The association between quality care and outcomes for a real-world population of Australian patients diagnosed with pancreatic cancer

Maharaj, Ashika; Evans, Sue; Ioannou, Liane; Croagh, Daniel; Earnest, Arul; Holland, Jennifer; Pilgrim, Charles; Neale, Rachel E.; Goldstein, David; Kench, James G.; Merrett, Neil D.; White, Kate; Burmeister, Elizabeth; Evans, Peter; Hayes, Theresa; Houli, Nezor; Knowles, Brett; Leong, Trevor; Nikfarjam, Mehrdad; Philip, Jennifer; Quinn, Maddy; Shapiro, Jeremy; Smith, M E Beth; Spillane, John; Wong, Rachel; Zalcberg, John

doi:10.1016/j.hpb.2021.11.005

Cited by 3 publications

(5 citation statements)

References 29 publications

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“…The implementation and subsequent evaluation of these QIs will draw greater awareness to the opportunity to improve quality of care for patients diagnosed with HCC by facilitating clinician and stakeholder engagement. [ 7 ] This will be achieved by providing risk‐adjusted benchmarked reports to participating hospital sites that will highlight variations in care and clinical outcomes at a health‐service level. [ 27 ] For participating sites to meet the optimal care QIs, all data variables/points will need to be met to comply with the overall QI.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Such QIs reflect compliance with processes of care that represent optimal practice; they should be evidence based and supported by expert opinion as well as being acceptable to a wide range of stakeholders and, importantly, feasible to measure. [7] The aim of this study was to develop a core set of nationally agreed QIs for the diagnosis, staging, and management of HCC by using a modified Delphi (mDelphi) consensus method. These QIs will be critical in measuring quality of care in HCC and understanding the extent of variation in the provision of high-quality care as well as the impact of this variation on clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Monitoring quality of care in hepatocellular carcinoma: A modified Delphi consensus

et al. 2022

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Although there are several established international guidelines on the management of hepatocellular carcinoma (HCC), there is limited information detailing specific indicators of good quality care. The aim of this study was to develop a core set of quality indicators (QIs) to underpin the management of HCC. We undertook a modified, two-round, Delphi consensus study comprising a working group and experts involved in the management of HCC as well as consumer representatives. QIs were derived from an extensive review of the literature. The role of the participants was to identify the most important and measurable QIs for inclusion in an HCC clinical quality registry. From an initial 94 QIs, 40 were proposed to the participants. Of these, 23 QIs ultimately met the inclusion criteria and were included in the final set. This included (a) nine related to the initial diagnosis and staging, including timing to diagnosis, required baseline clinical and laboratory assessments, prior surveillance for HCC, diagnostic imaging and pathology, tumor staging, and multidisciplinary care; (b) thirteen related to treatment and management, including role of antiviral therapy, timing to treatment, localized ablation and locoregional therapy, surgery, transplantation, systemic therapy, method of response assessment, and supportive care; and (c) one outcome assessment related to surgical mortality. Conclusion: We identified a core set of nationally agreed measurable QIs for the diagnosis, staging, and management of HCC. The adherence to these best practice QIs may lead to system-level improvement in quality of care and, ultimately, improvement in patient outcomes, including survival.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Monitoring quality of care in hepatocellular carcinoma: A modified Delphi consensus

et al. 2022

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“…They enable identification of best practice and can support shared learning. A metrics-based approach has been established to accredit and audit cancer centres in other tumour types, such as pancreatic, rectal and urological cancers, in healthcare systems equivalent to the UK, including Canada, Australia and Portugal [20][21][22][23]. QPIs include both clinical outcome measures, such as rate of postoperative complications, surgical mortality, surgical resection margins, colostomy rates, length of stay, readmission, recurrence rates and overall survival, as well as process measures, such as time from diagnosis to complete staging and to start of treatment.…”

Section: Learning From Other Health Systems: the Case For Evidence-ba...mentioning

confidence: 99%

British Gynaecological Cancer Society Recommendations for Evidence Based, Population Data Derived Quality Performance Indicators for Ovarian Cancer

Sundar

Nordin

Morrison

et al. 2023

Cancers

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Ovarian cancer survival in the UK lags behind comparable countries. Results from the ongoing National Ovarian Cancer Audit feasibility pilot (OCAFP) show that approximately 1 in 4 women with advanced ovarian cancer (Stage 2, 3, 4 and unstaged cancer) do not receive any anticancer treatment and only 51% in England receive international standard of care treatment, i.e., the combination of surgery and chemotherapy. The audit has also demonstrated wide variation in the percentage of women receiving anticancer treatment for advanced ovarian cancer, be it surgery or chemotherapy across the 19 geographical regions for organisation of cancer delivery (Cancer Alliances). Receipt of treatment also correlates with survival: 5 year Cancer survival varies from 28.6% to 49.6% across England. Here, we take a systems wide approach encompassing both diagnostic pathways and cancer treatment, derived from the whole cohort of women with ovarian cancer to set out recommendations and quality performance indicators (QPI). A multidisciplinary panel established by the British Gynaecological Cancer Society carefully identified QPI against criteria: metrics selected were those easily evaluable nationally using routinely available data and where there was a clear evidence base to support interventions. These QPI will be valuable to other taxpayer funded systems with national data collection mechanisms and are to our knowledge the only population level data derived standards in ovarian cancer. We also identify interventions for Best practice and Research recommendations.

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“…3 Preliminary findings using the registry data to explore compliance with clinical indicators as well as evaluate the association between compliance and survival, found that patients diagnosed in a regional area or diagnosed in a hospital with annual case volume of less than 10 had an increased risk of death in a univariate analysis. 4 The PC module of the UGICR has also been a platform for a number of research studies, including an innovative registry-based, randomized controlled trial of symptom monitoring and centralized care coordination.Funding to support existing data capture as well as expand this registry across Australia is badly needed. This would provide an opportunity to measure variation and monitor care at a national level as proposed by the authors.…”

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National clinical quality registry for pancreatic cancer – the time is nigh

Ioannou

Zalcberg

Croagh

2022

ANZ Journal of Surgery

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National clinical quality registry for pancreatic cancerthe time is nigh Dear Editor, We note the editorial by Aitken. 1 We would like to applaud the author for raising awareness of the variability in outcomes from pancreaticoduodenectomy (PD) across Australia and for advocating for a national pancreatic cancer (PC) clinical quality registry (CQR).In fact, in 2016, Monash University developed an Upper Gastrointestinal Cancer Registry (UGICR)a CQR that adheres to the framework outlined by the Australian Commission on Safety and Quality in Health Care (ACSQHC). The UGICR is a multi-modular registry that includes a module on PC (as well as oesophagogastric, biliary and primary liver cancers). The PC module was originally piloted in 2017, and now has data on 4225 people with PC recruited from 60+ participating hospitals across Victoria and New South Wales. 2 In line with the ACSQHC framework, the PC module of the UGICR routinely collects data to monitor the quality of care provided to individuals with PC by measuring and benchmarking clinical indicators to identify variations in care to improve patient outcomes. 3 Preliminary findings using the registry data to explore compliance with clinical indicators as well as evaluate the association between compliance and survival, found that patients diagnosed in a regional area or diagnosed in a hospital with annual case volume of less than 10 had an increased risk of death in a univariate analysis. 4 The PC module of the UGICR has also been a platform for a number of research studies, including an innovative registry-based, randomized controlled trial of symptom monitoring and centralized care coordination.Funding to support existing data capture as well as expand this registry across Australia is badly needed. This would provide an opportunity to measure variation and monitor care at a national level as proposed by the authors.

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The association between quality care and outcomes for a real-world population of Australian patients diagnosed with pancreatic cancer

Cited by 3 publications

References 29 publications

Monitoring quality of care in hepatocellular carcinoma: A modified Delphi consensus

Monitoring quality of care in hepatocellular carcinoma: A modified Delphi consensus

British Gynaecological Cancer Society Recommendations for Evidence Based, Population Data Derived Quality Performance Indicators for Ovarian Cancer

National clinical quality registry for pancreatic cancer – the time is nigh

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