Organization-based performance measures of cancer care quality: core measure development for breast cancer in Taiwan

Abstract

The purpose of the study was to develop organization-based core performance measures (CPMs) for breast cancer patients treated in hospitals that participated in cancer quality improvement programmes in Taiwan. CPMs were developed in three stages that included a preparation, a consensus building stage, and two stages of stakeholder feedback. Three criteria and seven subcriteria were applied in the development process. Indicators listed in a Delphi questionnaire were based on a literature search, indicators developed by relevant institutions and discussion by authors. Each indicator needed to meet inclusion criteria as a final indicator. Evidence-based guidelines, expert opinions from panel group, 27 hospitals and empirical data were all applied to develop and revise the core measures. Fifteen out of 28 indicators were selected and modified after the three stages. There were two pre-treatment indicators for screening and diagnosis, nine treatment-related indicators, and four monitoring-related indicators. Six indicators were supported by evidence level I, and four indicators by level II evidence. The CPMs for breast cancer can be developed systematically and be applied for internal quality improvement and external surveillance. Our experience can be extended to other cancer sites and adapted to link with pay for performance or certification program in cancer care.

Designing a balanced scorecard for a tertiary care hospital in Pakistan: a modified Delphi group exercise

“…The panel represented hospital domains of marketing (managers who conduct quarterly patient satisfaction surveys), clinical quality assurance (clinicians, physician, and nurse managers who monitor quality care indicators), human resource management (staff and managers who conduct annual staff satisfaction surveys), and budget and planning (financial managers furnishing financial reports). As per recommendation of other studies (Chung et al, 2008) it was ensured that experts committed time and involvement until the process was complete.…”

Molecular Subtypes of Breast Cancer Emerging in Young Women in Taiwan: Evidence for More Than Just Westernization as a Reason for the Disease in Asia

“…Taiwan Cancer Database was initiated in 2003 by the Bureau of Health Promotion, Department of Health, Taiwan. A joint breast cancer treatment committee at each participant hospital had established a prospectively collected database (27). Thirtytwo hospitals including NTUH had participated in this program by 2006.…”

Baseline Utilization of Breast Radiotherapy Before Institution of the Medicare Practice Quality Reporting Initiative

“…In contrast, a German population-based study found that 91% of patients with invasive breast cancer received radiotherapy following conservative surgery (6). Further, Taiwan recently adopted receipt of breast radiotherapy as a core performance measure for their nationwide cancer quality improvement program and may consider integration of this measure into a payfor-performance program, although baseline compliance with this measure has not yet been reported (7). As more countries look to measure the quality of their breast cancer programs and further seek to link quality of care to reimbursement, the data in this study will serve as a benchmark to define radiotherapy utilization rates that are achievable in the community practice setting.…”

“…The first step in evaluating the potential impact of PQRI is to determine baseline compliance with PQRI measures before their implementation. Further, quantification of compliance with this quality indicator in the U.S. population will serve as a benchmark for other countries with different health care systems who seek to measure and improve quality of breast cancer care (5)(6)(7). Therefore, we determined baseline utilization of radiotherapy before implementation of PQRI in a cohort of Medicare beneficiaries for whom breast radiotherapy is recommended.…”