The AIM Higher Initiative: new procedures implemented for assessment, information, and management of chemotherapy toxicities in community oncology clinics

Clin J Oncol Nurs. 2008 Apr;12(2):229-38. doi: 10.1188/08.CJON.229-238.


Chemotherapy-related toxicities are common and often undertreated in routine cancer care. Initiatives to improve toxicity management in practices may not always be effective. Quality improvement programs must engage multiple disciplines of the healthcare team and sustain efforts to institute and maintain procedures that address practice needs. The Assessment, Information, and Management (AIM) Higher Initiative, a quality improvement program undertaken at 15 community oncology practices, was initiated to improve the AIM of chemotherapy-related toxicities in patients with cancer. AIM Higher focuses on improving five chemotherapy-related toxicities: neutropenia, anemia, depression and anxiety, diarrhea and constipation, and nausea and vomiting. Led by a nurse champion at each of the clinics, a variety of new procedures, processes, and tools were implemented to improve quality of care. Nurses and practice administrators can use the quality improvement processes to generate changes in procedures and practices.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Ambulatory Care / organization & administration*
  • Antineoplastic Agents / adverse effects*
  • Drug Monitoring / nursing
  • Drug Monitoring / standards
  • Humans
  • Medical Oncology / organization & administration*
  • Models, Organizational
  • Neoplasms / drug therapy
  • Neoplasms / nursing
  • Nurse Clinicians / organization & administration
  • Nursing Assessment / organization & administration
  • Oncology Nursing / organization & administration*
  • Outcome and Process Assessment, Health Care
  • Patient Care Team / organization & administration
  • Patient Education as Topic
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / organization & administration*
  • Risk Assessment
  • Total Quality Management / organization & administration*
  • United States


  • Antineoplastic Agents