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J Am Coll Surg. 2014 Jan;218(1):16-25.e1-4. doi: 10.1016/j.jamcollsurg.2013.09.008. Epub 2013 Nov 23.

Florida Initiative for Quality Cancer Care: improvements on colorectal cancer quality of care indicators during a 3-year interval.

Author information

1
Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL. Electronic address: Erin.Siegel@moffitt.org.
2
Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL.
3
Department of Biostatistics, Moffitt Cancer Center, Tampa, FL.
4
Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL.
5
Center for Cancer Care & Research/Watson Clinic, Lakeland, FL.
6
Florida Cancer Specialists/Sarasota Memorial Hospital, Sarasota, FL.
7
Space Coast Medical Associates, Titusville, FL.
8
Ocala Oncology Center, Ocala, FL.
9
Robert & Carol Weissman Cancer Center at Martin Memorial, Stuart, FL.
10
Mayo Clinic, Jacksonville, FL.
11
Florida Institute of Research, Medicine, and Surgery, Orlando, FL.
12
North Broward Medical Center, Deerfield Beach, FL.
13
Tallahassee Memorial Healthcare, Tallahassee, FL.
14
University of Florida/Shands Cancer Center, Gainesville, FL.

Abstract

BACKGROUND:

The quality of cancer care has become a national priority; however, there are few ongoing efforts to assist medical oncology practices in identifying areas for improvement. The Florida Initiative for Quality Cancer Care is a consortium of 11 medical oncology practices that evaluates the quality of cancer care across Florida. Within this practice-based system of self-assessment, we determined adherence to colorectal cancer quality of care indicators (QCIs) in 2006, disseminated results to each practice and reassessed adherence in 2009. The current report focuses on evaluating the direction and magnitude of change in adherence to QCIs for colorectal cancer patients between the 2 assessments.

STUDY DESIGN:

Medical records were reviewed for all colorectal cancer patients seen by a medical oncologist in 2006 (n = 489) and 2009 (n = 511) at 10 participating practices. Thirty-five indicators were evaluated individually and changes in QCI adherence over time and by site were examined.

RESULTS:

Significant improvements were noted from 2006 to 2009, with large gains in surgical/pathological QCIs (eg, documenting rectal radial margin status, lymphovascular invasion, and the review of ≥ 12 lymph nodes) and medical oncology QCIs (documenting planned treatment regimen and providing recommended neoadjuvant regimens). Documentation of perineural invasion and radial margins significantly improved; however, adherence remained low (47% and 71%, respectively). There was significant variability in adherence for some QCIs across institutions at follow-up.

CONCLUSIONS:

The Florida Initiative for Quality Cancer Care practices conducted self-directed quality-improvement efforts during a 3-year interval and overall adherence to QCIs improved. However, adherence remained low for several indicators, suggesting that organized improvement efforts might be needed for QCIs that remained consistently low over time. Findings demonstrate how efforts such as the Florida Initiative for Quality Cancer Care are useful for evaluating and improving the quality of cancer care at a regional level.

KEYWORDS:

CRC; FIQCC; Florida Initiative for Quality Cancer Care; LN; LVI; NICCQ; National Initiative for Cancer Care Quality; PNI; QCI; QOPI; Quality Oncology Practice Initiative; colorectal cancer; lymph node; lymphovascular invasion; perineural invasion; quality of care indicator

PMID:
24275073
PMCID:
PMC4643215
DOI:
10.1016/j.jamcollsurg.2013.09.008
[Indexed for MEDLINE]
Free PMC Article
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