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Recently, ASCO added a new collection to its online library of chemotherapy documentation, care coordination, and cancer survivorship resources. In February 2009, the ASCO Lung Cancer Chemotherapy Work Group finalized treatment plan and summary templates for extensive-stage small-cell lung cancer, limited-stage small-cell lung cancer, adjuvant non–small-cell lung cancer, and advanced non–small-cell lung cancer (Data Supplements, online only). The lung cancer templates join the colon cancer adjuvant treatment plan and summary templates, the breast cancer treatment plan and summary templates, and the cancer treatment plan and summary templates, which are appropriate to use for any cancer diagnosis or treatment intent.
According to Daniel Hayes, MD, member of the lung cancer template development team, “the lung cancer treatment plan and summary templates are a great extension of ASCO's guidelines. They are effective tools that help oncologists utilize the large amount of information presented in the guidelines. Not only do they become a permanent part of the patients' records, but they also serve as a takeaway for patients to assist them in managing their care.”
There are many caregivers involved in a patient's treatment, which makes communication essential to ensure the best quality care. A study by Jefford et al1 concluded that a faxed sheet of information on chemotherapy is a simple way to increase the confidence of general practitioners, who play a vital role in the treatment of patients with cancer. In addition, in its report From Cancer Patient to Cancer Survivor: Lost in Transition,2 the Institute of Medicine of the National Academies recommends that after treatment, “every patient should be given a record of all care received and important disease characteristics.” Having this information on one form provides the best opportunity for coordination of care.
The treatment plan and summary templates can be used for both physician-to-patient and physician-to-physician communication, streamlining the documentation process. The documentation is intended to be a two-step process: First, when a patient embarks on a new chemotherapy regimen, the medical oncologist completes the treatment plan section of the template, and second, when a patient completes a chemotherapy regimen, the oncologist prepares the treatment summary. In both instances, completing the form should trigger a discussion with the patient about his or her care. The treatment plan and summary templates are not intended to replace more detailed chart documentation.
The lung cancer treatment plan and summary templates were developed under the leadership of Joseph Jacobson, MD, chair of the ASCO Quality of Care Committee. The process followed the same path as did the creation of the previous treatment plan and summary templates. First, Jacobson and a team of lung cancer experts convened to prioritize which data elements were necessary for each of the four templates (a list of the development team members is available at www.asco.org/treatmentsummary). The working drafts were distributed to the ASCO Quality of Care Committee, and feedback was incorporated into pilot templates. These pilot templates were tested in both academic and community settings. Participants in the pilot tests were asked to provide written feedback, along with completed, de-identified templates for each of the four types of lung cancer. This information was then provided to the development team, which used the feedback to generate the final published versions.
The ASCO treatment plan and summary templates are useful for oncologists intending to document patients' plans of care before administration and document summaries of care received after chemotherapy treatment. Several versions of the templates—designed to reflect the two-step completion process—are available at www.asco.org/treatmentsummary, including a customizable Microsoft Word (Microsoft Corp, Redmond, WA) file most appropriate for printing and written completion and a Microsoft Word form that can be completed electronically, as well as at http://jop.ascopubs.org/cgi/content/full/5/3/146/DC1. Microsoft Excel versions of the templates are in development.
In 2009, ASCO will continue to build its library of chemotherapy treatment plan and summary resources. The ASCO Quality of Care Committee welcomes feedback from template users regarding feasibility of implementation and/or specific data fields. Questions or comments can be sent via e-mail to gro.ocsa@ytilauqrecnac.