Documented quality of care in certified colorectal cancer centers in Germany: German Cancer Society benchmarking report for 2013

Purpose Building on previous research documenting differences in preventive care quality between cancer survivors and noncancer controls, this study examines comorbid condition care. Methods Using data from the Surveillance, Epidemiology, and End Results (SEER) –Medicare database, we examined comorbid condition quality of care in patients with locoregional breast, prostate, or colorectal cancer diagnosed in 2004 who were age ≥ 66 years at diagnosis, who had survived ≥ 3 years, and who were enrolled in fee-for-service Medicare. Controls were frequency matched to cases on age, sex, race, and region. Quality of care was assessed from day 366 through day 1,095 postdiagnosis using published indicators of chronic (n = 10) and acute (n = 19) condition care. The proportion of eligible cancer survivors and controls who received recommended care was compared by using Fisher's exact tests. The chronic and acute indicators, respectively, were then combined into single logistic regression models for each cancer type to compare survivors' care receipt to that of controls, adjusting for clinical and sociodemographic variables and controlling for within-patient variation. Results The sample matched 8,661 cancer survivors to 17,322 controls (mean age, 75 years; 65% male; 85% white). Colorectal cancer survivors were less likely than controls to receive appropriate care on both the chronic (odds ratio [OR], 0.88; 95% CI, 0.81 to 0.95) and acute (OR, 0.72; 95% CI, 0.61 to 0.85) indicators. Prostate cancer survivors were more likely to receive appropriate chronic care (OR, 1.28; 95% CI, 1.19 to 1.38) but less likely to receive quality acute care (OR, 0.75; 95% CI, 0.65 to 0.87). Breast cancer survivors received care equivalent to controls on both the chronic (OR, 1.06; 95% CI, 0.96 to 1.17) and acute (OR, 0.92; 95% CI, 0.76 to 1.13) indicators. Conclusion Because we found differences by cancer type, research exploring factors associated with these differences in care quality is needed.

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Quality of Care of Colorectal Cancer Patients in General Hospitals: Diffusion and Impact of Management Guidelines

Tumori Journal ◽

10.1177/030089169007600311 ◽

1990 ◽

Vol 76 (3) ◽

pp. 261-269 ◽

Cited By ~ 4

Author(s):

Giovanni Apolone ◽

Roberto Grilli ◽

Alexan A. Alexanian ◽

Carlo Confalonieri ◽

Roberto Labianca ◽

...

Keyword(s):

Colorectal Cancer ◽

Quality Of Care ◽

Cancer Patients ◽

General Hospitals ◽

Management Guidelines ◽

Colorectal Cancer Patients

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Social Service Counseling in Cancer Centers Certified by the German Cancer Society

Social Work in Health Care ◽

10.1080/00981389.2014.999980 ◽

2015 ◽

Vol 54 (4) ◽

pp. 307-319 ◽

Cited By ~ 10

Author(s):

Christoph Kowalski ◽

Julia Ferencz ◽

Ilse Weis ◽

Holger Adolph ◽

Simone Wesselmann

Keyword(s):

Social Service ◽

German Cancer Society ◽

Cancer Society ◽

Cancer Centers

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Quality measures for the diagnosis and management of colorectal cancer

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.16031 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 16031-16031

Author(s):

M. B. Patwardhan ◽

G. P. Samsa ◽

M. A. Michael ◽

R. G. Prosnitz ◽

D. A. Fisher ◽

...

Keyword(s):

Colorectal Cancer ◽

Rectal Cancer ◽

Quality Of Care ◽

Literature Search ◽

Stage Iv ◽

Quality Measures ◽

The United States ◽

Process Measures ◽

Diagnosis And Management

16031 Background: The huge burden of illness from colorectal cancer (CRC) can be reduced by improving the quality of care for CRC patients. Identifying appropriate quality measures that can assess the processes of care is the first step in this process. Therefore we conducted a comprehensive literature search to identify process measures available in the United States to assess the quality of care for diagnosing and managing patients with CRC and the extent to which they were field-ready. Methods: We conducted a standard literature search using MEDLINE and the Cochrane Database; also explored gray literature, and identified 3771 abstracts. By sequential exclusion, 74 of them were finally included. We included quality measures from traditional QI literature, and supplemented them with those included in studies where these measures were used as part of their research agenda. All measures were abstracted into evidence tables and evaluated using a set of standard criteria regarding their importance, usability, and scientific acceptability. In order to assess the extent to which they were field-ready, we devised a summary rating scale for each quality measure using three criteria: importance and usability, scientific acceptability, and extent of testing. Results: Overall, the coverage of general process measures in CRC is extensive. Process measures are available for diagnostic imaging, staging, surgical therapy, adjuvant chemotherapy, adjuvant radiation therapy, and colonoscopic surveillance. The highest rated measures were those related to chemotherapy (abstract submitted by Morse et al) and pathology reporting. There were no process measures for assessing the quality of: polyp removal, surgical management of stage IV rectal cancer, hepatic metastasis, chemotherapy for stage II colon cancer, stage IV rectal cancer, radiation for stage IV rectal cancer, and notes for endoscopy, surgery, chemotherapy and radiology - all because of lack of guidelines. Conclusions: Our evidence report suggests that we need to actively pursue the task of developing scientifically accurate quality measures for leverage points in the diagnosis and management of CRC; so we can evaluate the quality of care delivered by providers and initiate quality improvement activities, with the aim of providing better patient care. No significant financial relationships to disclose.

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The ASH Practice Improvement Module in Non-Hodgkin Lymphoma: Assessing the Feasibility, Reliability and Usefulness of a New Quality Improvement Tool

Blood ◽

10.1182/blood.v124.21.2651.2651 ◽

2014 ◽

Vol 124 (21) ◽

pp. 2651-2651 ◽

Cited By ~ 1

Author(s):

Michael D Jain ◽

Lee Mozessohn ◽

Lauren M Gerard ◽

Jackie Ostro ◽

Mansoor Radwi ◽

...

Keyword(s):

Quality Of Care ◽

Hepatitis B ◽

Patient Care ◽

Pathological Diagnosis ◽

Cancer Centers ◽

Greater Toronto Area ◽

Non Hodgkin Lymphoma ◽

Fertility Counseling ◽

Hepatitis B Testing

Abstract Background:The American Society of Hematology Practice Improvement Modules (ASH PIMs) are online tools designed for clinicians to monitor the quality of care in their practice. The ASH PIM for non-Hodgkin lymphoma (NHL) was designed by a committee of NHL experts and was recently released in the ASH Academy. The ASH PIM for NHL defines quality metrics in six areas: pathological diagnosis, staging, Hepatitis B testing, use of growth factors, vaccination, and fertility counseling. Objectives:1) Use the ASH PIM for NHL to measure quality of care at 4 cancer centers in the Greater Toronto Area. 2) Assess the feasibility, reliability, and usefulness of the ASH PIM for NHL. Methods:To measure quality of care, 78 patients undergoing first line chemotherapy for NHL were reviewed at 4 cancer centers (3 academic centers and 1 community center) near Toronto, Canada. Two hematology fellows independently scored each patient chart for the 6 quality metrics in the ASH PIM. After data collection, interviews (using structured questionnaires) were conducted with the chart reviewers as well as with physicians experienced at treating NHL. Results: Three out of the 4 cancer centers had high performances (>90%) in pathological diagnosis and staging. Two of the 4 centers had high performances for Hepatitis B testing. Zero of the 4 centers had high performances for documenting growth factor use, vaccinations and fertility counseling. A feasibility questionnaire revealed that each chart required 15 minutes for review. Reviewers noted that the ASH PIM for NHL was clear for how to score pathological diagnosis, staging, and hepatitis B testing (mean score >4 out of 5 for clarity), but unclear for how to score the use of vaccinations (mean 2.3/5). Reviewers were able to accurately score pathological diagnosis, staging, and hepatitis B (mean >4/5 for perceived accuracy), but were unable to accurately score vaccination and fertility counseling (mean <3/5). Interviews revealed concern that practices around vaccination and fertility counseling were not being well documented in the medical record. Inter-rater reliability was high across all 6 metrics (Gwet’s first order agreement coefficient 0.81 – 0.97). Of the 6 metrics, experienced NHL physicians rated pathological diagnosis and staging as most important, with vaccination and growth factor use rated as least important. When provided with the performance data for their own center, the results were perceived to accurately reflect patient care in 5 out of 6 of the metrics. Performance on fertility counseling was thought to be under-estimated due to poor documentation. Overall, the ASH PIM for NHL was perceived to capture the quality of patient care moderately well. Areas not captured by the ASH PIM, but perceived to be important to NHL patient care included: the reduction of delays between lymphoma suspicion and first treatment, patient satisfaction, and advanced care planning. Conclusions: The ASH PIM for NHL is feasible, reliable, and measures a number of important aspects of patient care. Some metrics could be made clearer by including more explicit definitions. Performance on the metrics relying on clinical documentation was not as high as for those relying on objective testing. The performance of cancer centers in the Greater Toronto Area on the ASH PIM for NHL suggests specific areas for quality improvement at each center. Disclosures Hicks: Gilead: Research Funding.

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1009 Timely Access and Quality of Care in Colorectal Cancer: Are They Related?

Gastroenterology ◽

10.1016/s0016-5085(08)60709-x ◽

2008 ◽

Vol 134 (4) ◽

pp. A-152

Author(s):

Yarrow McConnell ◽

Karen Inglis ◽

Geoff Porter

Keyword(s):

Colorectal Cancer ◽

Quality Of Care ◽

Timely Access ◽

Access And Quality

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Measuring Quality of Care in the Treatment of Colorectal Cancer: The Moffitt Quality Practice Initiative

Journal of Oncology Practice ◽

10.1200/jop.0722002 ◽

2007 ◽

Vol 3 (2) ◽

pp. 60-65 ◽

Cited By ~ 10

Author(s):

Paul B. Jacobsen ◽

David Shibata ◽

Erin M. Siegel ◽

Mihaela Druta ◽

Ji-Hyun Lee ◽

...

Keyword(s):

Colorectal Cancer ◽

Quality Of Care ◽

Cancer Care ◽

Medical Records ◽

Initial Phase ◽

Pathology Report ◽

Self Assessment ◽

Specific Level ◽

Lower Adherence

Purpose The Moffitt Quality Practice Initiative (MQPI) is a practice-based system of quality self-assessment, the ultimate goal of which is to improve the quality of cancer care at a statewide level. The initial phase of this project focused on developing procedures, determining feasibility, and evaluating utility for assessing quality of care for colorectal cancer within an existing affiliate network. Patients and Methods Representatives from four oncology groups selected quality measures consistent with evidence-, consensus-, and safety-based guidelines that could be abstracted from medical records. Trained abstractors then reviewed records of all eligible colorectal patients seen by each practice in 2004. Frequencies of responses for each indicator were tabulated for overall and practice-specific level of adherence and were compared among practices. Results Adherence was uniformly high for several indicators, including confirmatory pathology report, staging information, and chemotherapy discussion or recommendation. Lower adherence was evident across practices for performance of carcinoembryonic tests and complete colonoscopic evaluations. Significant variation among practices was evident only for consent for chemotherapy. Conclusion The initial phase of MQPI demonstrated the feasibility and utility of assessing quality indicators for colorectal cancer among members of an existing affiliate network. Findings identified areas where adherence to care was uniformly high, but also identified areas where both overall and practice-specific adherence were less than optimal. These efforts lay the groundwork for expanding MQPI in several directions that have in common the potential to improve the quality of cancer care on a statewide basis.

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