
Assessment and Intervention for Psychosocial Distress in Adults Receiving Cancer Treatment
Assessment and Intervention for Sleep-Wake Disturbance During Cancer Treatment
Education on Neutropenia Precautions
Post-Treatment Education

ONS EBP and EBQI Resource Matrix

Topic	ONS Practice Resource	Quality Metric/Tools/Resources
Cancer-Related Fatigue	ONS Fatigue PEP Resources	ONS Get Up, Get Moving (Physician Activity Recommendation) Toolkit Video: Simple Exercises for Your Patients with Cancer – Complete Version Video: Breathing Exercises to Teach Your Patient with Cancer Video: Exercise Warm-Ups for Your Patients with Cancer Video: Body Weight Exercises for Your Patients with Cancer Video: Simple Weight Training Exercises for Your Patients with Cancer Quality Metric: 1. Assessment for Fatigue – process measure 2. Recommendation for Exercise in Adult Cancer Survivors – process measure 3. Fatigue Improvement – outcome measure
Health-related Quality of Life		Quality Metric: Health-related Quality of Life (HRQoL) in Advanced Cancer – outcome measure
Immune Mediated Adverse Events	ONS Immunotherapy-induced Diarrhea PEP Resources	Quality Metric: Immune-mediated Adverse events – intermediate clinical outcome measure
Radiodermatitis	ONS Radiodermatitis PEP Resources
Skin Toxicity	ONS Skin Reactions PEP Resources
Lymphedema	ONS Lymphedema PEP Resources
Hot Flashes	ONS Hot Flashes PEP Resources
Constipation	ONS Constipation PEP Resources
Sleep-Wake Disturbance	ONS Sleep-Wake Disturbance PEP Resources	Quality Metric: Assessment and Intervention for Sleep-Wake Disturbance during Cancer Treatment – process metric
Prevention of Infection: General	ONS Prevention of Infection – General PEP Resources	Quality Metric: Education on Neutropenia Precautions – process measure
Anxiety and Depression	ONS Anxiety PEP Resources ONS Depression PEP Resources	Quality Metric: Assessment and Intervention for Psychosocial Distress in Adults Receiving Cancer Treatment – process measure

Why Use ONS Quality Measures?
The ONS eCQMs address care priorities important to people with cancer during and after treatment. The measures address care delivered by the entire health care team, especially providing data to support the value of nursing contributions in delivering quality care.

The ONS eCQMs have been tested for feasibility, reliability and validity; you can use them with confidence and compare your performance to peers within your care setting and across the country.

Contact ONS staff at Research@ons.org to learn more.