Doctor of Nursing Practice Program

Emily Skotte, DNP, MSN, ACNP-BC

Emily Skotte
  • Committee Chair Name & Credentials:
    Ty Williams, DNP, RN, ACNP-BC, FNP-BC, CNE


DNP Project Abstract

Improving Multidisciplinary Thoracic Tumor Board with a Case Submission Tool

The purpose of this project was to develop, implement, and evaluate the use of a research electronic data capture (REDCap) case submission tool to submit patient case information and optimize Multidisciplinary Thoracic Tumor Board (MTTB) presentation and discussions as measured by qualitative survey results.

A 10-item survey was developed to assess the MTTB participants' view on its function. Pre and post-tests were developed to assess function and efficiency and solicit opinions about available data using closed and open-ended questions. Post-test survey included three additional items to solicit opinions about the case submission tool. A case submission tool was developed in REDCap for use capturing pertinent patient data including medical record number, age, diagnosis, request for pathology or radiology review, and clinical questions. The tool was shared with MTTB members over four weeks. No patient data were collected for this project. Likert scale responses to closed ended questions were analyzed and reported as descriptive statistics. Thematic analysis was used to describe the qualitative data from open-ended questions, as described by Maguire & Delahunt (2017).

Pre- and post-implementation surveys were sent out to 26 MTTB participants, including medical oncologists, thoracic surgeons, interventional pulmonologists, radiologists, pathologists, clinical pharmacist, radiation oncologists, and advanced practice providers. Seventeen respondents (65%) completed the pre-implementation survey, and 14 respondents (54%) completed the post-implementation survey. Quantitative data revealed a 17% increase in agreement that the current tumor board function is adequate and an 18% increase in agreement that adequate information on patient comorbidities is presented. However, there was a 3% decrease in agreement that the current function of tumor board is efficient. Qualitative data themes included acknowledging the MTTB’s value with room for improvement, decisions should be recorded in the electronic health record, the deadline for submitting cases needs revision, and the need for case submission process improvements, including a point person for documentation and submission.

Implications for Practice
This case submission tool was a first step in improving the quality of the MTTB. Participants were invested in this process and have ideas about how to improve efficiency and an interest in improving transparency with electronic health record documentation. Next steps include exploring options to document MTTB activity and integrate investigations and outcomes in the electronic health record and revisit deadlines for case submission.