Steroid Tapering For Patients With Spinal Cord Compression Or Symptomatic Brain Metastases At Jackson Memorial Hospital.

238Background: Metastases to the spinal column and brain for patients with cancer are common occurrences seen in oncology practices. Steroids play a critical role in symptom management upon patient presentation and proper tapering of steroids is necessary to minimize risk of recurrent symptoms. Within our institution, which is a tertiary care facility primarily for the poor and near-poor of a large urban environment, 78% of patients with spinal cord compression or symptomatic brain metastases do not receive appropriate tapering of steroids following completion of radiation treatment. This leads to unnecessary side effects from continued steroid use, ultimately leading to an inefficient use of resources, including time and money. Methods: Through the guidance of American Society of Clinical Oncology (ASCO) Quality Training Program, we created a process map, cause and effect diagram, and acquired preliminary diagnostic data. This data was acquired via electronic medical record (EMR) review including evaluat...