Florida initiative for quality cancer care

Improvements on colorectal cancer quality of care indicators during a 3-year interval

Erin M. Siegel, Paul B. Jacobsen, Ji Hyun Lee, Mokenge Malafa, William Fulp, Michelle Fletcher, 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

12 Citations (Scopus)

Abstract

Background The quality of cancer care has become a national priority; however, there are few ongoing efforts to assist medical oncology practices in identifying areas for improvement. The Florida Initiative for Quality Cancer Care is a consortium of 11 medical oncology practices that evaluates the quality of cancer care across Florida. Within this practice-based system of self-assessment, we determined adherence to colorectal cancer quality of care indicators (QCIs) in 2006, disseminated results to each practice and reassessed adherence in 2009. The current report focuses on evaluating the direction and magnitude of change in adherence to QCIs for colorectal cancer patients between the 2 assessments. Study Design Medical records were reviewed for all colorectal cancer patients seen by a medical oncologist in 2006 (n = 489) and 2009 (n = 511) at 10 participating practices. Thirty-five indicators were evaluated individually and changes in QCI adherence over time and by site were examined. Results Significant improvements were noted from 2006 to 2009, with large gains in surgical/pathological QCIs (eg, documenting rectal radial margin status, lymphovascular invasion, and the review of ≥12 lymph nodes) and medical oncology QCIs (documenting planned treatment regimen and providing recommended neoadjuvant regimens). Documentation of perineural invasion and radial margins significantly improved; however, adherence remained low (47% and 71%, respectively). There was significant variability in adherence for some QCIs across institutions at follow-up. Conclusions The Florida Initiative for Quality Cancer Care practices conducted self-directed quality-improvement efforts during a 3-year interval and overall adherence to QCIs improved. However, adherence remained low for several indicators, suggesting that organized improvement efforts might be needed for QCIs that remained consistently low over time. Findings demonstrate how efforts such as the Florida Initiative for Quality Cancer Care are useful for evaluating and improving the quality of cancer care at a regional level.

Original languageEnglish (US)
JournalJournal of the American College of Surgeons
Volume218
Issue number1
DOIs
StatePublished - Jan 1 2014

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Quality of Health Care
Colorectal Neoplasms
Neoplasms
Medical Oncology
Quality Improvement
Documentation
Medical Records

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Florida initiative for quality cancer care : Improvements on colorectal cancer quality of care indicators during a 3-year interval. / Siegel, Erin M.; Jacobsen, Paul B.; Lee, Ji Hyun; Malafa, Mokenge; Fulp, William; Fletcher, Michelle; 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 the American College of Surgeons, Vol. 218, No. 1, 01.01.2014.

Research output: Contribution to journalArticle

Siegel, EM, Jacobsen, PB, Lee, JH, Malafa, M, Fulp, W, Fletcher, M, Smith, JCR, Brown, R, Levine, R, Cartwright, T, Abesada-Terk, G, Kim, G, Alemany, C, Faig, D, Sharp, P, Markham, MJ & Shibata, D 2014, 'Florida initiative for quality cancer care: Improvements on colorectal cancer quality of care indicators during a 3-year interval', Journal of the American College of Surgeons, vol. 218, no. 1. https://doi.org/10.1016/j.jamcollsurg.2013.09.008
Siegel, Erin M. ; Jacobsen, Paul B. ; Lee, Ji Hyun ; Malafa, Mokenge ; Fulp, William ; Fletcher, Michelle ; 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. / Florida initiative for quality cancer care : Improvements on colorectal cancer quality of care indicators during a 3-year interval. In: Journal of the American College of Surgeons. 2014 ; Vol. 218, No. 1.
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abstract = "Background The quality of cancer care has become a national priority; however, there are few ongoing efforts to assist medical oncology practices in identifying areas for improvement. The Florida Initiative for Quality Cancer Care is a consortium of 11 medical oncology practices that evaluates the quality of cancer care across Florida. Within this practice-based system of self-assessment, we determined adherence to colorectal cancer quality of care indicators (QCIs) in 2006, disseminated results to each practice and reassessed adherence in 2009. The current report focuses on evaluating the direction and magnitude of change in adherence to QCIs for colorectal cancer patients between the 2 assessments. Study Design Medical records were reviewed for all colorectal cancer patients seen by a medical oncologist in 2006 (n = 489) and 2009 (n = 511) at 10 participating practices. Thirty-five indicators were evaluated individually and changes in QCI adherence over time and by site were examined. Results Significant improvements were noted from 2006 to 2009, with large gains in surgical/pathological QCIs (eg, documenting rectal radial margin status, lymphovascular invasion, and the review of ≥12 lymph nodes) and medical oncology QCIs (documenting planned treatment regimen and providing recommended neoadjuvant regimens). Documentation of perineural invasion and radial margins significantly improved; however, adherence remained low (47{\%} and 71{\%}, respectively). There was significant variability in adherence for some QCIs across institutions at follow-up. Conclusions The Florida Initiative for Quality Cancer Care practices conducted self-directed quality-improvement efforts during a 3-year interval and overall adherence to QCIs improved. However, adherence remained low for several indicators, suggesting that organized improvement efforts might be needed for QCIs that remained consistently low over time. Findings demonstrate how efforts such as the Florida Initiative for Quality Cancer Care are useful for evaluating and improving the quality of cancer care at a regional level.",
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T2 - Improvements on colorectal cancer quality of care indicators during a 3-year interval

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AU - Jacobsen, Paul B.

AU - Lee, Ji Hyun

AU - Malafa, Mokenge

AU - Fulp, William

AU - Fletcher, Michelle

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 - Background The quality of cancer care has become a national priority; however, there are few ongoing efforts to assist medical oncology practices in identifying areas for improvement. The Florida Initiative for Quality Cancer Care is a consortium of 11 medical oncology practices that evaluates the quality of cancer care across Florida. Within this practice-based system of self-assessment, we determined adherence to colorectal cancer quality of care indicators (QCIs) in 2006, disseminated results to each practice and reassessed adherence in 2009. The current report focuses on evaluating the direction and magnitude of change in adherence to QCIs for colorectal cancer patients between the 2 assessments. Study Design Medical records were reviewed for all colorectal cancer patients seen by a medical oncologist in 2006 (n = 489) and 2009 (n = 511) at 10 participating practices. Thirty-five indicators were evaluated individually and changes in QCI adherence over time and by site were examined. Results Significant improvements were noted from 2006 to 2009, with large gains in surgical/pathological QCIs (eg, documenting rectal radial margin status, lymphovascular invasion, and the review of ≥12 lymph nodes) and medical oncology QCIs (documenting planned treatment regimen and providing recommended neoadjuvant regimens). Documentation of perineural invasion and radial margins significantly improved; however, adherence remained low (47% and 71%, respectively). There was significant variability in adherence for some QCIs across institutions at follow-up. Conclusions The Florida Initiative for Quality Cancer Care practices conducted self-directed quality-improvement efforts during a 3-year interval and overall adherence to QCIs improved. However, adherence remained low for several indicators, suggesting that organized improvement efforts might be needed for QCIs that remained consistently low over time. Findings demonstrate how efforts such as the Florida Initiative for Quality Cancer Care are useful for evaluating and improving the quality of cancer care at a regional level.

AB - Background The quality of cancer care has become a national priority; however, there are few ongoing efforts to assist medical oncology practices in identifying areas for improvement. The Florida Initiative for Quality Cancer Care is a consortium of 11 medical oncology practices that evaluates the quality of cancer care across Florida. Within this practice-based system of self-assessment, we determined adherence to colorectal cancer quality of care indicators (QCIs) in 2006, disseminated results to each practice and reassessed adherence in 2009. The current report focuses on evaluating the direction and magnitude of change in adherence to QCIs for colorectal cancer patients between the 2 assessments. Study Design Medical records were reviewed for all colorectal cancer patients seen by a medical oncologist in 2006 (n = 489) and 2009 (n = 511) at 10 participating practices. Thirty-five indicators were evaluated individually and changes in QCI adherence over time and by site were examined. Results Significant improvements were noted from 2006 to 2009, with large gains in surgical/pathological QCIs (eg, documenting rectal radial margin status, lymphovascular invasion, and the review of ≥12 lymph nodes) and medical oncology QCIs (documenting planned treatment regimen and providing recommended neoadjuvant regimens). Documentation of perineural invasion and radial margins significantly improved; however, adherence remained low (47% and 71%, respectively). There was significant variability in adherence for some QCIs across institutions at follow-up. Conclusions The Florida Initiative for Quality Cancer Care practices conducted self-directed quality-improvement efforts during a 3-year interval and overall adherence to QCIs improved. However, adherence remained low for several indicators, suggesting that organized improvement efforts might be needed for QCIs that remained consistently low over time. Findings demonstrate how efforts such as the Florida Initiative for Quality Cancer Care are useful for evaluating and improving the quality of cancer care at a regional level.

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