Evaluating the quality of colorectal cancer care in the state of Florida: Results from the Florida initiative for quality cancer care

Erin M. Siegel, Paul B. Jacobsen, Mokenge Malafa, William Fulp, Michelle Fletcher, Ji Hyun Lee, Jesusa Corazon R. Smith, Richard Brown, Richard Levine, Thomas Cartwright, Guillermo Abesada-Terk, George Kim, Carlos Alemany, Douglas Faig, Philip Sharp, Merry Jennifer Markham, David Shibata

Research output: Contribution to journalArticle

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Abstract

Purpose: The Florida Initiative for Quality Cancer Care (FIQCC) was established to evaluate the quality of cancer care at the regional level across the state of Florida. This study assessed adherence to validated quality indicators in colorectal cancer (CRC) and the variability in adherence by practice site, volume, and patient age. Methods: The FIQCC is a consortium of 11 medical oncology practices in Florida. Medical record reviews were conducted for 507 patients diagnosed with CRC and seen as new medical oncology patients in 2006. Thirty-five indicators were evaluated individually and categorized across clinical domains and components of care. Results: The mean adherence for 19 of 35 individual indicators was > 85%. Pathology reports were compliant on reporting depth of tumor invasion (96%; range, 86% to 100%), grade (93%; range, 72% to 100%), and status of proximal and distal surgical resection margins (97%; range. 86% to 100%); however, documentation of lymphovascular and perineural invasion did not meet adherence standards (76%; range, 53% to 100% and 39%; range, 5% to 83%, respectively). Among patients with nonmetastatic rectal cancer, documentation of the status of surgical radial margins was consistently low across sites (42%; range, 0% to 100%; P = .19). Documentation of planned treatment regimens for adjuvant chemotherapy was noted in only 58% of eligible patients. Conclusion: In this large regional initiative, we found high levels of adherence to more than half of the established quality indicators. Although the quality of care delivered within FIQCC practices seems to be high, several components of care were identified that warrant further scrutiny on both a systemic level and at individual centers.

Original languageEnglish (US)
Pages (from-to)239-246
Number of pages8
JournalJournal of Oncology Practice
Volume8
Issue number4
DOIs
StatePublished - Jul 1 2012

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Quality of Health Care
Colorectal Neoplasms
Documentation
Medical Oncology
Neoplasms
Adjuvant Chemotherapy
Rectal Neoplasms
Medical Records
Pathology
Margins of Excision

All Science Journal Classification (ASJC) codes

  • Oncology
  • Oncology(nursing)
  • Health Policy

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Evaluating the quality of colorectal cancer care in the state of Florida : Results from the Florida initiative for quality cancer care. / Siegel, Erin M.; Jacobsen, Paul B.; Malafa, Mokenge; Fulp, William; Fletcher, Michelle; Lee, Ji Hyun; Smith, Jesusa Corazon R.; Brown, Richard; Levine, Richard; Cartwright, Thomas; Abesada-Terk, Guillermo; Kim, George; Alemany, Carlos; Faig, Douglas; Sharp, Philip; Markham, Merry Jennifer; Shibata, David.

In: Journal of Oncology Practice, Vol. 8, No. 4, 01.07.2012, p. 239-246.

Research output: Contribution to journalArticle

Siegel, EM, Jacobsen, PB, Malafa, M, Fulp, W, Fletcher, M, Lee, JH, Smith, JCR, Brown, R, Levine, R, Cartwright, T, Abesada-Terk, G, Kim, G, Alemany, C, Faig, D, Sharp, P, Markham, MJ & Shibata, D 2012, 'Evaluating the quality of colorectal cancer care in the state of Florida: Results from the Florida initiative for quality cancer care', Journal of Oncology Practice, vol. 8, no. 4, pp. 239-246. https://doi.org/10.1200/JOP.2011.000477
Siegel, Erin M. ; Jacobsen, Paul B. ; Malafa, Mokenge ; Fulp, William ; Fletcher, Michelle ; Lee, Ji Hyun ; Smith, Jesusa Corazon R. ; Brown, Richard ; Levine, Richard ; Cartwright, Thomas ; Abesada-Terk, Guillermo ; Kim, George ; Alemany, Carlos ; Faig, Douglas ; Sharp, Philip ; Markham, Merry Jennifer ; Shibata, David. / Evaluating the quality of colorectal cancer care in the state of Florida : Results from the Florida initiative for quality cancer care. In: Journal of Oncology Practice. 2012 ; Vol. 8, No. 4. pp. 239-246.
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abstract = "Purpose: The Florida Initiative for Quality Cancer Care (FIQCC) was established to evaluate the quality of cancer care at the regional level across the state of Florida. This study assessed adherence to validated quality indicators in colorectal cancer (CRC) and the variability in adherence by practice site, volume, and patient age. Methods: The FIQCC is a consortium of 11 medical oncology practices in Florida. Medical record reviews were conducted for 507 patients diagnosed with CRC and seen as new medical oncology patients in 2006. Thirty-five indicators were evaluated individually and categorized across clinical domains and components of care. Results: The mean adherence for 19 of 35 individual indicators was > 85{\%}. Pathology reports were compliant on reporting depth of tumor invasion (96{\%}; range, 86{\%} to 100{\%}), grade (93{\%}; range, 72{\%} to 100{\%}), and status of proximal and distal surgical resection margins (97{\%}; range. 86{\%} to 100{\%}); however, documentation of lymphovascular and perineural invasion did not meet adherence standards (76{\%}; range, 53{\%} to 100{\%} and 39{\%}; range, 5{\%} to 83{\%}, respectively). Among patients with nonmetastatic rectal cancer, documentation of the status of surgical radial margins was consistently low across sites (42{\%}; range, 0{\%} to 100{\%}; P = .19). Documentation of planned treatment regimens for adjuvant chemotherapy was noted in only 58{\%} of eligible patients. Conclusion: In this large regional initiative, we found high levels of adherence to more than half of the established quality indicators. Although the quality of care delivered within FIQCC practices seems to be high, several components of care were identified that warrant further scrutiny on both a systemic level and at individual centers.",
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AU - Fulp, William

AU - Fletcher, Michelle

AU - Lee, Ji Hyun

AU - Smith, Jesusa Corazon R.

AU - Brown, Richard

AU - Levine, Richard

AU - Cartwright, Thomas

AU - Abesada-Terk, Guillermo

AU - Kim, George

AU - Alemany, Carlos

AU - Faig, Douglas

AU - Sharp, Philip

AU - Markham, Merry Jennifer

AU - Shibata, David

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N2 - Purpose: The Florida Initiative for Quality Cancer Care (FIQCC) was established to evaluate the quality of cancer care at the regional level across the state of Florida. This study assessed adherence to validated quality indicators in colorectal cancer (CRC) and the variability in adherence by practice site, volume, and patient age. Methods: The FIQCC is a consortium of 11 medical oncology practices in Florida. Medical record reviews were conducted for 507 patients diagnosed with CRC and seen as new medical oncology patients in 2006. Thirty-five indicators were evaluated individually and categorized across clinical domains and components of care. Results: The mean adherence for 19 of 35 individual indicators was > 85%. Pathology reports were compliant on reporting depth of tumor invasion (96%; range, 86% to 100%), grade (93%; range, 72% to 100%), and status of proximal and distal surgical resection margins (97%; range. 86% to 100%); however, documentation of lymphovascular and perineural invasion did not meet adherence standards (76%; range, 53% to 100% and 39%; range, 5% to 83%, respectively). Among patients with nonmetastatic rectal cancer, documentation of the status of surgical radial margins was consistently low across sites (42%; range, 0% to 100%; P = .19). Documentation of planned treatment regimens for adjuvant chemotherapy was noted in only 58% of eligible patients. Conclusion: In this large regional initiative, we found high levels of adherence to more than half of the established quality indicators. Although the quality of care delivered within FIQCC practices seems to be high, several components of care were identified that warrant further scrutiny on both a systemic level and at individual centers.

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