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J Oncol Pract. 2011 Nov;7(6):e25-31.

Quality of care in non-small-cell lung cancer: findings from 11 oncology practices in Florida.

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H. Lee Moffitt Cancer Center and Research Institute, Tampa; Center for Cancer Care and Research, Lakeland; Florida Cancer Specialists, Sarasota; Space Coast Medical Associates, Titusville; Ocala Oncology Center, Ocala; Robert and Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Cancer Centers of Florida, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; University of Florida/Shands Cancer Center, Gainesville, FL; Karmanos Cancer Institute, Detroit, MI.



Limited data on the quality of care in non-small-cell lung cancer (NSCLC) are available. This study aims to assess the quality of care in NSCLC among 11 medical oncology practices in Florida and to explore the impact of practice volume on care.


Clinical guidelines and existing indicators were reviewed, and an expert survey was conducted to identify a set of process-based quality of care indicators (QI). Medical records of new patients with NSCLC seen in 2006 were retrospectively reviewed for the adherence to these QIs.


We reviewed the compliance with a set of 11 QIs (four general and seven NSCLC specific) among 531 patients. The patient median age was 68 years; 51% were male, and 49% had advanced NSCLC. The median adherence rates to general QIs and NSCLC-specific QIs were 95% (range 69% to 99%) and 69% (range 29% to 91%), respectively. We identified three main areas of deficiencies: chemotherapy consenting (69%), brain staging for stage III NSCLC (59%), and performance status assessment for advanced stages (42%). Significant variation in the adherence rates across practice sites was observed in five of 11 QIs.


On the basis of this data set of participating institutions in Florida, several areas in the care of patients with NSCLC were identified as targets for future quality improvement efforts.

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