Development of Quality Indicators for Patients Undergoing Colorectal Cancer Surgery
| Autor: | Clifford Y. Ko, Paul G. Shekelle, Marcia L. McGory |
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| Rok vydání: | 2006 |
| Předmět: |
Rural Population
Research design Cancer Research medicine.medical_specialty Medical Records Systems Computerized Quality Assurance Health Care Colorectal cancer MEDLINE Preoperative care Health care Humans Medicine Colectomy Quality Indicators Health Care business.industry General surgery Cancer medicine.disease United States Surgery Systematic review Oncology Research Design Colorectal Neoplasms business Colorectal Surgery Health care quality |
| Zdroj: | JNCI: Journal of the National Cancer Institute. 98:1623-1633 |
| ISSN: | 1460-2105 0027-8874 |
| DOI: | 10.1093/jnci/djj438 |
| Popis: | Background: Colorectal cancer is the second most common cancer type among new cancer diagnoses in the United States. Attention to the quality of surgical care for colorectal cancer is of particular importance given the increasing numbers of colorectal cancer resections performed in the aging population. A National Cancer Institute – sponsored consensus panel produced guidelines for colorectal cancer surgery in 2000. We have updated and extended that work by using a formal process to identify and rate quality in dicators as valid for care during the preoperative, intraoperative, and postoperative periods. Methods: Using a modifi cation of the RAND/UCLA Appropriateness Methodology, we carried out structured interviews with leaders in the fi eld of colorectal cancer surgery and systematic reviews of the literature to identify candidate quality indicators addressing perioperative care for patients undergoing surgery for colorectal cancer. A panel of 14 colorectal surgeons, general surgeons, and surgical oncologists then evaluated and formally rated the indicators using the modifi ed Delphi method to identify valid indicators. Results: A total of 142 candidate indicators were identifi ed in six broad domains: privileging (which addresses surgical credentials), preoperative evaluation, patient – provider discussions, medication use, intraoperative care, and postoperative management. The expert panel rated 92 indicators as valid. These indicators address all domains of perioperative care for patients undergoing surgery for colorectal cancer. Conclusions: The RAND/UCLA Appropriateness Methodology can be used to identify and rate indicators of high-quality perioperative care for patients undergoing surgery for colorectal cancer. The indicators can be used as quality performance measures and for quality-improvement programs. [J Natl Cancer Inst 2006;98: 1623 – 33 ] |
| Databáze: | OpenAIRE |
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