Using Plan-Do-Study-Act (PDSA) cycles increased the percentage of patients with gastrointestinal (GI) cancer referred to a cancer rehabilitation (CR) program by oncologists, according to a study published in JCO Oncology Practice (2020; OP2000432. doi:10.1200/OP.20.00432.)
Upon learning that their cancer center had low CR referrals for patients with GI cancer, Michelle B Nadler, MD, Princess Margaret Cancer Centre, University Health Network (Toronto, ON, Canada), and colleagues conducted a study aiming to increase their number of GI cancer patient referrals to CR programs by 50% and to increase the proportion of referrals coming from oncologists.
Dr Nadler and colleagues used a rapid cycle improvement approach to enhance CR referrals. Barriers included knowledge of CR program existence, awareness of the referral process, time, and lack of CR program exposure.
The team implemented “[PDSA] cycles every 2 months from January to December 2019 to address barriers,” using a p-chart to analyze results.
These PSDA cycles included:
- CR program advertisement
- A presentation to GI staff
- Nurse-led patient identification
- Patient-facing posters
- Clinician thank-you emails
Findings showed that the number of referrals had a relative increase of 100%, and the percentage of patients referred by oncologists increased from 50% to 75%.
The percentage of GI cancer patients referred by an oncologist to a CR program increased with the use of PDSA cycles, giving patients the opportunity to participate in a treatment that could optimize their “physical social, and vocational functioning.” —Marta Rybczynski
