Clinical auditing as an instrument for quality improvement in breast cancer care in the Netherlands: The national NABON Breast Cancer Audit
| Autor: | Marie-Jeanne T. F. D. Vrancken Peeters, Vivianne C. G. Tjan-Heijnen, Pauline E. R. Spronk, Carolien H. Smorenburg, Michel W.J.M. Wouters, Nabon Breast Canc Audit, Marc B. I. Lobbes, Annelotte C. M. van Bommel, John H. Maduro, Sabine Siesling, K. Schreuder, Thijs van Dalen, Pieter J. Westenend, Marc A.M. Mureau, Agnes Jager, J. Verloop |
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| Rok vydání: | 2016 |
| Předmět: |
Gynecology
Clinical audit medicine.medical_specialty Quality management business.industry medicine.medical_treatment Carcinoma in situ General surgery General Medicine Audit medicine.disease 03 medical and health sciences 0302 clinical medicine Breast cancer Oncology Surgical oncology 030220 oncology & carcinogenesis medicine Surgery 030212 general & internal medicine Breast reconstruction business Mastectomy |
| Zdroj: | Journal of Surgical Oncology. 115:243-249 |
| ISSN: | 0022-4790 |
| Popis: | Background In 2011, the NABON Breast Cancer Audit (NBCA) was instituted as a nation-wide audit to address quality of breast cancer care and guideline adherence in the Netherlands. The development of the NBCA and the results of 4 years of auditing are described. Methods Clinical and pathological characteristics of patients diagnosed with invasive breast cancer or in situ carcinoma (DCIS) and information regarding diagnosis and treatment are collected in all hospitals (n = 92) in the Netherlands. Thirty-two quality indicators measuring care structure, processes and outcomes were evaluated over time and compared between hospitals. Results The NBCA contains data of 56,927 patients (7,649 DCIS and 49,073 invasive cancers). Patients being discussed in pre- and post-operative multidisciplinary team meetings improved (2011: 83% and 91%; 2014: 98% and 99%, respectively) over the years. Tumour margin positivity rates after breast-conserving surgery for invasive cancer requiring re-operation were consistently low (∼5%). Other indicators, for example, the use of an MRI-scan prior to surgery or immediate breast reconstruction following mastectomy showed considerable hospital variation. Conclusions Results shown an overall high quality of breast cancer care in all hospitals in the Netherlands. For most quality indicators improvement was seen over time, while some indicators showed yet unexplained variation. J. Surg. Oncol. 2017;115:243-249. © 2016 Wiley Periodicals, Inc. |
| Databáze: | OpenAIRE |
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