• Laura A Sena, Ramy Sedhom, Susan Scott, Amanda Kagan, Andrew H Marple, Jenna V Canzoniero, Melinda Hsu, Qasim HussainiSyed MSM0000-0002-8006-5343The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD., Amin S Herati, Lauren Reschke, Maria Facadio Antero, Mindy S Christianson, Adam F Binder, Allen R Chen, Ross C Donehower, Kristen A Marrone, and Arjun Gupta.
• The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD.
• JCO Oncol Pract. 2021 Sep 25: OP2100479.

PurposeOncofertility counseling regarding the reproductive risks associated with cancer therapy is essential for quality cancer care. We aimed to increase the rate of oncofertility counseling for patients of reproductive age (18-40 years) with cancer who were initiating systemic therapy at the Johns Hopkins Cancer Center from a baseline rate of 37% (25 of 68, June 2019-January 2020) to 70% by February 2021.MethodsWe formed an interprofessional, multidisciplinary team as part of the ASCO Quality Training Program. We obtained data from the electronic medical record and verified data with patients by phone. We surveyed patients, oncologists, and fertility specialists to identify barriers. After considering a prioritization matrix, we implemented Plan-Do-Study-Act (PDSA) cycles.ResultsWe identified the following improvement opportunities: (1) oncologist self-reported lack of knowledge about counseling and local fertility preservation options and (2) lack of a standardized referral mechanism to fertility services. During the first PDSA cycle (February 2020-August 2020, disrupted by COVID-19), we introduced the initiative to increase oncofertility counseling at faculty meetings. From September 2020 to November 2020, we implemented a second PDSA cycle: (1) educating and presenting the initiative at Oncology Grand Rounds, (2) distributing informative pamphlets to oncologists and patients, and (3) implementing an electronic medical record order set. In the third PDSA cycle (December 2020-February 2021), we redesigned the order set to add information (eg, contact information for fertility coordinator) to the patient after-visit summary. Postimplementation (September 2020-February 2021), counseling rates increased from 37% to 81% (38 of 47).ConclusionWe demonstrate how a trainee-led, patient-centered initiative improved oncofertility care. Ongoing work focuses on ensuring sustainability and assessing the quality of counseling.

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