1. Engagement, Resources, and Quality Improvement Lesley Breech, MD Comprehensive Fertility Care and Preservation Program

2. Engagement

3. Collaboration Optimal Outcome Oncology/ Endocrinology Care Managers
Gynecology/
Surgery/
Urology/
REI
PCP
Care Managers
Social Work
Ethics
Patient/Family
Optimal
Outcome
Patient Navigator
Leslie

4. Engagement of the Primary Team
Be visible
Various team meetings
Gain information and network
“Yes, we’d love to present to your group”
Local, regional, national
Lectures, social media, blogs, webinars, live-chats
Take the initiative

5. Engagement of the Primary Team
Be timely
With communication
With consultation
With follow up
Work toward fertility consultation becoming expected, not elective
Establish as the standard approach
Culture change helps to fuel the growth of the program

6. Make the existing culture work for you
Leukemia/Lymphoma, Solid Tumor, Neuro-onc
On the surface not so different – same guidelines, same players, etc
Actually work very differently
Need a system that is flexible enough to work with all teams but simple enough to understand
Single access point (Fertility Navigator)!!!
Look for the common denominator
Care manager role exists in all teams
Keepers of the new patient checklist

7. Institutional Engagement
Institutional intranet highlights
Program achievements
Developments in the field
Patient and Family Advocacy
Area magazine highlights
Radio broadcast
Local news story broadcast nationally
2017 Faculty Clinical Team Award
Recognize the contribution of all team members!!!
Leadership recognition of “return on mission”

8. Initial Barriers to needed resources
Lack of dedicated institutional support & oncology buy-in
Financial Barriers
Coordination of fertility care (No fertility navigator)
Data management and electronic health record
Tissue processing in pediatric facility
OR logistics for fertility procedures
Lack of Research Infrastructure
Logistics of 3 oncology services + BMT

9. Overcoming Barriers Dedicated institutional funding secured
Sound business plan
Partnerships with other programs
OncoFertility Consortium
University of Cincinnati adult program
Partnering with patient/family support groups
Stupid Cancer
Leverage divisional resources for additional support
Philanthropic funds to support patient care costs

10. Facilitating Factors

11. Quality Improvement Science
Partnered with the Anderson Center at CCHMC
Experienced Quality Improvement Consultant embedded in team
Consistently analyze data
Every miss is a learning opportunity
Use each instance to improve the quality of service
Make yourself accountable
Presented monthly at AYA & CFCPP Meeting
Share with teams requesting consultation

15. Added 1 solids patient to January data

20. Added 1 OTC for Jan

22. Comprehensive Fertility Care and Preservation Program at CCHMC
Began with dedicated passionate team members
Survived and grew due to diligence, passion of team and increased awareness inside and outside CCHMC
Has become a national leader in the pediatric fertility preservation care delivery space