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首页> 外文期刊>Journal of the advanced practitioner in oncology >Oncology Advanced Practice Provider Tumor Board: From Pilot to Expansion Across the Health System
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Oncology Advanced Practice Provider Tumor Board: From Pilot to Expansion Across the Health System

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Background: Previously, we reported on an Oncology Advanced Practice Provider (APP) Tumor Board (TB) pilot implementation in a small community-based cancer center affiliated with a large academic institution. Common challenges for oncology APPs included sub-optimal oncology-specific education, and limited access to sub-specialty collaboration. The pilot APP TB provided a successful avenue for APPs to share patient cases in a learning environment, increase collaboration, and implement evidence-based practice recommendations. Therefore, it was recommended by leadership to expand TB to include participation of all oncology APPs across the healthcare system cancer institute. Our purpose was to explore the 1) interest and feasibility of expanding Oncology APP TB to include oncology sites across the healthcare system, 2) characteristics of APP TB. Methods: A 15-item survey, consisting of multiple choice and 5-point Likert scale matrix table items, assessing oncology APP practice factors such as collaboration practices and utilization of traditional TB. Survey was sent via email to 123 APPs representing 10 locations and 11 departments. The APP TB was expanded to include all healthcare system oncology APPs. Demographics for these meetings were collected and include: attendance, case presentation diagnosis and rationale, recommendation summation and resources utilized. Results: Survey response rate was 42.3. While 72 of responding APPs attend a traditional TB, 69.4 rarely or never bring a case to that TB. APPs utilize collaboration with APP peers and supervising physicians most often when making diagnosis or treatment decisions; they use traditional TB only -35 of the time. Important factors in considering participation in APP TB were: increasing oncology patient care knowledge and keeping up to date with practice innovations. Five expanded TB meetings have been offered; an average of 3.4 cases were presented each month. As location was considered a barrier for participation, location rotated between two central sites and virtual presence through streaming services was offered. An average of 14 APPs attended monthly, including an av erage of 9 virtually. Most cases were presented for the purpose of sharing educational value. Greater than 50 of cases provided opportunities for discussion on supplemental educational information, including journal or UpToDate articles. Updated data collection will be presented for an additional 3 TB meetings. Conclusions: The expansion of the APP TB program has been valued and successful. Oncology APPs of varying age, experience, specialty, and location report increased oncology knowledge, camaraderie, and collaboration with APP peers. APP TB is a novel way to stay up to date on current oncology practice standards and to improve access to a diverse group of APP peers despite distance in physical location. Alternating physical location of TB and offering virtual streaming allows collaboration across a large multi-site cancer center. Barriers to participation, including location and time of meeting and busy workload may contribute to relatively low attendance. Recommendations: Disseminate follow-up survey to assess participant satisfaction, suggestions for improvement, and ways to minimize barriers to participation and increase attendance. Oncology APP TB is an innovative forum for advancing oncology education and APP collaboration and should be considered at other facilities.

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