Regional Oncology Research Center

项目摘要 本研究的长期目标是提高对标准治疗建议的依从性， 神经心理学评估（NPA）的儿童中枢神经系统（CNS）肿瘤治疗在我们的 通过制定卫生系统干预措施，克服向国家行动计划转诊的障碍，建立一个机构。具体目标 包括：1）确定卫生系统/组织、提供者和社区/病人一级特征， 导致诊断为CNS肿瘤的儿童转诊[标准治疗] NPA的差异。2)发展 提供者利益相关者参与的卫生系统/组织干预， 实施护理标准，最大限度地减少已查明的障碍。实现目标一的方法包括 针对护理团队和卫生系统特定数据、提供者调查和患者/社区的电子医疗审查 健康的相关社会决定因素的数据。将对数据进行分析，以确定适合的特征 健康系统的干预。实现目标二的方法包括召集供应商利益相关者， 系统政策之后，将政策嵌入既定的提供者机构教育，并制定一个 EMR，自我维持，干预，以促进遵守护理标准和机构政策。经过 实施政策/EMR干预至少3个月（例如，2022年6月至8月）， 将查询神经肿瘤学数据库，以确定接受治疗的非晚期脑肿瘤患者 并与转诊数据库进行交叉查询，以确认转诊已经完成。的 我们的目标是把转介率由初步数据所显示的43%提高一倍至最少86%。

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%.