Regional Oncology Research Center

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Project Summary The long-term objective of this study is to improve compliance with standard of care recommendations for neuropsychological assessment (NPA) for children with central nervous system (CNS) tumors treated at our institution by developing a health system intervention to overcome barriers to referral for the NPA. Specific Aims include; 1) Identify health system/organizational, provider and community/patient-level characteristics that contribute to disparities in referral for [standard of care] NPA in children diagnosed with CNS tumors. 2) Develop a provider stakeholder engaged health system/organization intervention that addresses more consistent implementation of the standard of care and minimizes identified barriers. Methods for aim one will include electronic medical review for care team and health system specific data, provider survey and patient/community data for pertinent social determinants of health. The data will be analyzed to identify the characteristics amenable to a health system intervention. Methods for aim two include convening provider stakeholders to establish health system policy followed by embedding policy into established provider institutional education and developing an EMR, self-sustaining, intervention to promote compliance with standard of care and institutional policy. After at least 3 months of implementation of the policy/EMR intervention (e.g., presumably June-August 2022), the neuro-oncology database will be queried to identify brain tumor patients with non-terminal disease receiving care in the time frame and cross-reference with the referral database to confirm referral has been completed. The target goal will be to double the referral rate from that observed in our preliminary data of 43% to at least 86%.