Shila Pandey, DNP, AGPCNP-BC, ACHPN, FPCN, Memorial Sloan Kettering Cancer Center, New York, New York, presented the development and outcomes of an advanced practice provider (APP)-led Quality Assurance Committee designed to enhance patient safety and care quality in oncology at the 2025 Journal of the Advanced Practitioner in Oncology (JADPRO) meeting in National Harbor, Maryland.

The committee reviewed more than 1,200 APP-related safety events, most commonly involving care coordination, medication, and lab issues, leading to actionable improvements such as new guidelines, education modules, and EMR updates. 

The initiative demonstrated the value of APP-driven leadership in identifying system-level issues, implementing quality improvements, and strengthening APP engagement in institutional safety efforts.

Transcript:

Hello, my name is Shila Pandy. I'm a nurse practitioner at Memorial Sloan Kettering Cancer Center. I work primarily in a palliative care clinic, and I have the role as an APP quality assurance committee lead. My work was presented at the JADPRO conference just last month. Today I'm going to share with you a little bit about what we were able to do at Memorial building a APP-led quality assurance committee, and some of the data we reported at the conference. I'd like to tell you we did garner a lot of excitement and interest in the work that we did, so I look forward for you sharing that excitement as well.

Now, I'll give a little background. There are committees throughout most hospitals and healthcare organizations that look at quality and safety. What they rely on are clinicians, the staff, to report events that they're seeing, potential safety events, whether it reached the patient or not.

At our cancer center, we recognize that while advanced practice providers, nurse practitioners and physician assistants alike, they were on these committees, but we didn't have a standalone committee where APPs could speak directly to their scope of practice and how they observed the role of APPs in these potential patient safety events. What we outlined and aimed to do with this work was to develop a structure so that we could have our standalone committee and have much more of a say in analyzing these patient safety events and being part of the solutions to make oncology care safer and of higher quality. 

This work started by leaders in our organization in 2022, we started to gather folks that were on these committees and we created a huddle, a once monthly huddle, where we'd all come together and talk about the themes we were seeing. This evolved with some background work and garnering leadership sponsors to help us create our own committee. In 2023, we created our own APP Quality Assurance Committee. From 2023 of June to June of 2025, we monitored this data rigorously and that's what was presented at this conference. I'll review that with you here. 

Before I get into some of the numbers, what we looked at was monthly meetings that were held, number of cases reviewed, what types of cases were being discussed, and the level of severity of those cases as well, and in what settings. What we found was that from June 2023 to 2025, we had a total of about 1,216 patient safety events that were reviewed by this APP-led QA committee. All of these cases involved APP care, and those numbers of events increased from 295 and 2023 to 586 in 2024 and 335 in 2025. We recognized that 2023 and 2025 were both half year events. But when we look at that on a monthly level, it was still showing a trend of an increase.

The locations were most commonly at the main hospital, 34%, in clinic, 33%. The most common themes were care coordination, which is not surprising. That was 49% and followed by medication fluid, which was 18% and about 10% involving lab specimen. We took a closer look at each of these categories to subcategories, and we found that care coordination had a breakdown of 14% related to delays in patient care, 8% in miscommunication, and 5% in policy violations with 2% in handoff issue and that is a big chunk of what we are still seeing in these patient safety events.

We had 39 cases presented at these monthly meetings, and we broke that down by year and what we were most proud to present were all the action items that we were able to accomplish from this work. Guideline and all APP-led as guideline development, revision education modules from how to recognize new blast in the clinic, grand rounds, changes in the electronic medical record, appropriate alerts for clinicians, workshops like documentation improvement, and developing some more competency-based skills.

We found that, yes, it's hard work, you really need to get the lay of the land, but it's such important work for APPs to have their standalone committee and space to have a voice in reviewing cases and also have a role in those solutions for elevating patient care. Having these metrics really help to target resources. What do we put our energy in teaching or quality improvement events? That really help to allocate resources appropriately.

 What we know is you do need good dedicated APP leadership to push this type of work forward. We hope that this is exciting to you and you can model some of this where you are, and please always feel free to contact us for any future collaboration. Thank you.

Source:

Pandey S. Safeguarding Excellence: Insights from a Novel Advanced Practice Provider-Led Quality Assurance Committee. October 23-26, 2025; National Harbor, Maryland. Abstract JL1340C.