Brustzentren?Entwicklung in Deutschland

Brucker

2012

Arch Gynecol Obstet

PurposeThis review summarizes the rationale for the creation of breast centres and discusses the studies conducted in Germany to obtain proof of principle for a voluntary, external benchmarking programme and proof of concept for third-party dual certification of breast centres and their mandatory quality management systems to the German Cancer Society (DKG) and German Society of Senology (DGS) Requirements of Breast Centres and ISO 9001 or similar. In addition, we report the most recent data on benchmarking and certification of breast centres in Germany.MethodsReview and summary of pertinent publications. Literature searches to identify additional relevant studies. Updates from the DKG/DGS programmes.Results and conclusionsImprovements in surrogate parameters as represented by structural and process quality indicators suggest that outcome quality is improving. The voluntary benchmarking programme has gained wide acceptance among DKG/DGS-certified breast centres. This is evidenced by early results from one of the largest studies in multidisciplinary cancer services research, initiated by the DKG and DGS to implement certified breast centres. The goal of establishing a nationwide network of certified breast centres in Germany can be considered largely achieved. Nonetheless the network still needs to be improved, and there is potential for optimization along the chain of care from mammography screening, interventional diagnosis and treatment through to follow-up. Specialization, guideline-concordant procedures as well as certification and recertification of breast centres remain essential to achieve further improvements in quality of breast cancer care and to stabilize and enhance the nationwide provision of high-quality breast cancer care.

Section: Introductionmentioning

confidence: 99%

Multidisciplinary breast centres in Germany: a review and update of quality assurance through benchmarking and certification

Brucker

2012

Arch Gynecol Obstet

“…In this context, the quest for strategies to reduce breast cancer morbidity and mortality has focused on the setting required for the optimal treatment of breast cancer because epidemiological and clinical data have pointed to the urgent need for the reorganisation and improved delivery of breast cancer care [4,5]. …”

Section: Introductionmentioning

confidence: 99%

“…Under this aspect, breast cancer care requires elements of quality management, particularly at the various interfaces along the multidisciplinary and bisectoral, i.e. in- and out-patient, process chain [4,5]. Moreover, all health care providers in Germany are required by national law to perform quality assurance, although certification or other external monitoring of a complete quality management system (QMS) is not mandatory [11].…”

Section: Introductionmentioning

confidence: 99%

Certification of breast centres in Germany: proof of concept for a prototypical example of quality assurance in multidisciplinary cancer care

et al. 2009

BackgroundThe main study objectives were: to develop a set of requirements of comprehensive breast centres; to establish a nationwide voluntary certification programme for breast centres based on such requirements, a certified quality management system (QMS), and scheduled independent, external audits and periodic recertification; and to demonstrate the general acceptance of such a certification programme with a view to introducing similar certification programmes for other major cancers.MethodsBreast centres introduced a QMS and voluntarily participated in an external certification procedure based on guideline-derived Requirements of Breast Centres specifically developed for the application procedure, all subsequent audits and recertification. All data (numbers of pending and successful applications, sites/centre, etc.) were collected by a newly founded, independent organisation for certification of cancer services delivery. Data analysis was descriptive.ResultsRequirements of Breast Centres were developed by the German Cancer Society (DKG), the German Society of Senology (DGS) and other relevant specialist medical societies in the form of a questionnaire comprising 185 essential items based on evidence-based guidelines and the European Society of Breast Cancer Specialists' (EUSOMA) requirements of specialist breast units. From late 2002 to mid 2008, the number of participating breast centres rose from 1 to 175. As of mid 2008, 77% of an estimated 50,000 new breast cancers in Germany were diagnosed and treated at certified breast centres, 78% of which were single-site centres.ConclusionNationwide voluntary certification of breast centres is feasible and well accepted in Germany. Dual certification of breast centres that involves certification of breast services to guideline-derived requirements in conjunction with independent certification of a mandatory QMS can serve as a model for other multidisciplinary site-specific cancer centres.

“…The main objective in establishing such multidisciplinary centers was to ensure that care was based on clinical guidelines and continual quality assurance (QA) measures, and that quality management (QM) systems were introduced. In addition, it has become a legal requirement in Germany in recent years that all healthcare service providers introduce QA programs and maintain a QM system [4,5,8,21].…”

Section: Introductionmentioning

confidence: 99%

“…Since 2003, a QM system and continual QA with comprehensive documentation of all treatments and external analysis of the QA data have also been prerequisites for certification to the Requirements of Breast Centers (Fachliche Anforderungen für Brustzentren; FAB) in Germany [4,5,8,10]. The FAB were jointly developed by the German Cancer Society (Deutsche Krebsgesellschaft; DKG) and the German Society of Senology (Deutsche Gesellschaft für Senologie; DGS) largely on the basis of two evidence-based multidisciplinary level-3 guidelines [1,16,17,22] and the EUSOMA (European Society of Breast Cancer Specialists) requirements for accreditation of breast units [2].…”

Section: Introductionmentioning

confidence: 99%

Optimizing the Quality of Breast Cancer Care at Certified German Breast Centers

et al. 2011

The current data confirm proof-of-concept for the established benchmarking program, which allows participating institutions to be compared and changes in quality of BC care to be tracked over time. Overall, marked QI increases suggest that BC care in Germany improved from 2003-2009. Moreover, it has become possible for the first time to demonstrate improvements in the quality of BC care longitudinally for individual breast centers. In addition, subgroups of relevant QIs can be used to demonstrate the progress achieved, but also the need for further improvement, in specific interdisciplinary specialties.