New Study to Address Critical Gap in Chemotherapy Safety

The $1.4 million study will examine how communication and technology influence chemotherapy in ambulatory clinics where most patients receive their treatment.

ANN ARBOR, Mich. – An overwhelming majority of cancer patients receive their chemotherapy in ambulatory oncology clinics, but little research has been done to understand communication processes in this high-risk and complicated environment. In oncology settings, poor communication or mistakes in communication could mean delays in treatment, unexpected reactions sometimes requiring the patient to be hospitalized and other adverse effects.

A team of University of Michigan researchers will investigate clinician communication processes and technologies, and how they may influence safe chemotherapy administration, with support from a $1.4 million grant from the federal Agency for Healthcare Research and Quality (AHRQ).

Dr. Christopher Friese and Dr. Milisa ManojlovichChristopher R. Friese, PhD, AOCN, FAAN, a University of Michigan School of Nursing (UMSN) professor and member of U-M’s Comprehensive Cancer Center and Institute for Healthcare Policy and Innovation (IHPI), and Milisa Manojlovich, PhD, RN, CCRN, a UMSN associate professor and IHPI member, will lead the three-year effort.

“Providers of cancer care services face extraordinary challenges to deliver high-quality care to more patients with fewer resources, yet we currently have little evidence to guide daily patient care,” says Dr. Friese. “Our study will identify promising ways for cancer care teams to deliver safe, effective, and efficient care to patients, with an emphasis on avoiding preventable complications.”

The researchers will work in collaboration with the Michigan Oncology Quality Consortium (MOQC), a state-wide quality collaborative, sponsored by Blue Cross Blue Shield of Michigan, which works to improve cancer care in Michigan.

The sample will come from more than 50 practices participating in MOQC. Those practices represent various ambulatory oncology settings such as those embedded in health systems, free-standing, solo and group practices. These ambulatory settings account for 19 of the estimated 23 million adult chemotherapy visits in the United States each year.

“This innovative proposal will yield data from a diverse network of practices in MOQC,” says co-investigator Jennifer Griggs, MD, MPH, a professor of Hematology/Oncology and Health Management and Policy at U-M, and MOQC Program Director. “Such diversity is critical in drawing meaningful conclusions across patients cared for in the community.”

The mixed-methods study will begin with a detailed assessment and categorization of current communication processes and use of technologies correlated with rates of delayed treatment and unplanned emergency department visits or hospital admissions.

The investigators will also take a closer look at a sample of practices. Through observation, clinician shadowing and patient interviews, they will explore how communication processes influence adverse patient events and safe chemotherapy administration. The researchers will share their findings and work to develop interventions for future projects and testing. 

“This study will highlight how clinician communication processes and communication technologies either promote or hamper safe chemotherapy delivery,” says Dr. Manojlovich. “In talking to clinicians, we will learn about barriers and facilitators to safe chemotherapy delivery, which will inform subsequent intervention studies designed to improve ambulatory cancer care.”

Research in this release is supported by AHRQ under grant number R01HS0249114. The content is solely the responsibility of the authors and does not necessarily represent the official views of AHRQ.

Media Contact:
Jaime Meyers
University of Michigan School of Nursing
(734) 764-7006