Abstract In this introduction, I summarize the different contributions presented by alumni and faculty about patient care during the alumni meeting on the tenth anniversary of the inauguration of the Advanced Oncology study programme of the University of Ulm. The chapters represent the diversity of the different authors, being from low-income, middle-income (LMICs) as well as high-income countries (HICs), considering specific aspects of the entire spectrum of cancer care. What unifies them is their drive to improve patient care in their areas of expertise, with the means they have at hand and the skillset they acquired during their professional and educational journeys, frequently taking them from different parts of the globe to other ones. The task at hand, to reduce cancer-related morbidity and mortality, remains, as do the cornerstones of cancer control like primary prevention, screening and early treatment. Therefore, the interruptive force of the COVID-19 pandemic should be acknowledged, and measures must be implemented to prevent further delays in care for patients with cancers. 

Improving Patient Care

Quality cancer care is efficient, accessible, coordinated, and evidence-based. Recognizing the necessary key components, development of pathways and guidelines to incorporate these key domains, and finally respectful adaptation to cultural differences can ensure that cancer care globally is of the highest quality. This quality care should be judged not only on how it optimizes health outcomes for patients, but also its impact on the care providers and the global community. 

Impact of Medical Oncology–Focused Quality Programs on Cancer Care Around the World

With the aim of improving the quality of cancer care globally, ASCO began to offer its quality improvement programs to interested international oncology practices. In this manuscript, we describe the experiences with ASCO quality initiatives in low- and middle-income countries (LMICs). The experience acquired from different practices in Latin America and Africa was reviewed and various action steps were summarized. Encountered challenges and implemented solutions to mitigate these challenges were identified to list as lessons learned for oncology practices in LMICs or low-resource settings to use in their future quality improvement initiatives and providing a proactive approach for those practices considering starting quality improvement programs. Having programs tailored to LMICs may facilitate the participation of more practices and help them take advantage of these programs to enhance patient care. The preliminary data and learning are promising and demonstrate that participation in quality improvement activities can have a positive effect. Although this early experience is encouraging, each country and resource-limited practice will have its own unique challenges as highlighted in this article. Having more practices participate will further enhance the knowledge base, build experience in addressing challenges, and enable oncology patients to reap the benefits worldwide. 

Access of Low-Resource Areas to ASCO Quality Initiatives: Initial Experience and Lessons Learned

ABSTRACT Objective To evaluate the impact of COVID-19 pandemic on the care delivered to hospitalized cancer patients in end-of-life. Methods A retrospective analysis of data of hospitalized patients with advanced solid tumors, who died under exclusive palliative care during first wave (March 2020 to July 2020) compared with the period previous pandemic (January 2018 to February 2020). Results A total of 190 oncologic patients were included, 161 patients before the pandemic, and 29 in the period from March 2020 to July 2020. The average hospitalization was 497.2 patients per month, before the pandemic, and dropped to an average of 46.5 in the pandemic, whereas the death rate decreased from an average of 6.3 patients per month to 4.8. Considering the benchmarks for quality of care during end-of-life care, preferences on life assistance were discussed prior to hospitalization for 34.4%, before the pandemic, and 13.8% during the pandemic (p=0.0298); 9.3% received chemotherapy 15 days prior to the date of death, before the pandemic, and 20.7%, in the pandemic (p=0.1012). Conclusion Based on the present results, despite the decrease in oncology admissions, the advanced-stage cancer patients continued to seek hospital for end-of-life care. However, we could observe in our benchmarking analyses for palliative quality of care that talks about prognosis occurred less often during the pandemic.

https://journal.einstein.br/wp-content/uploads/articles_xml/2317-6385-eins-20-eAO6459/2317-6385-eins-20-eAO6459.pdf

Palliative care to cancer patients: how COVID-19 pandemic could affect quality of care

Abstract Data suggest that the quality of care delivered to patients by a physician decreases over the years of clinical practice. In order to ensure quality care delivery, the American Society of Clinical Oncology (ASCO) has developed the Quality Oncology Practice Initiative (QOPI) and uses this program for international outreach activities. In this chapter, we describe the successful application of the quality management principles to our practice, Oncocentro, which is part of the Oncoclinicas Group. 

/pdf/quality-oncology-practice-improvement-qopi-in-brazil-a-39osac1t.pdf

Quality Oncology Practice Improvement (QOPI) in Brazil: A Successful Knowledge Transfer Under the Auspices of the American Society of Clinical Oncology (ASCO)

/pdf/international-perspective-on-the-pursuit-of-quality-in-5h4yd6lojh.pdf

International Perspective on the Pursuit of Quality in Cancer Care: Global Application of QOPI and QOPI Certification

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International Perspective on the Pursuit of Quality in Cancer Care: Global Application of QOPI and QOPI Certification