Guideline-Based Quality Indicators for Kidney and Bladder Cancer in Germany: Development and Implementation

Abstract

<b><i>Introduction:</i></b> As part of the development of the evidence-based (S3) clinical practice guidelines for kidney and bladder cancer by the German Guideline Program in Oncology, quality indicators (QIs) were defined to measure the quality of care. Based on these guidelines and QIs, the German Cancer Society (DKG) developed two new certification systems. The aim of this article is to show the process of development and implementation of QIs in certified cancer centres. <b><i>Methods:</i></b> Based on strong recommendations of each guideline and an additional systematic literature review for national and international QIs, two sets of QIs were derived in a multistep standardized approach. These QIs were implemented in the centres in certification data sheets to measure their outcomes. First results of treatment years 2018 and 2019 are available. <b><i>Results:</i></b> The final sets include 9 QIs for kidney cancer and 12 QIs for bladder cancer. Two-thirds of the QIs were transferred to the data sheets. In 2018 and 2019, the results of all but one QI are within the plausibility limits. From 2020 on, they are replaced by stricter target values that will challenge centres to improve their outcomes. <b><i>Conclusions:</i></b> Guideline-derived QIs make relevant aspects of patient care measurable and consequently improvable. The first QI results are encouraging. However, the DKG certification system and the methods of measuring quality are under ongoing development. Systematic QI implementation and evaluation may help to generate broader databases and thus expand knowledge.

Implementation of quality indicators for vulvar cancer in gynaecological cancer centres certified by the German Cancer Society (DKG)

“…Using guideline based QIs to implement and assess medical care for women with vulvar cancer can have a positive impact on measuring of high-quality patient care, and this aids in the improvement of quality in diagnosis and treatment over the long term (Rückher et al 2022 ; Butea-Bocu et al 2021 ; Beckmann et al 2011 ; Haj et al 2017 ; Kreienberg et al 2018 ; Trautmann et al 2018 ).…”

“…The quality indicators derived from these guidelines play a crucial role in maintaining these standards (Kowalski et al 2017 ). The primary objective of the DKG certification system is to ensure a high level of quality in the treatment of cancer patients within certified gynaecological cancer centres (Stuebs et al 2023 ; Rückher et al 2022 ).…”

“…The quality cycle serves as an interdisciplinary network, as depicted in Fig. 1 (Stuebs et al 2023 ; Rückher et al 2022 ). This article presents the methodology of QI development for vulvar cancer in the context of clinical guideline development and analyses the results of these QIs from the certified cancer centres (Rückher et al 2022 ; Langendam et al 2020 ; Nothacker et al 2016 ).…”

Weiterentwicklung und Vernetzung der onkologischen Versorgungsstrukturen, der Qualitätssicherung und der Forschung

“…Die jährliche Gesamtübersicht aller onkologischen Leitlinienthe men zeigt, dass aus 30 Leitlinienthemen 221 Qualitätsindikatoren (Range: 1 bis 13 pro Leitlinie) abgeleitet wurden [4]. Auch wurde evaluiert, wie viele der von den LL-Gruppen definierten QI-Vor schläge implementiert werden konnten [5][6][7].…”

Development and Update of Guideline-based Quality Indicators in Lung Cancer

“…As essential part of the quality cycle in oncology, these parameters are evaluated by the DKG and reflected to both, the certified cancer centers, and the German Guideline Program in Oncology (GGPO) (▶ Fig. 1) [15]. The quality cycle describes the information flow between the above-mentioned partners and is embedded into the National Cancer Plan.…”