Assessing oncology fellows' insights to enhance cancer care: A quality improvement initiative.

Abstract

e23241 Background: Improving cancer care requires integrating feedback from oncology fellows actively involved in patient management. Our program, consisting of 20 hematology and oncology fellows, initiated a Quality Improvement (QI) project to identify barriers and opportunities for enhancing clinical practices, communication, and multidisciplinary collaboration using Plan-Do-Study-Act (PDSA) cycles. The primary objective was to assess fellows' perspectives on current clinical practices, shared decision-making, and interprofessional collaboration. Methods: A structured survey was developed with input from fellows and faculty, addressing treatment decision-making frameworks, barriers to early palliative care integration, psychosocial resources, and gaps in training. The survey was distributed to all 20 fellows, and responses were analyzed to identify trends and actionable areas for improvement. Key insights focused on decision-making processes, use of evidence-based resources, confidence in patient communication, and collaboration with multidisciplinary teams. Results: Decision-making: 78.6% of fellows prioritized tumor stage/molecular profiles; 57.1% considered patient age/performance status. Evidence-based practices: All fellows used clinical guidelines (e.g., NCCN, ASCO), with no reliance on journals or online databases. Communication: 50% felt confident in explaining complex diagnoses; 28.6% reported moderate confidence. Palliative care integration: 64.3% delayed involvement until curative options were exhausted, citing misconceptions and lack of time as barriers. Multidisciplinary collaboration: 50% reported frequent collaboration; gaps were noted in communication with surgery and primary care teams. AI: 50% felt somewhat trained in integrating AI tools into oncology practice; the majority expressed interest in further training for better use in treatment planning. Conclusions: The PDSA cycle guided several targeted interventions: Multidisciplinary tumor boards for enhanced care coordination. Training on shared decision-making and patient communication to improve fellows' confidence. Standardized protocols for early palliative care to ensure timely integration. Improved access to evidence-based resources and AI tools for precision in clinical decision-making. This QI initiative highlights gaps in oncology care delivery. Interventions such as fostering multidisciplinary collaboration, early palliative care, and enhanced communication training can significantly improve care quality and patient outcomes. Incorporating AI tools into decision-making is a promising path to more accurate and efficient treatment planning. Future cycles will evaluate the impact of these interventions, aiming for sustainable improvements in cancer care delivery.