| Sumario: | Significance & Background: An evidence-based symptom management guideline with algorithmic pathways was developed to reduce chemotherapy-related hospital admissions, minimize treatment interruptions, and improve patient quality of life, supporting the OP-35 CMS quality measures. Barriers were identified for consistent adherence and workflow integration. In response, a multidisciplinary team--nurses, educators, pharmacists, and informatics were formed to optimize workflow integration. Purpose: Develop a digital tool that triage nurses can use for assessment and management of chemotherapy symptoms. Timely standardized evidence-based symptom triage, reduces variability, supports OP-35 compliance, enhances patient outcomes, and improves nursing confidence. Interventions: The multidisciplinary team met bi-weekly over eight months. To ensure consistent guideline use, the team created an EMR SmartPhrase that embeds provider-approved symptom management algorithms into nursing documentation, guiding nurses through structured symptom assessment and intervention. Its development included a detailed review of each symptom, its grading criteria, and corresponding interventions. The SmartPhrase was initially piloted in two of the 22 oncology offices, with nurse education supported by the Nursing Professional Development Specialists. Training included on-site support, an SBAR communication tool, and a tip sheet to guide nurses through the SmartPhrase workflow. Results: The development and integration of the triage SmartPhrase within the EMR represents a significant advancement in nursing-led chemotherapy symptom management. Designed to streamline clinical decision-making, the tool empowers nurses with real-time, evidence-based guidance tailored to specific chemotherapy-related toxicities. Feedback from front line nurses on the implementation of this Smart- Phrase has been well received, highlighting its ease of use and clear, evidence-based guidance. The development and implementation of this tool is expected to improve patient outcomes by reducing preventable admission and treatment delays. Comprehensive data on its impact will be collected and analyzed through chart review and quality data. Discussion: The project involved a multidisciplinary team that developed and implemented an EMR SmartPhrase to improve nursing-led chemotherapy symptom management. By embedding evidence-based algorithms and structured guidelines into nursing documentation and piloting the tool in oncology offices, nurses received real-time, standardized guidance that streamlined clinical decision-making. Positive feedback and ongoing data analysis suggest the SmartPhrase enhances nurse autonomy, care coordination, and compliance with national standards, with the goal of reducing preventable hospital admissions and treatment delays and ultimately improving patient outcomes.
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