The six IOM quality aims in practice: A multidisciplinary assessment of the scope and focus of quality activities in oncology

44 Background: Strategies to address quality have evolved through adaptation of best practices, need to address institutional priorities, and mandates from accreditation organizations. Therefore evolution of QA/QI practice has been mostly reactive in nature. In the IOM report “The Quality Chasm” 6 key quality aims were identified: safety, timeliness efficacy, equitability, patient centeredness, and efficiency. To date however, a comprehensive assessment of the relationship of quality activities in oncology to these aims has not previously been reported. We hypothesized that there is variability in focus and scope of quality related activities in oncology as they pertain to the IOM key quality aims. Methods: Multidisciplinary quality activities in our department were identified by our quality committee. For each activity, 10 committee members individually identified in their opinion which of the 6 IOM quality aims were addressed by that activity and ranked in order the relative focus of each identified aim per activity. The percentage of respondents associating an aim to an activity and relative focus score per activity (1-6 with 1 representing the primary focus) were tabulated. Results: Imbalance with emphasis on safety was noted. Average relative focus scores linking the six quality aims to each quality activity are shown in the Table. Conclusions: Review of department quality activities revealed imbalances in focus on the IOM quality aims. While there is relative emphasis on safety as expected, opportunities exist for development of activities focused on other quality aims including timeliness and equitability. [Table: see text]