Clinical Setting and Electronic Medical Record
This study was conducted at the University of California San Diego and Rady Children’s Hospital San Diego. Rady Children’s Hospital is a large tertiary academic institution. Pediatric cancer care is provided at the Peckham Center for Cancer and Blood Disorders, the largest pediatric cancer care facility in San Diego, Riverside and Imperial counties, providing care for children and adolescents with blood disorders and cancer diagnoses in a region that includes around one million children. Approximately 260 new cases of pediatric cancer are diagnosed annually at our institution. Most patients require treatment with chemotherapy, radiation, immunotherapy, stem-cell transplant, or a combination of these modalities.
During clinic visits and hospital admissions, patients with cancer are seen either by advance practice providers, resident and fellow physicians with a supervising pediatric hematology/oncology attending physician acting as the preceptor, or solely by an attending physician. All clinical documentation is completed electronically in a commercial electronic medical record (EMR) [Epic® Systems Corporation, Verona, Wisconsin], which was implemented six years prior to the beginning of our QI initiative.