Quality improvement: Enhancing family history documentation for invasive cancer patients in a community oncology clinic.

Abstract

e23284 Background: Accurate collection and documentation of family history in patients diagnosed with invasive malignancies is a vital metric for improving cancer patient outcomes. Unfortunately, comprehensive documentation in Electronic Health Records remains suboptimal. Methods: Our study included patients aged 18 and older with a diagnosis of invasive malignancy. Data was gathered by impartial abstractors and reported to the Michigan Oncology Quality Consortium (MOQC). The Abstractors extracted documentation information as yes or no from patient charts and submitted them to MOQC in a de-identified format. Patient data was collected on a rolling basis throughout the year and presented at semi-annual MOQC meetings. The Intervention: The QI initiative focused on provider education regarding accurate documentation of specific family history metrics in oncology clinic notes. These metrics were Invasive cancer diagnoses history in first degree relatives like biological parents, siblings and children and second-degree relatives like biological grandparents, aunts and uncles. Age at the time of diagnosis for affected relatives, or document age unknown A definitive closing statement: "No additional oncological history in first- or second-degree relatives." Intervention was initiated in early 2024 and education was completed via in-person lecture during quarterly staff meetings and supplemental informational pamphlets posted in provider workspaces. Data was collected from MOQC already de-identified over three years: 2023, 2024 and 2025. Results: Prior to initiation of the quality improvement, in the year 2023, 16% of the audited charts (99 patients) had complete documentation of Family History parametric in the notes. In year 1 of initiation of the quality improvement, in 2024, 22% of the audited charts (264 patients) had complete documentation of Family History parametric in the notes. In year 2 of initiation of the quality improvement, in 2025, 29% of the audited charts (235 patients) had complete documentation of Family History parametric in the notes. Following the initiation of the project, there was an absolute improvement of 13% in documentation compliance over two years. Conclusions: Suboptimal data collection can result in missed opportunities for hereditary genetic evaluations and cancer screenings. While our QI initiative demonstrated a steady upward trend in compliance, there remains significant room for growth. Barriers to sharper response include our large practice size and high provider turnover being a fellowship training site We have not yet reached the state target of 35%. To bridge this gap, future strategies may include: Increasing the frequency of provider education sessions. Implementing internal random chart audits. Targeted feedback to providers with consistently low documentation rates.