Degree of variability in performance on breast cancer quality indicators

Findings from the florida initiative for quality cancer care

Jhanelle E. Gray, Christine Laronga, Erin M. Siegel, Ji Hyun Lee, William J. Fulp, Michelle Fletcher, Fred Schreiber, Richard Brown, Richard Levine, Thomas Cartwright, Guillermo Abesada-Terk, George Kim, Carlos Alemany, Douglas Faig, Philip Sharp, Merry Jennifer Markham, David Shibata, Mokenge Malafa, Paul B. Jacobsen

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Purpose: The Florida Initiative for Quality Cancer Care (FIQCC) comprises 11 Florida practice sites that participate in comprehensive reviews of quality of care specific to patients with cancer. Here, we examined site adherence to performance indicators to assess quality of care for patients with breast cancer (BC). Methods: Quality indicators were scripted on the basis of accepted guidelines from the Quality Oncology Practice Initiative, National Comprehensive Cancer Network, American College of Surgeons, and site-specific expert panel consensus. Comprehensive chart reviews, including both medical and surgical oncology quality measures, were conducted for patients with BC first seen in 2006 by a medical oncologist at one of the sites. Statistical comparisons were made by the Pearson χ2 exact test, using Monte Carlo estimation. Results: Charts of 622 patients were reviewed. Of the 34 indicators, seven for medical oncology and four for surgical oncology fell below the 85% level of adherence. A statistically significant difference (P < .001) in variation of performance across the sites was found for the following medical and surgical oncology indicators: documentation of menopausal status, family history, informed consent, planned chemotherapy regimen and flow sheet, American Joint Committee on Cancer staging, HER2/neu status, reporting of margin orientation and inking of the margins, histological grade, having a sentinel lymph node biopsy for invasive BC, and obtaining a mammogram within 14 months of definitive surgery. Conclusion: The FIQCC has identified how multiple aspects of BC care can be improved. Findings are being used at the participating institutions to guide quality improvement efforts.

Original languageEnglish (US)
Pages (from-to)247-251
Number of pages5
JournalJournal of Oncology Practice
Volume7
Issue number4
DOIs
StatePublished - Jul 1 2011

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Quality of Health Care
Medical Oncology
Breast Neoplasms
Neoplasms
Sentinel Lymph Node Biopsy
Neoplasm Staging
Quality Improvement
Informed Consent
Documentation
Consensus
Guidelines
Drug Therapy
Surgical Oncology

All Science Journal Classification (ASJC) codes

  • Oncology
  • Oncology(nursing)
  • Health Policy

Cite this

Degree of variability in performance on breast cancer quality indicators : Findings from the florida initiative for quality cancer care. / Gray, Jhanelle E.; Laronga, Christine; Siegel, Erin M.; Lee, Ji Hyun; Fulp, William J.; Fletcher, Michelle; Schreiber, Fred; Brown, Richard; Levine, Richard; Cartwright, Thomas; Abesada-Terk, Guillermo; Kim, George; Alemany, Carlos; Faig, Douglas; Sharp, Philip; Markham, Merry Jennifer; Shibata, David; Malafa, Mokenge; Jacobsen, Paul B.

In: Journal of Oncology Practice, Vol. 7, No. 4, 01.07.2011, p. 247-251.

Research output: Contribution to journalArticle

Gray, JE, Laronga, C, Siegel, EM, Lee, JH, Fulp, WJ, Fletcher, M, Schreiber, F, Brown, R, Levine, R, Cartwright, T, Abesada-Terk, G, Kim, G, Alemany, C, Faig, D, Sharp, P, Markham, MJ, Shibata, D, Malafa, M & Jacobsen, PB 2011, 'Degree of variability in performance on breast cancer quality indicators: Findings from the florida initiative for quality cancer care', Journal of Oncology Practice, vol. 7, no. 4, pp. 247-251. https://doi.org/10.1200/JOP.2010.000174
Gray, Jhanelle E. ; Laronga, Christine ; Siegel, Erin M. ; Lee, Ji Hyun ; Fulp, William J. ; Fletcher, Michelle ; Schreiber, Fred ; Brown, Richard ; Levine, Richard ; Cartwright, Thomas ; Abesada-Terk, Guillermo ; Kim, George ; Alemany, Carlos ; Faig, Douglas ; Sharp, Philip ; Markham, Merry Jennifer ; Shibata, David ; Malafa, Mokenge ; Jacobsen, Paul B. / Degree of variability in performance on breast cancer quality indicators : Findings from the florida initiative for quality cancer care. In: Journal of Oncology Practice. 2011 ; Vol. 7, No. 4. pp. 247-251.
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AU - Alemany, Carlos

AU - Faig, Douglas

AU - Sharp, Philip

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