Improving multidisciplinary patient-centered care for adolescents and young adults with cancer

e13503 Background: Approximately 90,000 adolescents and young adults (AYA) are diagnosed with cancer annually. Poor outcomes are associated with decreased access to specialized care, limited opportunities for clinical trial participation, treatment protocol variations, and limited psychosocial resources. Fortunately, there has been an increased awareness of the unique challenges faced by AYA patients with the establishment of AYA programs around the world. In order to maximize management opportunities for this marginalized population, our academic healthcare system embarked to establish an effective AYA Oncology Program to serve within the continuum of Pediatric and Medical Oncology and survivorship. Herein, we report the outcomes from this important quality improvement initiative. Methods: In May 2018, the AYA program was established within Pediatric Oncology. We were able to hire a dedicated social worker in March 2020. At this time, growth of the program was limited due to the COVID pandemic. In January 2021, the consult order was updated to enhance tracking metrics. We aimed to increase AYA program consult orders by 20% from 2021 to 2022. In June 2021, we presented the AYA program to Medical Oncology and Malignant Hematology to increase program awareness. We implemented several other educational activities with the Department of Pediatrics, Department of Medicine (including Medical Oncology and Malignant Hematology), and the community via multiple Plan-Do-Study-Act (PDSA) cycles. Results: Since 2020, the AYA program has tracked 91 answered consults – 86 in the last 2 years. In 2022, there were 50 total consults placed compared to 36 in 2021, a 38.9% increase. Since 2021, the AYA program was consulted on 17.2% of newly diagnosed AYA patients. Inpatient consults were more common at 62.6%. Thirteen total consults were ordered for patients ≥30yo, of which only 2 were for patients older than 32. The AYA program was consulted on only 3.5% of newly diagnosed adults ≥30yo compared to 28.7% for the younger AYA patients. Upon surveying medical oncologists at our institution, most providers simply forget to order consults to the AYA program. Conclusions: Total AYA program consult numbers are increasing, however, there is opportunity for growth, especially in reaching the older AYA patients. Our healthcare system has recently approved the establishment of a Best Practice Advisory (BPA) in our electronic medical record to remind providers to order AYA program consults, if appropriate. Once the BPA is established, subsequent PDSA cycles will emphasize reaching older AYA patients by re-circulating educational resources and activities to providers and social workers in Medical Oncology and Malignant Hematology. Future objectives will evaluate outcomes in quality of life, overall survival, healthcare utilization, and clinical trial enrollment amongst other metrics.